Can an aftercare service reduce suicide risk in young people? An effectiveness-implementation evaluation

Suicide is the leading cause of death among young Australians. Self-harm is more common and is the greatest predictor of future suicide. Emergency departments (EDs) are a key point of contact for people at risk of suicide and the period following discharge from the ED is one of elevated risk for both repeated self-harm and suicide. It has been estimated that better care at this time would reduce the numbers of self-harm hospitalisations and suicide deaths by 5.65% and 5.45% respectively. In response, both federal and state governments are recommending the roll-out of ‘aftercare services’ to provide support for people with suicide-related behaviour presenting to the ED.
The aim of the proposed study is to conduct a robust evaluation of a brand-new youth-focused aftercare service being developed and delivered by Orygen. The service will provide a 3-month episode of care to young people aged 12-25 who present to any ED across north-west Melbourne after self-harm and/or suicidal ideation.
This effectiveness-implementation study will be the first to rigorously evaluate a youth-focused aftercare service. It will employ a mixed-methods design to examine service reach, implementation, effectiveness (including cost effectiveness) and maintenance/scalability. It will be conducted over a 5-year period in order to assess both the implementation and early impacts of the service.
The study meets all five objectives of the Partnership Scheme. It is based on a solid partnership with Orygen and the Victorian Department of Health both of whom recognise that the evaluation will provide critical data to inform future service implementation. As such, it has a strong translational element. Indeed, the findings from the evaluation will not only feed back into the ongoing development of this particular service but, with support from the department, will also inform future services developed across the state and potentially nationally.