Evaluation of a service introduced to support young people at risk of suicide using a cohort design, a mixed methods analysis and cost-benefit analysis

Abstract

This evaluation sought to determine to what extent a suicide prevention service, designed for young people at severe risk of suicide, was successful in reducing suicide risk and distress and improving well-being outcomes. The 3-month service was co-designed at the height of the COVID-19 pandemic in Melbourne, Australia, with young people and carers who had lived experience of youth suicide. The evaluation involved a mixed methods analysis of data collected during the first 20 months of operation, from February 2022 to September 2023. Ninety one young people were admitted to the service during this period, of whom 28 agreed to participate in the evaluation. Primary data were collected by telephone or online, and secondary data for hospital service use were collected for 70 of the young people. Analysis found that there were significant reductions in suicide risk and psychological distress at discharge, associated with significant improvements in quality of life and reductions in the use of hospital services. Qualitative analysis supported these survey results, highlighting the peer and psycho-social support as particularly beneficial aspects of the service. However, the qualitative analysis also indicated that some individuals felt the service was too short and abruptly ended, with insufficient attention paid to the creation and maintenance of support services that could continue after discharge. A small sample size was a limitation of this study, particularly for the three and six month follow-up surveys. Also, the cost-benefit analysis included secondary routine hospital admission data covering only 12 months. Nevertheless, the overall findings are positive, suggesting that services of this nature can have real benefits for young people at serious risk of suicide. It is likely that an extension of the cost-benefit analysis, to allow for benefits beyond a one year period, would have suggested that the benefits outweigh the costs.