Stakeholder Insights Into a Systems-Based Suicide Prevention Program Implemented in Regional and Rural Tasmanian Communities

Purpose: Emerging evidence indicates that systems-based suicide prevention programs can help optimise suicide prevention activities, with the National Suicide Prevention Trial using these approaches in regional and community contexts throughout Australia. The Tasmanian arm of the Trial adopted the LifeSpan systems framework to deliver suicide prevention activities across three distinct geographical areas, focusing on high-risk populations of men aged 40-64 and people 65 and over. The University of Tasmania’s Centre for Rural Health undertook a local-level evaluation of the Trial in Tasmania.Aims: To explore key stakeholder perceptions of the implementation of a systems-based suicide prevention program in regional and rural communities in Tasmania, Australia.Method: Focus groups and interviews with 46 participants, comprising Working Group members (n=25), Tasmania’s Primary Health Network employees (n=7), and other key stakeholders (n=14), with the majority (53.3%) reporting a lived experience of suicide. Thematic analysis was used to explore data and study aims.Results: Key themes centred on how the National Suicide Prevention Trial was understood and established in Tasmania; Working Group governance structures and processes; communication and engagement processes; reaching priority population groups; the LifeSpan model and activity development; and the effectiveness and sustainability of activities.Discussion: Findings showed communities were wary of suicide and wanted to engage to take action and the Trial provided the resources and coordination to do so. Perceived limitations implementing the Trial included varied involvement of key stakeholders, and lack of role clarity within Working Groups. Barriers delivering activities to the priority population groups suggested a strict adherence to the Lifespan model was challenging. Working Groups embraced a pragmatic approach, preferring activities that best utilised available capital and resources to meet perceived needs within communities. While a focus on effectiveness and sustainability of activities was seen as important, barriers at the community-level, i.e. nobody to run them, hindered these efforts. Analysis of stakeholder perceptions provides crucial insights for guiding future community-based suicide prevention efforts in regional and rural areas, and with high-risk groups.