COMPAS: Checking on mental health, providing alternatives to suicide

Telehealth intervention for people identified at risk of suicidal behaviour in the future, Telehealth includes safety planning, assessment, and referral. We have developed a multivariable algorithm, embedded in an online survey, that accurately identified individuals at increased risk of suicidal behaviour within the next 12 months. We work with our clinical psychology trainees to proactively reach out to these people to offer a telehealth intervention comprising risk assessment, safety planning, and linking with appropriate resources. In the telehealth intervention, clinical trainees will talk with at risk students one-on-one (via phone or text) to determine their current needs. All students will complete safety planning. Resources and supports offered vary based on student need. Examples include linking in with student clubs and societies, facilitating visits to the GP for medication or a mental health care plan, and in rare cases encouraging students to attend to the emergency department. Phone calls average 30 minutes in duration. We aim to contact students within one hour of survey completion. We will invite all first-year students across the universities to participate in an online survey, administered using Qualtrics, accessible on any smart device. To recruit participants we will: 1. Embed invitations to participate in Orientation activities, encouraging students to complete the screening survey as a normalised part of the orientation process; 2. Use flyers and present talks at information sessions during Orientation week; 3. Market the study on social media, digital screens, videos, and lecture theatre screens across campus; 4. Present in lectures, and post notices on Blackboard, for mandatory first year lectures; 5. Work with our Partner Organisations to host mental health awareness events on campus; 6. Provide regular updates of our progress with the project to participating universities. Participants will respond to a range of questions regarding mental health and wellbeing. Items from the CIDI screener are used to assess psychological disorders (e.g., major depressive disorder, bipolar disorder, generalised anxiety disorder, panic disorder, conduct disorder, ADHD, eating disorder, alcohol/substance use disorders). Items from well-validated measures are used to assess suicide risk and protective factors: Physical health/health behaviours; Alcohol/drug use; Sexual orientation; Adverse childhood experiences, Sexual and physical abuse; Bullying, Recent stressful events; Academic stress; Religiosity, Spirituality; Family/peer support; Reasons for living. We will include the Acquired Capability for Suicide Questionnaire assessing fearlessness of death, pain tolerance, and perceived ability to take one’s life, and the 10-item Interpersonal Needs Questionnaire to assess perceived burdensomeness and thwarted belongingness, key theoretical components underlying suicide. The survey will take approximately 20 minute to complete.. All students will receive a comprehensive list of searchable local and national mental health resources, including resources for diverse groups of students. Examples of these include: Lifeline, Beyond Blue, University counselling services, drug and alcohol services etc. They will also have free access to an online emotion regulation program developed by CI Hasking and Prof James Gross from Stanford University. This online program contains 5 modules: 1. introduction to emotion regulation; 2. drawing your attention; 3. how we think is how we feel; 4. taking action and putting it all together; and 5. summary guide and feedback. The modules are focused on cognitive reappraisal as the key emotion regulation strategy and include text, videos, worksheets, and online exercises. This is self-paced and non-guided. Students reporting suicide plan or suicide attempt in the last 12 months will additionally be directed to the BeyondNow smartphone safety planning App, ensuring no wait time to online support. Students can freely download the App to their phone and progress through a series of safety planning questions: 1. My warning signs 2. Things I can do to make my space safe 3. My reasons to live 4. Things I can do by myself 5. People and places I can connect with 6. People I can talk or yarn to 7. Professional support Students can do this on their own or in conjunction with someone else (eg a friend, a therapist). Students can download their completed plan to their phone and update it any time. They can also share their plan with someone else. Completion time will vary depending on how much detail students enter into their plan. Master of Clinical Psychology trainees undergo a 2-day manualised training program (half online modules, half face-to-face) that includes: information about COMPAS values and the evidence-base; adopting a person-centred approach to suicide prevention; talking compassionately with students in distress; safety planning and referral; and self-care. This training is delivered at least one week before recruitment starts. Clinical training was originally developed in collaboration with Lifeline WA, who will continue to provide input on training materials. Training is delivered by the research team or a trained clinician at sites interstate. Online module will be developed by the research team to ensure fidelity of training across sites. Clinical trainees will receive fortnightly 1 hour group supervision, as well as on-call support, for the duration of the call period (6 months each year). Supervision will include discussion of the calls (eg case review), individualised feedback for trainees, and review of referral pathways. In conjunction with headspace we will also deliver free online workshops for supervisors, offering professional development in current approaches to suicide assessment and prevention, and developing a professional network of staff working on suicide prevention in university settings. These will include the headspace workshops: Real Talk (1 hour) - A presentation that builds the capacity of all university staff to engage in relevant conversations around mental health, including introducing the NIP it in the bud framework; what to Notice, how to Inquire and what supports to Provide someone experiencing mental health difficulties; Real Talk 2 in practice (2 hours) - An interactive session that takes a deep dive into case studies to build on the knowledge and skills from Real Talk 1 to engage in conversations and offer a variety of supports relevant to individuals at your university.; Responding to suicide (90 minutes) - This session focuses on the planning and response phases of postvention activities following a suicide, including guiding principles of postvention and immediate responses; Recovery after suicide (90 minutes) - This session focuses on the recovery phase of postvention, to support all staff to engage in activities to build mentally healthy universities following a suicide. This session is appropriate regardless of whether your university has been impacted by a suicide previously. This is a 5 year project with a 6 month call period delivered to each incoming group of first-year university students