Community-based strategies to address youth suicide: development, implementation and formative evaluation

Abstract

This thesis describes the Youth Suicide Prevention Project, the aims of which were to develop, implement, and evaluate community-based strategies to address youth suicide. The focus of the evaluation was formative and was designed to constructively influence all the components of the project. The overall goal of the project was to provide information likely to improve the health and wellbeing of young people and thereby contribute, in the long term, to a reduction in youth suicide. This project, which was undertaken by Ms Coggan over a period of 26 months, involved collaboration with the Mental Health Foundation, and included the participation of community groups and young people. While several community-based strategies to address youth suicide were developed and implemented as part of this project, only three were central components of the Youth Suicide Prevention Project. The first strategy involved the use of a questionnaire designed to obtain information on the range and level of risk-taking behaviours occurring among young people and their perceptions of health-harming activities. The information obtained both assisted a local community to develop strategies to enhance the health and wellbeing of its young people and provided information to policy-makers on the extent of risk-taking behaviour and its association with self-harm. The second community-based strategy was the development and trialing of a teaching resource for use in forms three and four. This resource (Mental Health Matters) was designed to provide students with an opportunity to acquire information and skills to better promote and protect their mental health. The final strategy involved the conduct of a community action programme focused exclusively on youth health. Included in this programme was the provision and dissemination of local information on youth health and the conduct of three workshops: i) developing a mentally healthy school; ii) improving the identification, referral and acute management of suicidal young people; and iii) a community activation workshop designed to allow a community to prioritise strategies to improve youth health. Four aspects of formative input to the Youth Suicide Prevention Project are reported in this thesis: the developmental phase, the Youth Health and Risk-taking Survey, the Mental Health Matters programme, and the Youth Health Community Action Programme. This has involved the review of literature; the use of archival data and records; attendance at meetings; participant observation; the identification of evaluation procedures and methods; the design of data collection techniques; qualitative and quantitative data analyses including consultation with a statistician; and report preparation and timely dissemination both to the participants and to the wider community. The main findings of this evaluation indicated: that adopting a range of 15-24 years for youth was not realistic; that the occurrence of youth suicide and attempted suicide was spread evenly within the North Health region; that young people and school personnel saw a need for health promotion strategies to be developed; that young people identified a need for information on how to help themselves and others in times of crisis; that young people at school would provide information on a range of risk-taking activities; that high levels of risk-taking were occurring among young people at school; that an association exists between certain risk-taking behaviour and self-harm; that the provision of local information on youth risk-taking behaviour could act as a stimulus for the development of community-based strategies to address these; that a curriculum based programme with a positive focus on mental health should, with modification, be implemented nationally; that there is a need for the wider community to have information to dispel the myths surrounding suicide and suicide ideation; and that it is possible to successfully conduct a community action project exclusively focused on the health needs of young people. Major implications identified for future projects were the importance of providing relevant and local data to enable a community to develop strategies to address youth health issues and the need to further examine the high levels of risk-taking behaviours and the association of risk-taking behaviour and self-harm. This project also showed that teachers and students supported the further development of a curriculum-based programme called Mental Health Matters. This project also highlighted the need for an ongoing process of interaction between the community and research-based knowledge to ensure that strategies, proposed by the community are able so be implemented. Finally, while there is a need to focus on youth at risk, this thesis has demonstrated a need to provide the wider community with information and resources to dispel all the myths that surround suicide and suicide ideation.