Suicide prevention

Implementation evaluation of a multi-component systems approach to suicide prevention

Project Members - Macquarie University

Yvonne Zurynski – Associate Professor, Health Systems Sustainability E:yvonne.zurynski@mq.edu.au

Louise Ellis - Research Fellow E: louise.ellis@mq.edu.au

Janet Long – Senior Research Fellow E: janet.long@mq.edu.au

External members

Fiona Shand – Associate Professor, Black Dog Institute

Project contacts

Yvonne Zurynski

Louise Ellis

Project Description

Lifespan is a comprehensive systems approach to suicide prevention comprised of nine evidence-informed strategies and a community-led implementation and service delivery approach. Implementing a multifaceted, multi-component health intervention such as LifeSpan is a complex endeavour where it can be difficult to anticipate the challenges and opportunities that arise throughout the implementation process. It is this complexity which we seek to understand, in order that the lessons gained about the implementation of LifeSpan can be translated, scaled and spread to inform implementation in other local contexts.

Background

This program of work for the Black Dog Institute (BDI) aims to use the latest implementation science and complexity science approaches to evaluate the implementation of Lifespan in sites across New South Wales and the Australian Capital Territory.

To ensure that Lifespan is sustained beyond the life of the two year program funding, an understanding of the factors that helped or hindered implementation and what processes were deployed to enable implementation while leveraging off local strengths while overcoming barriers is crucial.

The key objectives for the implementation evaluation are to examine:

To what extent were the components of Lifespan implemented at each site and were these implemented as intended?
What were the common systems barriers and enablers encountered during LifeSpan implementation across the sites?
Which stakeholder engagement strategies were most successful and how was engagement achieved and maintained in each site?
What are the critical aspects of the roles of LifeSpan coordinators and how have these roles evolved over time?
What are the lessons learned and how could these be applied to future roll-out of LifeSpan.

Benefits

Understanding not only what has been implemented across sites but also how LifeSpan has been implemented is essential for the interpretation of the success or failure of the program in terms of the broad clinical and societal outcomes. Understanding how the program was implemented in different contexts and identifying barriers and enablers also informs scaling and spreading to other diverse contexts. This is important as the LifeSpan program is being rolled out nationally.

Publications

Braithwaite, J., Churruca, K., Ellis, L. A., Long, J., Clay-Williams, R., Damen, N., Herkes, J., Pomare, C., & Ludlow, K. (2017). Complexity science in healthcare. Aspirations, approaches, applications and accomplishments. A white paper. Sydney, Aust: Australian Institute of Health Innovation, Macquarie University.

Ellis, L. A., Churruca, K., & Braithwaite, J. (2017). Mental health services conceptualised as complex adaptive systems: what can be learned? International Journal of Mental Health Systems, 11(1), 1-5. [43]. https://doi.org/10.1186/s13033-017-0150-6

Ellis, L. A., Augustsson, H., Grødahl, A. I., Pomare, C., Churruca, K., Long, J. C., Ludlow,K., Zurynski, Y. A., & Braithwaite, J. (2020). Implementation of e-mental health for depression and anxiety: a critical scoping review. Journal of Community Psychology, 48(3), 904-920. https://doi.org/10.1002/jcop.22309

Ellis, L. A., Wiles, L. K., Selig, R., Churruca, K., Lingam, R., Long, J. C., ... CareTrack Kids Investigative Team (2019). Assessing the quality of care for paediatric depression and anxiety in Australia: a population-based sample survey. Australian and New Zealand Journal of Psychiatry, 53(10), 1013-1025. https://doi.org/10.1177/0004867419866512

Pomare, C., Ellis, L. A., Churruca, K., Long, J. C., & Braithwaite, J. (2018). The Reality of Uncertainty in Mental Health Care Settings Seeking Professional Integration: A Mixed-Methods Approach. International journal of integrated care, 18(4).

Pomare, C., Long, J. C., Ellis, L. A., Churruca, K., & Braithwaite, J. (2018). Interprofessional collaboration in mental health settings: a social network analysis. Journal of interprofessional care.

Zurynski, Y., Ellis, L. A., Tong, H. L., Laranjo da Silva, L., Clay-Williams, R., Testa, L., & Groedahl, A. (2019). Effectiveness of mental health electronic medical records: an Evidence Check rapid review brokered by the Sax Institute for the NSW Ministry of Health. Sydney: The Sax Institute.

Other publications

Ellis, L., Wiles, L., Lingam, R., Arnolda, G., Hibbert, P., & Braithwaite, J. (2020). Children with anxiety and depression may be at greater risk due to gaps in care. Emerging Minds, June, 2020. https://emergingminds.com.au/resources/children-with-anxiety-and-depression-may-be-at-greater-risk-due-to-gaps-in-care/