TY - JOUR PB - BMJ PUBLISHING GROUP VL - 12 IS - 5 JF - BMJ Open TI - Youth Culturally adapted Manual Assisted Problem Solving Training (YCMAP) in Pakistani adolescent with a history of self-harm: protocol for multicentre clinical and cost-effectiveness randomised controlled trial EP - 8 UR - http://dx.doi.org/10.1136/bmjopen-2021-056301 N1 - © Author(s) (or their employer[s]) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/). Y1 - 2022/05// A1 - Husain, Nusrat A1 - Tofique, Sehrish A1 - Chaudhry, Imran B A1 - Kiran, Tayyeba A1 - Taylor, Peter A1 - Williams, Christopher A1 - Memon, Rakhshi A1 - Aggarwal, Shilpa A1 - Alvi, Mohsin Hassan A1 - Ananiadou, S A1 - Ansari, Moin Ahmad A1 - Aseem, Saadia A1 - Beck, Andrew A1 - Alam, Sumira A1 - Colucci, Erminia A1 - Davidson, Kate A1 - Edwards, Sarah A1 - Emsley, Richard A1 - Green, Jonathan A1 - Gumber, Anil A1 - Hawton, Keith A1 - Jafri, Farhat A1 - Khaliq, Ayesha A1 - Mason, Thomas A1 - Mcreath, Ann A1 - Minhas, Ayesha A1 - Naeem, Farooq A1 - Naqvi, Haider Ali A1 - Noureen, Amna A1 - Panagioti, Maria A1 - Patel, Anita A1 - Poppleton, Aaron A1 - Shiri, Tinevimbo A1 - Simic, Mima A1 - Sultan, Sarwat A1 - Nizami, Asad Tamizuddin A1 - Zadeh, Zainab A1 - Zafar, Shehla Naeem A1 - Chaudhry, Nasim AV - public ID - discovery10154454 N2 - INTRODUCTION: Suicide is a global health concern. Sociocultural factors have an impact on self-harm and suicide rates. In Pakistan, both self-harm and suicide are considered as criminal offence's and are condemned on both religious and social grounds. The proposed intervention 'Youth Culturally Adapted Manual Assisted Problem Solving Training (YCMAP)' is based on principles of problem-solving and cognitive-behavioural therapy. YCMAP is a brief, culturally relevant, scalable intervention that can be implemented in routine clinical practice if found to be effective. METHOD AND ANALYSIS: A multicentre rater blind randomised controlled trial to evaluate the clinical and cost-effectiveness of YCMAP including a sample of 652 participants, aged 12-18 years, presenting to general physicians/clinicians, emergency room after self harm or self referrals. We will test the effectiveness of 8-10 individual sessions of YCMAP delivered over 3?months compared with treatment as usual. Primary outcome measure is repetition of self-harm at 12 months. The seconday outcomes include reduction in suicidal ideation, hopelessness and distress and improvement in health related quality of life. Assessments will be completed at baseline, 3, 6, 9 and 12?months postrandomisation. The nested qualitative component will explore perceptions about management of self-harm and suicide prevention among adolescents and investigate participants' experiences with YCMAP. The study will be guided by the theory of change approach to ensure that the whole trial is centred around needs of the end beneficiaries as key stakeholders in the process. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Ethics Committee of University of Manchester, the National Bioethics Committee in Pakistan. The findings of this study will be disseminated through community workshops, social media, conference presentations and peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04131179. ER -