Deliberate self-harm (DSH) is a major public health problem in the Sundarban region, India. This study is aimed to develop a DSH-suicide prevention programme based on the principles of community-based participatory research (CBPR). Perception and opinion of community about the problem of pesticide-related DSH and suicide were elicited in a series of facilitated focus group discussions in Namkhana block of Sundarban region. Based on their suggestion, a broad preventive programme was launched involving the development of information, education, and communication (IEC) and training modules and training of the stakeholders of the block. Most of the members of each target group found that the IEC materials were culture fair (message is acceptable, understandable, and meaningful in the local context) and very useful. Analysis of Dwariknagar BPHC, DSH admission data showed a definite reduction of DSH incidents after this CBPR approach to prevention was initiated. Similar model of DSH prevention in the other blocks of Sundarban region or in agricultural community may help to reduce the enormous mortality and morbidity from pesticide-related DSH and suicide. 1. Introduction Deliberate self-harm (DSH), both fatal and nonfatal, is one of the most challenging public health issues in the Sundarban region, West Bengal [1, 2]. It is reported that one-year incidence rates from population surveys of nonfatal DSH ranged from 700 to 1,100 per 100,000 people, and life-time prevalence rate ranged from 720 to 5,930 per 100,000 persons [3]. Nonfatal DSH (or nonsuicidal self-injury) is 10 times more common than suicide [4]. In India, about 100,000 persons commit suicide every year, which is approximately 10% suicides in the world [5]. Suicide is among the top ten causes of death in India and among the top three causes of death among those between 16 and 35 years [6]. Indian research on DSH [7–11] has focussed on the positive association of various sociocultural and environmental factors with suicidal behavior, thereby highlighting the importance of community-based psychosocial intervention. Suicidal deaths are preventable if sufficient knowledge and understanding of this maladaptive behaviour can lead to timely intervention. Recent suicide prevention programmes address this intervention aspect as one of the top priority public health agenda. The present study is an attempt at understanding DSH behaviour, both fatal and nonfatal, and its preventive approach from the community perspective at a primary care setting and thereby devising a preventive methodology based on
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