**2. Materials and methods**

#### **2.1 Selection of 60 lay counselor recruits**

Leaders of the host communities of the participating volunteer lay counselors, based on the predefined criteria and in consultation with communities, selected the 60 trainees. Each person should have shown that they were kind, friendly, and approachable to other persons in distress, be willing to help distressed individuals, be trusted, be of good social standing, be male or female, be a youth or of older age, and be willing to work on voluntary basis. Preparations and selection process followed several levels of discussions as depicted in **Figure 1**.

The research team held several consultative meetings with Gulu District Officials, which delegated the District Community Development Officer (DCDO), as the contact person to oversee the suicide prevention initiative. The DCDO accordingly appointed the various Assistant Community Development Officers (ACDOs) based in the Sub Counties of District. The ACDOs in term granted authority to the Parish Community Development Officers (PCDOs) of the participating parishes. Each PCDO selected lay community volunteers for the training. The goals of the consultative meetings, preparation, and processes were to gather information from the various stakeholders about suicidal behavior, introduce a self-help community response to the wave of self-destructive behavior at the time, explain the mental health philosophy behind the response, and align it with the prevailing traditional, cultural, and religious belief systems concerning suicidal behavior.

There were 20 participants at each of three Sub-County Headquarters. The trainers were a senior psychiatrist, a clinical psychologist who was a doctoral research student, two social workers, and a senior physician assistant in mental health. Training consisted of 8 hours of a review of the learning objectives of the previous day, a short introductory talk by one of the trainers on the areas to cover during the day, life problems that commonly cause psychological or social distress, plenary discussions, and examples of recent suicide or suicide attempt, or other life problems. The short introductory lecture on the very first day of training provided an overview of the entire 5-day training. The assessment of mental wellbeing followed the overview of the training after which the training progressed smoothly. In the course of the training, each trainee provided personal accounts of their own difficulties whenever they wished to. In this way, the trainers supported the

**Figure 1.** *Preparation and process of selection of volunteer lay counselors.*

individual to tell their own lived story, and the rest of the trainees to listen without interruption or show of judgmental attitude. The training reference material was a standard mental health teaching methodology adopted in Uganda's health training institutions [13].
