Showcasing: Next Steps Suicide Prevention Aftercare Service
South Eastern NSW
The Next Steps service operates in two regions of South Eastern NSW (SE NSW) led by Grand Pacific Health (GPH) in partnership with:
- Flourish Australia and South Coast Medical Service Aboriginal Corporation (Illawarra-Shoalhaven region)
- Katungal Aboriginal Corporation (South of Nowra region).
Living Well domain
Providing the right type of care
Next Steps offers a combination of clinical and peer-based support to assist people at risk of suicide after being discharged from hospital or after presentation to a hospital emergency department. Peer workers are people with a lived experience of mental health issues who offer one-on-one support and understanding.
Next Steps launched in July 2017 and to date has received around 260 referrals. The Illawarra Shoalhaven program is funded by the NSW Health Suicide Prevention Innovation Fund until July 2020 and the southern program is funded by Coordinare (the South Eastern NSW Primary Health Network) through to June 2019.
In NSW more than 850 people die from suicide each year and it is estimated that during that time another 25,000 will make a suicide attempt. Suicide has a huge impact on families, workplaces and communities.
Each day people present to emergency departments across NSW seeking help for issues related to emotional and psychological distress. The days and weeks after discharge from an emergency department or hospital stay are known to be a high-risk period for people experiencing suicidal thoughts. It is important to provide support in these early days to minimise the risk of suicide and reduce distress, however people are often discharged without access to follow-up support.
In 2018, the NSW Government released The Strategic Framework for Suicide Prevention in NSW 2018-2023, a collaboration between the Mental Health Commission of NSW and the NSW Ministry of Health. The Framework outlined one of three critical areas for immediate investment as effective follow-up care for people after a suicide attempt. Next Steps is part of the response to this need in South Eastern NSW.
People are referred to Next Steps who have presented to an emergency department with high risk of suicide and who do not require an inpatient admission. The program is designed to help people get the support they need in the community.
The support from Next Steps involves a collaborative planning meeting with the person and their identified support person after leaving an emergency department or hospital to set clear goals for their recovery aligned with the person’s individual values and needs. Contact is intensive over the first month and usually comprises three to four visits per week. Support can be provided to the person for up to an additional eight weeks, usually at less intensive intervals.
Support is provided primarily by a peer worker and a mental health clinician. The program gives participants the support they need to identify and work towards goals they have, while also looking at opportunities to connect with support services in the community.
Kristie had a history of mental health issues and recent personal circumstances caused her depression to worsen. She began to experience thoughts of suicide before making an attempt on her life in 2019.
She was referred to Next Steps in Bega. The team helped Kristie deal with her psychological distress by offering support from a clinician as well as a mental health peer worker.
Kristie reports feeling better than before: “I’m managing to get my mind focussed on what it’s meant to be focussed on and I’m getting out more.”
Feedback from carers indicated they have witnessed a noticeable improvement in the person’s attitude towards themselves and their future. Carers also receive support from the Next Steps team.
While the Next Steps service is new, it is based on the emerging evidence for peer work in helping people with suicidality.
The program has shown positive outcomes with participants reporting reduced depression, anxiety and feelings of hopelessness. On exiting the Next Steps program, 100% of participants had met at least one of their short-term recovery goals and 66.7% met a long-term recovery goal.