Across Victoria, the adult Hope (Hospital Outreach Post-Suicide Engagement) service has been successful in caring for adults in the immediate aftermath of a suicide attempt or chronic suicidal ideation. In late 2021 there was a planned expansion of this initiative at four metropolitan health services in Victoria, which was aimed at addressing suicidality in children and adolescents. This expansion included an extensive co-design process for each of these services. This presentation will describe an evaluation of the co-design and implementation processes for the Child and Youth Hope program (CY Hope) undertaken by Alfred Health.
Co-designed interventions are becoming more common in health services, particularly for the design and development of mental health programs and interventions. Our follow-up interviews with co-design participants confirmed the results of previous research, showing that particular challenges are experienced when multiple stakeholders are involved in such co-design processes. These challenges include power imbalances between participants and facilitators, and burdensome levels of consultation in the context of time constraints. Despite this the participants we interviewed tended to find the process rewarding, leaving them with the feeling that they had made a worthwhile contribution to the design of a new service, which would support suicidal young people in the future.
Previous research has also shown that there are challenges when implementing such co-designed programs, such as a mismatch in expectations. In particular, our interviews with the implementation staff disclosed a mismatch between the types of client anticipated during the co-design process and the actual clients presenting at the new service. This mismatch meant that the implementation staff had to quickly adapt the program, allowing for the adoption of an individualised approach for the care of the young people attending the service. This presentation will also describe how the implementation staff overcame other challenges in order to provide “smooth …wrap-around support” for young people and their families at a critical time. In particular, it will stress the importance of clear communication, training, adaptability, flexibility and continuity of staff in the transition from a co-design process to an implementation process for programs of this nature.