A Community Development approach in suicide preventionCreating an evaluation toolkit for local networks
Article in Review: Ferguson, M., McIntyre, H., Martinez, L., Eygenraam, J., Baker, A. & Proctor, N. (2020). Development of an evidence-based Evaluation Toolkit for suicide prevention networks in regional Australia, Australian Journal of Rural Health, DOI: 10.1111/ajr.12618
Summary & relevance: South Australia’s Suicide Prevention Networks operate at 27 sites around South Australia, primarily in regional areas. These community-led partnerships are valuable local, community-based initiatives that seek to address suicide in localised areas. The Local Government Association of South Australia provided funding to the University of South Australia to work alongside a suicide prevention network service to develop an evaluation tool to be used across the network in the state.
Suicide risk in rural and remote areas
The contributors to suicide are unique and varied, however, there are demographic influences that can contribute to an increased rate of suicide in certain populations. In Australia, there is a 50% increase in suicide by people living in rural, regional or remote areas. Contributing factors to this statistic are believed to be:
- Economic instability
- Environmental uncertainty
- Access to lethal means
- Reluctance to seek mental health support
- Limited access to health services
While the risk of suicide does increase for those living in non-metropolitan areas, there is also much strength in many regional communities. Often this leads communities seeking to work together to address local community issues, and an associated sense of resilience.
Suicide Prevention Network model
The innovation Suicide Prevention Network (SPN) Model that operates in South Australia is a whole of community response to addressing suicide at a local level. Network groups aim to “develop communities to be suicide aware, to be able to respond to individuals in suicidal crisis and support those bereaved by suicide”. Through a community development approach, networks bring together clinicians, local governments, businesses, including schools, sporting clubs and individuals who are interested in working to address suicide. In 2020 there were 24 SPN’s across South Australia, primarily bases in regional areas. Each is established with its own individual Suicide Prevention Action Plan, outlying a local and multi-faceted approached for that particular community. Commonly, the aims of the plan will include:
- Reducing stigma
- Connecting with the community
- Education and training
- Postvention support
A need for SNP’s to be able to evaluate and compare outcomes was recognized, leading to the funding of this initiative.
To gather information to guide the development of an evaluation toolkit, participatory action research was undertaken with one of the regional SNP’s to draft and produce a kit. A three-phase project was undertaken.
- Planning – to build a rapport, discuss and design the project, set tasks and timelines and obtain ethics approval.
- Action and Observation – to review existing documents, gather further information about the SNP model and draft an initial toolkit. This was done through interviews with five SNP committee members, one focus group with nine members of the SNP committee, and an online survey to identify how the group’s impacts might be measured, and explore ideas for the approach and format the toolkit could take.
- Reflection Phase – seeking feedback from the committee during which advice was received to redraft and refine the toolkit.
It was recognised that an easy to use and accessible evaluation tool kit would enable SNPs to better measure their impact on achieving the goals set out in their plan, and to communicate this in a uniform manner. It was also hoped the tool kit would improve opportunities for sharing achievements with other networks, stakeholders and funding bodies.
The data indicated that the toolkit should be clearly written in lay language; provide clear instructions and sample tools and resources for further information. The toolkit would also contain guidance on:
- How to identify proprieties for evaluation
- How to identify key details of an evaluation activity to inform the selection of an appropriate evaluation methodology
- Introductory information about conducting quantitative surveys and qualitative interviews and focus groups
- How to track community connections and fundraising efforts
- Key considerations such as minimising distress when exploring suicide
Community-based strategies play an important part in responding to suicide. While governments have a pivotal role, community engagement and participation has also been recognised as essential to improving outcomes. Formal assessment on the toolkit has yet to be done however anecdotal evidence indicates it is useful, especially the templates which can be adapted and used to evaluate events and initiatives.