Global Engagement Grant Recipient Working to Reduce Adolescent Suicide in Uganda

Ronald Asiimwe, far right, poses with colleagues in Uganda. 

A University of Minnesota researcher is working to implement family-based interventions to prevent teen suicide in Uganda.

Dr. Ronald Asiimwe, an assistant professor in the family social science department at UMN’s College of Education and Human Development, in partnership with his Ugandan collaborators from Makerere University and Kabale University, recently hosted a two-day workshop in Mbarara, Uganda, focused on Attachment-Based Family Therapy (ABFT), an empirically supported family intervention designed to reduce depression and suicide risk among adolescents by strengthening their relationships with caregivers.

The work was funded by a Global Engagement Grant from the Center for Global Health and Social Responsibility. 

ABFT has been shown to be effective in reducing depressive symptoms, particularly suicidal ideation, among adolescents, but most of the program’s evidence has been based on studies and trials conducted with North American samples. 

ABFT has not been introduced in an African context so Asiimwe’s work marked significant initial efforts to introduce ABFT in Uganda. He hopes his work will catalyze more ABFT for adolescents in Uganda, where the suicide rate is increasing.

“Through future research, including larger cultural adaptation studies and randomized controlled trials, we aim to build an evidence base for how ABFT can be tailored and scaled in Uganda, and hopefully, other parts of Africa, where the rates of adolescent suicide risk are on the rise,” said Asiimwe.

We asked Asiimwe about his experience with the Global Engagement Grant program and how he hopes his work will provide long-term efficacy in reducing adolescent suicide in Africa.

Could you briefly describe what a family-based intervention to prevent adolescent suicide is?

A family-based intervention to prevent adolescent suicide is an approach that goes beyond focusing solely on the individual adolescent. Rather, a family-based intervention aims to bring the adolescent’s caregivers or family members or any adult person responsible for the wellbeing of the teen into the process of therapy. Instead of treating a teenager’s suicidal thoughts or behaviors in isolation, this approach works systemically to repair broken family bonds, build trust, and open communication within the home. One well-established model that uses this approach is ABFT, which is specifically designed to reduce depression and suicidal risk among adolescents by strengthening their relationship with their caregivers. 

Why did you decide to focus on a family-based approach to suicide prevention?

We decided to focus on introducing a family-based approach to treating teen suicide risk for several reasons. 

First, family-based interventions have a strong research evidence base for preventing adolescent suicide. ABFT, for example, has demonstrated significant success in other parts of the world, but until now, it had not been introduced in an African context. In Uganda, because of the collectivistic nature of the cultures, the research clearly indicates that a supportive family can be a powerful protective factor for young people.

However, many mental health professionals in Uganda haven’t had specialized training in how to involve families effectively. This is due to several reasons, but the main one is the lack of expert training at the graduate level on how to work with family systems.  

Given the prominence of individual psychology in Uganda and other parts of Africa, most of the training mental health professionals get in graduate school focuses on symptom removal for the individual rather than the entire family system. A second issue compounding the issue of teenage suicide in Uganda is the widespread stigma surrounding suicide and the criminalization of suicidal ideation and behavior. Both discourage families and youth from seeking professional help and increase the shame associated with suicidality. 

Under Ugandan law, attempted suicide is punishable by imprisonment, meaning that adolescents who survive a suicide attempt may face incarceration rather than receiving the care they need. Beyond the legal system, predominant cultural norms and beliefs have reinforced stigma by attributing suicidal behavior to evil spirits, witchcraft, or a curse from God. 

You recently hosted a workshop focused on ABFT in Mbarara. What did the workshop consist of?

The workshop consisted of two days of training on how to engage caregivers in preventing teen suicide risk. The two-day workshop was held in Mbarara, western Uganda, and brought together 38 mental health professionals, including psychologists, psychiatric nurses, clinical officers, social workers, and school counselors.

The workshop was designed to balance theory with practical skills. It introduced participants to the foundations of ABFT, explained how the model works, and explored the cultural beliefs and norms around youth suicide, and how to naviage these issues in treating teen suicide in the Ugandan context. There were interactive activities, role plays, and discussions where practitioners could think through how to adapt what they were learning to the realities of their work.

The feedback from participants was overwhelmingly positive. Many described it as an eye-opening experience. Participants also appreciated how the training connected the ABFT model to local cultural realities, which made the content feel relevant and actionable.

Could you speak to your experience with the Global Engagement Grant program?

This project would not have been possible without the support of the Global Engagement Grant from the Center for Global Health and Social Responsibility. The grant provided us with the initial funding needed to deliver the workshop, bring in trusted local partners, and adapt the training content to fit Uganda’s cultural and social context.

Funding from the grant also helped us build a strong collaborative network with key local partners like the Africa Center for Suicide Prevention led by Dr. Godfrey Zari Rukundo, Prof. Herbert Ainamani at Kabale University, and Prof. Roscoe Kasujja, head of the Department of Mental Health & Community Psychology at Makerere University. These partnerships were invaluable for fostering local trust and ensuring that the workshop was both relevant and credible.

The Global Engagement Grant has provided a crucial foundation for expanding this work. It has positioned us to apply for larger grants, like an NIH R34, that we hope can fund more rigorous research, larger-scale training and implementation, and broader community engagement to protect Uganda’s youth.