Dynamic modelling: the key to suicide prevention

Researchers from the University of Sydney’s Brain and Mind Centre (BMC) have used dynamic modelling to reveal which strategies can help prevent suicide, as the ongoing coronavirus (COVID-19) pandemic impacts mental health. A prototypic national policy model simulated a range of strategies to determine the most effective methods to bend the mental health curve. The strategies include persisting with JobKeeper to reduce financial uncertainty, providing further education support for young people and reducing social dislocation. Lead researchers Associate Professor Jo-An Atkinson and BMC co-director Professor Ian Hickie believe the development of this decision support tool will help determine which national policy actions will have the greatest impact in reducing psychological distress across the country, and prevent lives lost to suicide. “Other countries have not yet employed these robust methods to inform national mental health responses to COVID-19,” Professor Hickie said.

Dynamic modelling

According to Professor Hickie, these tools go beyond traditional statistical models that cannot account for the complex interactions and dynamics of economic, educational, social and healthcare drivers of population risk. The national report now complements the team’s earlier regional and place-based models similar to the North Coast Primary Health Network model released in May, which are critical to understanding regional variations in the factors contributing to mental ill health and suicide. The new national report, titled Road to Recovery, recommends persisting with JobKeeper for as long as the economic and health uncertainty persists. The report states that the most important thing governments can do for mental health is slow the rate of job loss, to try to alleviate the devastating impacts of chronic stress from prolonged financial insecurity.

The report also recommends increasing education support for young people, as entry into education and training is a substitute for the loss of jobs and career development in the face of COVID-19. Governments are also encouraged to reduce social dislocation through minimising community spread of the virus, leading to repeated lockdowns. The report recommends National Budget Provisions in October 2020, to increase real health service capacity, particularly for those with more complex disorders, to be in place by early 2021. According to Professor Hickie, other countries have not employed these methods to inform national mental health responses to COVID-19. “While governments and policymakers have embraced the negative impacts of COVID-19 on mental health and suicide, the national narrative needs to speak directly to those most affected,” Professor Hickie said. “Most notably those at risk of losing their jobs, women and young people who have already been hardest hit and those experiencing the most social dislocation.”

Benefits

Professor Hickie believes the research provides preliminary evidence, from a mental health perspective, about what works and what does not. “To move forward, we need better delineation of the complex relationships between the economy, the education sector, physical health and social policy, and mental health outcomes. Coordinated action that will help to mitigate the scale of mental health impacts,” Professor Hickie said. Associate Professor Atkinson said the model represents an early national decision support infrastructure that can forecast the impacts of policy initiatives and mental health system reform, before they are implemented in the real world.

“This approach will help to guide more effective actions, avoid unintended consequences, improve efficiency in the way we invest in the mental health system, help prevent the system from becoming overwhelmed and most importantly, save lives, just as COVID-19 transmission modelling has done,” Professor Atkinson said. The prototypic model will be used to evaluate the real-time impact of national initiatives such as JobKeeper on national mental health and suicide outcomes. Further developments will consider the consequence of reduced productivity and deteriorating mental health of Australians and the impact on the national economy. The work will also explore the impact of current and new policy, major health service decisions and planning initiatives on at-risk populations, particularly women.

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