Emerging Minds x Mental Health Innovations Placement Project

The purpose of this project was to understand what factors contributed to suicide de-escalation in young imminent risk texters. This project used anonymised information from young people who initiated a text conversation with the Shout 85258 service and were considered at imminent risk after expressing they had a wish, plan, means and timeframe to attempt suicide in a ladder up risk assessment with the volunteer. Half of the conversations we examined reflected a de-escalating trend, in which the texter ultimately agreed to a safety plan. The other half reflected an escalating trend, in which texters did not agree to a safety plan, resulting in clinical supervisors having to notify emergency services so they could attempt an active rescue. Separately, we conducted interviews with clinical supervisors and volunteers to get their perspective on what works and does not work in de-escalating suicidal behaviours and preventing them through the platform. We anticipated that the findings from this project would help us enhance training and support for volunteers and generate knowledge that is of broad interest to those working in suicide prevention. 

This project revealed several key findings which overall suggested the importance of assessing risk factors and promoting protective factors in conversations. While texters with deteriorating mental health, troubling relationships, past traumas, prior suicide attempts and a history of self-injury were at a greater risk of an active rescue, texters with social support, coping skills and professional mental health support were more likely to de-escalate and become calmer whilst texting with a volunteer. Notably, texter’s emotions and behaviours aligned with our knowledge of existing theories of suicide and known pathways from suicidal ideation to action, highlighting the importance of evidence-based practice. Lastly, we found that exploring feelings, behaviours, and goals was an essential part of the conversation structure and might aid in de-escalating imminent risk texters. Indeed, our findings suggest that building rapport, maintaining connectedness, and validating an individual’s experience so that they feel heard and understood is essential for emergency suicide prevention and intervention, especially when following protocols that are required to ensure that someone’s physical safety is prioritised.

From a personal perspective, it was a great experience to work at Mental Health Innovations. I witnessed the effort and dedication that volunteers, supervisors, and dedicated teams at MHI devoted to Shout, and their commitment to help support thousands of individuals across the nation struggling with mental health issues. MHI is not only actively engaging in conversations with the government, agencies, and academics about important issues such as suicide, but they are also informing research and policy, promoting public engagement, fundraising new mental health initiatives, and finding new ways to improve training and awareness for their volunteers to provide potentially life-saving support. I feel very lucky that I had the opportunity to take part in an Emerging Minds x Mental Health Innovations placement and experience first-hand the impact of Shout. As a doctoral student in psychology, it was an invaluable opportunity to learn from this collaboration how to integrate clinical practice, evidence-based research, and digital innovation to understand unique aspects of young people’s mental health.