In 2020, following the release of the recommendations of the Royal Commission into Victoria’s Mental Health System, a pilot Child-Youth Hospital Outreach Post-Suicidal Engagement (CY-HOPE) program was established at 4 sites in metropolitan Melbourne. This symposium presents the findings of an evaluation of the Alfred’s CY-HOPE program over the course of its design, implementation and first 18 months of operation. The program is a hybrid clinical/non-clinical assertive outreach program aiming to engage, support and improve mental health and coping skills in young people at risk of suicide or self-harm. The evaluation was funded by an Innovation Research Grant from Suicide Prevention Australia.
Firstly, Dr Hopkins provides an overview of the program, from its initial co-design to its implementation and evaluation processes. The co-design approach allowed the voice of lived experience to permeate the evaluation, developing an evidence base about suicidal behaviour and suicidal prevention in young people with high suicide risk after discharge from hospital.
Prof Meyer then presents quantitative analyses of data collected by telephone or online surveys, using age-appropriate outcome measures at entry and discharge to the program. The results showed significant improvements for quality of life, and significant reduction in psychological distress and suicide risk among those aged 17-24. Participants highly endorsed the helpfulness of the peer support and family support workers. Importantly, young people felt heard, understood, respected and involved in the goal and strategy setting process.
Dr Kehoe presents further in-depth discussion of young people’s experiences in HOPE, with thematic analysis conducted on qualitative data from phone interviews and online surveys. Young people highlighted the benefits of the consistent outreach visits, the emotional support, and the practical help they received. The less-clinical approach and the support of peer workers with lived experience created a sense of safety and care, that the participants had not experienced in other services.
Finally, the fourth talk by Ms Osborne presents an economic cost-benefit analysis, including: an outline of the analysis approach, the data collection challenges, and an overview of the outcomes. The benefits quantified included: reduction in ED attendances (both at home and hospital) and reduction in days in hospital. The costs included all salaries and oncosts associated with the multidisciplinary team, accommodation, and outreach costs.
Collectively the studies in this symposium provide an evidence base to inform and improve future services, systems and policies related to suicide prevention in Australia.