Step Project

Project Overview

The STEP Project is being directed across the spectrum for intervention, as set out in Commonwealth 1999 “Mental Health Promotion and Prevention Action Plan”. There will be a particular emphasis on the prevention and early intervention end of the spectrum. Blackmore* et al (1999) made the recommendation that “key areas where further work could be done in producing high quality resources for use within communities [for youth suicide prevention] that do more than teach warning signs and responses, and which emphasise and explore primary prevention”. It is also felt that prevention and early intervention are more appropriate long-term strategies than crisis intervention, if inroads into reducing the target groups risk for suicide are to be achieved.

STEP is based on two main assumptions. Firstly, connection to a significant other can reduce the risk of suicidal behaviour for a young person. Secondly, the factors that interplay amongst these young people that may increase their risk of suicidal behaviour are complex and many are beyond the individualâs control. Therefore a range of strategies and interventions are required.

The issue of youth suicide in Australia is topical. There has been ongoing debate and discussion about the best approaches to prevent youth suicide. Indeed ‘preventing youth suicide’ is a problematic term of itself. The term ‘suicide prevention’ is only one aspect of how youth suicide is being tackled. It would seem more realistic to consider using the terms promoting good mental health or well-being when referring to the range of suicide prevention strategies. When the range of suicide prevention programs are examined the central aim is to enable the individual to improve or increase control over their mental health. This viewpoint is based on the belief that if an individual has a good level of mental health they are not likely to be suicidal.

There is a growing movement away from purely a clinical focus that is aimed at the treating the symptoms (illness focus) towards a holistic approach to mental health. This translates to looking at the whole picture and the individual and the underlying factors that may be precipitating a young person’s crisis.

Youth suicide is a complex problem that requires a range of responses towards the factors affecting the mental health and well-being of young people. Therefore the manual and training has been developed under a public health approach that is regarded as holistic and ensures a range of strategies are implemented. As evidenced in the emphasis of the STEP manual and training that encourages workers to reflect on several issues: their current understanding of the factors affecting the mental health of these young people; their current work skills; and the local responses available for young people from the target groups. As well as, encouraging professionals to integrate the training and information to broaden their practice to be more inclusive of all marginalised young people.

Much has been written about youth suicide and its prevention, but little attention has been given to the relationship between sexuality and suicide. This is probably because of the sensitive and highly controversial nature of both subjects. The issue of sexuality is regarded as controversial, particularly in the rural areas were the sense of isolation and lack of suitable services are compounded for SSA young people. Locating the Project within CAMHS across the state reflects the legitimacy of the need for change and supports the idea that change is required. Further organisations working together gives legitimacy not only to the issue, but also to those participating in the process. A direct gain will be a show of broad support and advocacy for an issue.

To ensure that STEP maintains a collaborative approach a deliberate strategy of consulting with a range of key groups has been employed. Focus groups have been conducted with young people from the target groups to determine their needs. The results of the focus groups have been used to inform the development of materials and strategies for workers to promote the mental health of these young people.

Active involvement and consultation with a range of key stakeholders who work with the three target groups has been vigorously sought and nurtured. The key stakeholders formed three Advisory Reference Groups to assist in development of the training materials. The intention of such collaborative interaction has been to support sustainability of the impact of STEP beyond the Project’s funding. As well as, broadening the impact of STEP, reducing the occurrence of activities being conducted in isolation from one another. This occurrence serves to confuse the community and more importantly the young people in need of support. Dynamic involvement by all parties in the development of information for the manual and training has promoted a sense of shared ownership and working together, not in opposition to each other.

Strategies and opportunities for local activities that respond directly to the needs of the young people have been sort. Training provides an opportunity to consult with local groups and services providers to develop these strategies, as a continuance of the impact of the training. This expectation is further enhanced by the presence of regional based MHPO’s. Along side this strategy there have been letters of support and a range of discussions with key service providers to assist in funding submissions or the development of local initiatives for the young people.

Advocacy about the issues impacting on the young people from the target groups has been achieved by using the regional training as a medium for contacting the local media with the express purpose of raising awareness about the issues for the young people. As well as, promoting local knowledge amongst the young people themselves, their family and friends about the issues and the availability of supportive professionals.

Evaluation has been integrated to inform the development of STEP, rather than at completion of the program. This means there is a greater likelihood of achieving outcomes that meet the needs of the target audience.

The design of the program is intended to make it easier and more likely that professionals will adopt skills taught during the training. The training is intended support enhanced service access by the young people from the target group. For example amongst a range of information the manual will contain tear out quick reference guides; extensive information about useful resources or agencies; posters to inform young people about local services.

Project Target Group

The Project’s overall target group is the young people from the specified high risk groups. The target group for whom the manual is being developed and training being conducted includes professionals who’s work brings them into contact with Aboriginal, same sex attracted and refugee young people.

For the purpose of the project professionals are defined as those individuals or groups whose education, training and working environments brings them into contact with youth, particularly at risk youth. It includes those working in a clinical capacity, such as general practitioners, nurses, psychologists, psychiatrists, accident and emergency staff. It also includes, but is not limited to professionals such as police, juvenile justice workers, social service workers, youth and community workers, social workers, institutional, local government and community health centre staff, teachers and welfare co-ordinators, legal and drug/alcohol workers (Blackmore et al 1999).

REFERENCE

Blackmore, K., et al (1999) “National Youth Suicide Prevention Strategy: Resource Guide on Education and Training” Published by University of Wollongong & Commonwealth Department of Health and Aged Care. Guide is available on internet at: http//www.ysp.medeserv.com.au