Networks to strengthen community social capital for suicide prevention in regional Australia: the LifeSpan suicide prevention initiative

Abstract

Introduction Mental health services are fragmented in Australia leading to a priority being placed on whole-of-community approaches and integration. We describe the LifeSpan suicide prevention intervention developed by the Black Dog Institute that draws upon nine evidence-based community-wide strategies. We examined the suicide prevention Collaborative group at each site. We evaluated how the social capital of the community and service providers changed, and how the brokerage roles of the Collaborative affected integration of effort. Methods This was a two phase, explanatory mixed methods study. Participants were LifeSpan Coordinators, The Collaborative and working group members at four LifeSpan sites in New South Wales (three metropolitan/regional, one regional/rural). Quantitative social network data was collected through an online survey and analysed using Gephi software. Qualitative data through focus groups and interviews with Lifespan Coordinators and community stakeholders. Results The social network survey was administered in three sites and was completed by 83 people. Data gave quantitative evidence of increased engagement across key stakeholders in each region who had not previously been working together. Nominations of other collaborators showed this network extended beyond the formal structures of The Collaborative. LifeSpan Coordinators were empirically identified as key players in the networks. Qualitative data was collected from 53 individuals (18 interviews and five focus groups) from across all sites. Participants identified benefits of this collaborative approach including greater capacity to run activities, better communication between groups, identification of “who’s who” locally, improvement in the integration of priorities, services and activities, and personal support for previously isolated members. LifeSpan Coordinators were key to the smooth running of The Collaborative. This may represent a risk to sustainability if they left. The collaboration model that suited metropolitan sites was difficult to sustain in rural sites, but gains were seen in better coordinated postvention efforts. Conclusion LifeSpan Coordinators were noted to be exceptional people who magnified the benefits of collaboration. Geographic proximity was a potent driver of social capital. Initial engagement with local stakeholders was seen as essential but time-consuming work in the implementation phase. Coordinators reported this important work was not always acknowledged as part of their formal role.

Four System Enablers of Large‐System Transformation in Health Care: A Mixed Methods Realist Evaluation

“…When priorities are not aligned, clinicians feel they must compromise, and thus dilute their effectiveness. Change fatigue is being reported, as stakeholders struggle to meet the demands of successive or concurrent projects that pull them in different directions 40,41 . Ad hoc approaches to change set up a context of confusing priorities that can trigger disengagement, tokenistic efforts, or cynicism.…”

Systems resilience in the implementation of a large-scale suicide prevention intervention: a qualitative study using a multilevel theoretical approach

“…It could be argued that all these strategies promoted possibilities for learning, growth and development within the broader LifeSpan team, and ultimately may have enhanced healthcare system functioning within each of the sites involved [ 37 ]. Indeed, as identified from our social network survey study of LifeSpan [ 24 ], the site coordinators were empirically identified as the “key players in the networks”, and “were noted to be exceptional people who magnified the benefits of collaboration” (p.1). All in all, the efforts of the LifeSpan coordinators in building a collaborative network in each site was identified as a key success factor for the implementation of LifeSpan [ 24 ].…”

“…Indeed, as identified from our social network survey study of LifeSpan [ 24 ], the site coordinators were empirically identified as the “key players in the networks”, and “were noted to be exceptional people who magnified the benefits of collaboration” (p.1). All in all, the efforts of the LifeSpan coordinators in building a collaborative network in each site was identified as a key success factor for the implementation of LifeSpan [ 24 ].…”

“…This study is based on a secondary thematic analysis of qualitative interview data collected during the implementation evaluation study of the LifeSpan initiative [ 24 ], using the theoretically and empirically driven Berg and Aase [ 22 ] framework to identify characteristics of resilience across multiple system levels. Secondary analysis of existing datasets has increasingly been considered an effective way of maximising knowledge and potential benefits of research [ 26 ].…”

“…We aimed to fill the gap in the limited research examining resilience across multiple system levels in a community-based setting. The objective of this study was to conduct a secondary analysis of interview data collected as part of a larger study [ 24 ] to examine resilient characteristics across varying system levels during the implementation of a planned large-scale community-based suicide prevention intervention known as ‘LifeSpan’.…”