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Description of the project: Background: Suicide is an international public health issue. Barriers to suicide prevention include lack of resources, access to care, lack of human resources (services and mental health care professionals),) stigma, lack of awareness and cultural and geographical factors. Most important amongst these barriers is lack of manpower for setting up services for identification, intervention and prevention of suicide. In most of the places either professional are not available or available professions lack the skills to identify and manage suicidal patients. Suicide is one of the leading causes of premature death worldwide and claims the lives of approximately one million individuals annually. More than 60% of all suicide occurring world over, take place in Asian Countries and about 2/3 in LMIC. The number of suicides in India alone is equivalent to the total number of suicides in the four European countries with the highest number of suicides3. In the past three decades the rate of suicide in India increased by 43% and most recent official statistics indicate that 134,599 individuals died by suicide in 2010. Across India, suicide rates range from 0.5 to 45.9/100,000 population5. Researchers estimate the actual suicide rate to be six to nine times the official rate.. The majority of suicides (60%) occur in rural areas Suicide reports from India highlight a complex array of risks factors, which are associated with suicide among them: family problems and interpersonal relationship (29.2%) and illness (22.3%). Presently, there are approximately 3000 psychiatrists, 500 clinical psychologists, 400 psychiatric social workers, and 900 mental health nurses in India.

Thus the ratio of mental health professional to population ratio is extremely low. Government mental health programs are primarily directed toward the severely mentally ill. Only 21% of suicides have been in any health care system, which includes 7% of those who were having mental illness., as per NCRB.(Govt of India) Studies also show that not more than a quarter of suicide patients are in any mental health system in Western Countries( Ref.Hunt and Kapur). Bringing more people who are at-risk for suicide or in a suicidal crisis, in the health care system is one of the urgent requirements for suicide prevention education and training is main resource for increasing knowledge base and awareness., however it is necessary that pathways of administering education and training is effective, economical and feasible. This project is regarding knowledge translation for effective clinical and Public Health approach for suicide prevention. Issues such as suicide prevention are not specifically mentioned in these programs, suggesting low priority and thus making these important services inaccessible to the community. Only 9% of 269 suicide decedents had been in contact with a mental health professional or family physician or were in treatment before their suicide

The present initiative: The proposed initiative is an effort to address the need for suicide prevention training and competencies enhancement for healthcare professionals in Lowe and middle income countries (LMIC). The overarching objective to prevent suicide in areas where mental health human resources and services are lacking. Lack of manpower resources seriously affects suicide prevention initiatives in both urban and rural areas. To add to this scarcity is the unfortunate reality of health professionals choosing not to practice in areas farther than urban and metro regions. We believe that an internet based course for training program can address the existing gap in health care professional knowledge and competencies which ultimately promote and encourage professional suicide assessment and intervention skills can fulfill this gap and create opportunities for suicide prevention which can encourage identification and intervention. This training utilizes local, pre-exiting manpower so that consistent and sustainable services can be developed. We also believe that such facilities can be economical, easily accessible and can be monitored using electronic media at any distance.

The aim of this a study is to evaluate an e-learning suicide prevention training program for primary care physicians and health care workers.