First dynamic modelling of national suicide prevention strategies released

Dynamic modelling by researchers from the University of Sydney’s Brain and Mind Centre, has revealed key findings that show what strategies are required to help prevent suicide in the face of the ongoing COVID-19 pandemic impacts on mental health.

The results are from the first prototypic national policy model that simulated a range of strategies to determine the most effective methods to bend the mental health curve.

They include persisting with JobKeeper to reduce financial uncertainty, providing further education support for young people, and reducing social dislocation.

Lead researchers Associate Professor Jo-An Atkinson and co-director of the Brain and Mind Centre Professor Ian Hickie say the development of this decision support tool places Australia at the forefront in understanding which urgent national policy actions will have the greatest impact in reducing psychological distress across the country and preventing lives lost to suicide.

“Other countries have not yet employed these robust methods to inform national mental health responses to COVID-19,” said Professor Hickie.  

“These 21^st century tools go beyond traditional statistical models that are not capable of accounting for the complex interactions and dynamics of economic, educational, social and health-care drivers of population risk, nor of allowing scenario testing to guide decisions about the most effective suite of preventive actions.”  

The national report now complements the team’s earlier regional and place-based models similar to the North Coast Primary Health Network model released in May, which are critical to understanding regional variations in the factors contributing to mental ill-health and suicide.

1. Persisting with JobKeeper for as long as the economic and health uncertainty persists, suggesting the most important thing governments can do for mental health now is slow the rate of job loss and provide some certainty to try to alleviate the devastating impacts of chronic stress from prolonged financial uncertainty.
2. Ramping up education support for young people, as entry into education and training is the best substitute for the loss of jobs and career development in the face of COVID-19.
3. Reducing social dislocation through minimising community spread of the virus leading to repeated lockdowns. The sooner the nation can get back to near zero community transmission, the sooner people can connect again at work and in their normal families and social lives.
4. National Budget Provisions in October 2020, to markedly increase real health service capacity, especially for those with more complex disorders, to be in place by early 2021. There is an urgent need for a strong emphasis on post-suicide attempt assertive aftercare and IT-based service co-ordination.

Professor Hickie said: “While governments and policy makers have embraced the negative impacts of COVID-19 on mental health and suicide, the national narrative needs to speak directly to those most affected. Most notably those at risk of losing their jobs, women and young people who have already been hardest hit, and those experiencing the most social dislocation. The public policy decisions now need to include those economic, educational, and other social actions policies (nationally and regionally) that are most effective.

“We now have preliminary evidence, from a mental health perspective, about what works and what doesn’t. To move forward, we need better delineation of the complex relationships between the economy, the education sector, physical health and social policy, and mental health outcomes.

“Coordinated action that will help to mitigate the scale of mental health impacts.”

Associate Professor Jo-An Atkinson said: “This model represents an early national decision support infrastructure capable of forecasting the likely impacts of policy initiatives and mental health system reform before they are implemented in the real world.

“This approach will help to guide more effective actions, avoid unintended consequences, improve efficiency in the way we invest in the mental health system, help prevent the system from becoming overwhelmed, and most importantly, save lives, just as COVID-19 transmission modelling has done.”

The prototypic model, produced as part of the YOUTHe initiative, a NHMRC Centre for Research Excellence into suicide prevention, will now be used to evaluate the real-time impact of key national initiatives such as JobKeeper, on national mental health and suicide outcomes.

Further developments will look at the consequence of reduced productivity and deteriorating mental health of Australians and the impact on the national economy.

In addition, the work will explore the impact of current and new policy, the impact of major health service decisions and planning initiatives on at-risk populations, particularly women.

Declaration: The modelling was carried out under YOUTHe, a NHMRC funded Centre of Research Excellence (CRE) in suicide prevention for young people. The modelling is based on methods that have been extensively peer-reviewed, are used internationally and have been published previously in the academic literature (and can be obtained from the authors). This specific report has not yet been submitted for academic publication or peer-review. The report, and its underlying assumptions, are available online from the Brain and Mind Centre website. Professor Hickie has a 5% equity share in Innowell Pty Ltd, a joint venture company established by the University of Sydney and PwC to support the development, evaluation and distribution of digital mental health. 

If you are experiencing distress and need support, you can contact:

For Youth:
Kids Helpline: 1800 551 800
Headspace: 1800 650 890
ReachOut: au.reachout.com

For Adults:
Lifeline: 13 11 14
Beyond Blue:1300 22 46 36.
Suicide Callback Service: 1300 659 467
MensLine Australia: 1300 789 978