The year 2020 was a difficult one for many young people in the Northern Sydney region, with an increase in youth deaths by suspected suicide and in youth mental health presentations to emergency departments (ED). From this arose an urgent and essential need to develop a tailored suicide prevention program in addition to existing all-age services.
The solution was a novel, semi-hybrid model, blending the attributes and ideals of the NSW Government’s SPOT (Suicide Prevention Outreach Teams) and Safe Haven initiative as an alternative to attending an ED. It has its own title – the Pilot Youth Response Team.
“Opening a Safe Haven during the pandemic and staffing that physical location would’ve been challenging,” Liz Penman, Clinical Change Manager Towards Zero Suicide for the Northern Sydney Local Health District, explains. “And following a conversation with one of our lived experience advisors, we saw this real need in our community to get out to young people, instead of them having to come into the ED or a dedicated location.
“So that’s the background on why we ended up running a hybrid model based on the SPOT concept. We’ve got mental health clinicians and peer workers visiting young people in their home, providing support they may otherwise have received in ED or a Safe Haven. We’re trying to create a Safe Haven environment in their home, their school, or wherever they reside.”
From the young person’s perspective, it creates a space where they feel comfortable at a time they may have otherwise felt unsafe, and without the clinical environment of an emergency department. The clinicians and peer workers get to see first-hand what the young person is experiencing – they might also spot a painting or a photograph that helps them get a conversation started with the young person.
“That’s where our peer workers have been remarkable. They’re fairly young and exceptionally approachable themselves, and our clinicians have also been very ready to work collaboratively with them,” Liz adds. “They’ll start a conversation however they can and follow the lead of the young person.
“We have some overwhelmingly positive stories. In fact, around 97 per cent of the young people this team are interacting with aren’t needing to go to the emergency department, which is phenomenal. I cannot thank the team enough for the work they’re doing.”
Another positive of the pilot service is the operating hours of 2pm to 10.30pm, seven days a week, where clinical-based care services generally run business hours. It’s reassuring to those looking after the young people that there is an additional, after-hours offering.
The referral pathway is open to young people, parents, counsellors or other healthcare professionals referring, and internally through NSLHD’s own services. While acknowledging there is still an increase in demand and complexity compared to pre-COVID, Liz remains cautiously optimistic.
She also sees a flow-on benefit for other services: “Previously, our adult acute care team provided extended hours support to our young people, so we’ve been able to pick up that load from them.
“At the moment we are helping people from 12 through to 18 if they’re still in school, or otherwise 17. And we have a view to be going up to 24 year olds. If we can support a young person at this age then hopefully they can progress towards their recovery journey and live a full and amazing life. Because we meet some of the most incredible young people.”
Being a member of the South Eastern Sydney Local Health District Suicide Prevention Outreach Team (SPOT) involves covering the expansive Sutherland Shire within one of the largest local health districts in the metropolitan region. While there’s lots of driving, the fact that the team is mobile and able to conduct home visits, after hours, is hugely appreciated by everyone who requires the service.
It saves travel time, transport costs and potentially the trauma of attending a hospital or clinic when they’re experiencing emotional stress.
Jeannelle Aranda, a senior clinician with the team, also enjoys the way the service operates and the unique benefits it brings, particularly having a peer worker to accompany her on visits.
“It’s great, actually. We always see people in pairs and it’s completely equal across the board with us… The peers have really valuable input, given their own lived experience, and it is usually a highlight for the clients we’ve seen,” Jeannelle says.
Jeannelle, herself, is an occupational therapist with acute care experience who has been working in mental health since 2009. When a SPOT referral comes in – usually from the district’s Acute Care team or the NSW Mental Health Line (1800 011 511) – a team member makes contact within a day to set up a face-to-face appointment.
“We introduce ourselves and explain the nature of our service, highlighting the things we’re able to offer such as the home visits, seeing them in the community or in a place of their choice where they’re most comfortable.
“We explain that we’re a small team, and just reassure them that we treat this more like a conversation. We don’t call it an assessment, we like to look at it more as getting to know the person and what’s going on in their life, and that’s usually what helps us build rapport.”
SPOT support generally lasts four to six weeks, although no one is discharged if they’re not ready and don’t have sufficient supports in place. Part of the service, however, is finding resources and services that will help in the longer term.
As an experienced clinician and occupational therapist, Jeannelle says "I like to see people within their homes, see how they function within their own environment, because that’s where you get more of a reality of how things are for them.
“Often the people we see haven’t had much experience with mental health challenges and so, for them, it may be quite scary. It’s really helpful then if they have a positive experience, as it opens their eyes to the fact they don’t have to go it alone.
“So I think that SPOT has been super important and it’s definitely a much-needed service everywhere.”
