A critical review of the first six months of operation of a trial Hospital Outreach Post-suicidal Engagement (HOPE) service in Australia

Objective: To review the Hospital Outreach Post-suicidal Engagement (HOPE) service in the first six months of the pilot program in a metropolitan Melbourne setting, including a description of: (a) socio-demographic, health and psychosocial stressors of people referred; (b) method of presentation; (c) interventions provided and (d) outcomes measured. Method: A retrospective case file analysis reviewed the first six months of HOPE service operation. Results: Forty people received HOPE service during the study period, 60% female, mean age 35 years (range 17–58). The majority had previously engaged in self-harm (72.5%) or attempted suicide (67.5%). Stressors included social isolation, relationship breakdown, unemployment, financial stress, medical problems, history of mental illness, exposure to family violence and adverse childhood events. Statistically significant improvements occurred in the Outcome Rating Scale (ORS) and Session Rating Scale (SRS) following intervention. There were no deaths by suicide during the study period. Conclusion: People referred to HOPE had significant health and psychosocial stressors. Engagement significantly improved subjective well-being and connection with supports. Findings highlighted the need for an integrated clinical and psychosocial model to promote hope and connection in life post suicide attempt. It remains unclear which interventions improved well-being and if this contributes to suicide prevention.