NIH Grant Supports Suicide Interventions For Pregnant And Postpartum Women

Yale School of Public Health Assistant Professor Ashley Hagaman, Ph.D., M.P.H., has received a prestigious K01 grant from the National Institutes of Health in support of her research investigating suicide among women of reproductive age in low- and middle-income countries.

“Suicidality and postpartum depression are important contributors to maternal mental health,” said Hagaman, a researcher with the YSPH Department of Social and Behavioral Sciences and an affiliated faculty member with the Yale Institute for Global Health.

Hagaman’s research centers on understanding the social determinants of depression and suicidal ideation among pregnant women and mothers in Pakistan and Nepal, and developing culturally relevant sustainable interventions.

“Motherhood [in Pakistan and Nepal] confers some social mobility, but it also means additional responsibilities,” she said. “Some expectant mothers endure concurrent violence and vulnerabilities while pregnant and after giving birth, so it is essential to create more psycho-social support for them at this specific time.”

The K01 grant is an early career development award for investigators. Hagaman said the funding will support her ongoing effort to develop culturally appropriate interventions through implementation science. Her goal is to create interventions that can be easily scaled up and adopted in health systems, ranging from large tertiary care centers to the community level.

“Our interventions need to be culturally adapted and thoughtfully deployed, since suicide is a delicate matter,” she said. “We partner with community health leaders in these regions who are already working to address suicidality in women. We build on the existing infrastructure that exists in the local context.”

One of the ways Hagaman aims to make the interventions sustainable is through her team’s peer-driven pilot suicide prevention package known as SuPP. The SuPP process focuses on community engagement and support to help mitigate suicidality in postpartum women and also creates an implementation plan for health systems to adopt evidenced-based suicide prevention practices such as screening, safety planning and contact follow-up.

The program is adapted from two existing interventions for mental health endorsed by the World Health Organization: Thinking Healthy Program Peer-Delivered and the Mental Health Gap Action Program. It leverages existing peer health workers in helping to detect and support women in crisis. These women are closely integrated within the social context, working alongside Lady Health Workers (the backbone of Pakistan’s primary and maternal health care systems), and are especially close with pregnant women and mothers, “which makes them the ideal wraparound agent for our project,” Hagaman said.