Periodic Reporting for period 2 - SEYMOUR (SYSTEM DYNAMICS MODELLING FOR SUICIDE PREVENTION)
Période du rapport: 2024-02-01 au 2025-01-31
Suicide is one of the leading causes of mortality among young people aged 15–24 globally. The suicide mortality rate is one of the indicators within the UN’s Sustainable Development Goal (SDG) 3, and the WHO Comprehensive Mental Health Action Plan (2013–2030) identifies young people as a high-risk group. Despite increasing investment in suicide prevention activities from many governments worldwide, we still do not know which interventions, policies, or programs, for which groups of young people, for how long and with what intensity could generate the greatest reductions in youth suicide rates. Progress in youth suicide prevention has been stalled by many factors including:
• A lack of involvement of young people in the design of interventions meaning that they are not youth-focused and, therefore, not acceptable to end-users.
• A lack of planning for the systematic uptake and implementation of strategies in the real world.
• Limited adequacy and accuracy of current methodological approaches (e.g. meta-analyses, regression models) which do not account for the interdependence of suicide risk factors as they operate across multiple levels (e.g. individual, social, health system); and consider the complexity of health systems and the influence of factors such as healthcare constraints.
SEYMOUR (System Dynamics Modelling in Suicide Prevention) offers a novel paradigm for guiding the efficient and effective deployment of national and global youth suicide prevention strategies using system dynamics modelling (SDM). SDM is a computer-assisted method that helps frame, test and simulate the causal processes and interactions that underlie complex systems or behaviours (such as suicide) to inform policy making. A unique selling point of SDM is that it may be guided by a participatory approach, which leverages empirical data together with the experiential knowledge of stakeholders, to inform model building, evaluation, and implementation.
The overall objective of SEYMOUR was to adopt participatory systems modelling to develop and evaluate a computational model to inform youth suicide prevention policy, planning and implementation in Australia and the UK.
• A lack of involvement of young people in the design of interventions meaning that they are not youth-focused and, therefore, not acceptable to end-users.
• A lack of planning for the systematic uptake and implementation of strategies in the real world.
• Limited adequacy and accuracy of current methodological approaches (e.g. meta-analyses, regression models) which do not account for the interdependence of suicide risk factors as they operate across multiple levels (e.g. individual, social, health system); and consider the complexity of health systems and the influence of factors such as healthcare constraints.
SEYMOUR (System Dynamics Modelling in Suicide Prevention) offers a novel paradigm for guiding the efficient and effective deployment of national and global youth suicide prevention strategies using system dynamics modelling (SDM). SDM is a computer-assisted method that helps frame, test and simulate the causal processes and interactions that underlie complex systems or behaviours (such as suicide) to inform policy making. A unique selling point of SDM is that it may be guided by a participatory approach, which leverages empirical data together with the experiential knowledge of stakeholders, to inform model building, evaluation, and implementation.
The overall objective of SEYMOUR was to adopt participatory systems modelling to develop and evaluate a computational model to inform youth suicide prevention policy, planning and implementation in Australia and the UK.
Work package 1
This WP involved the development of a computer simulation model (through a participatory systems modelling approach) of mental health service pathways and suicidal behaviour among young people in North-West Melbourne. An expert stakeholder group conceptually mapped the causal pathways for the development of suicidal behaviour in young people, and their help-seeking journey through health and non-health settings (e.g. community services) including mental health service pathways.
Main scientific achievements
1. A computer simulation model of mental health service pathways and suicidal behaviour among young people in North-West Melbourne which can be used as a decision support tool to inform service planning and resource allocation.
2. One of very few evaluations of participatory systems modelling involving young people with lived and living experience of self-harm/suicidal behaviour and professionals.
3. The first ever conceptual framework for understanding the active ingredients of a successful PSM for developing complex systems models.
Work package 2
This WP involved the calibration and validation of the computer simulation model developed in WP1 using local and national datasets.
Main scientific achievements
The first fully calibrated computational model for youth suicide prevention in North-West Melbourne. Once model validation has been completed, simulation analyses will demonstrate which intervention scenarios will lead to the most significant reductions in rates of suicide, attempted suicide and self-harm hospitalisations in young people in North-West Melbourne.
Work package 3
Qualitative interviews with the expert stakeholder group explored their experience of taking part in the participatory model building workshops. Using a realist approach to evaluation, data from stakeholders was used to validate, falsify and modify the original conceptual framework focusing on: in what circumstances, for whom and why PSM works when developing complex systems models.
Main scientific achievements
The findings of WP3 offer novel methodological and theoretical insights that enhance our understanding of how collaborative decision-making processes, such as PSM, can be applied in diverse contexts (considering contextual barriers and facilitators) and for various stakeholder groups.
Work package 4
This WP involved the development of a new conceptual model of mental health service pathways and suicidal behaviour among young people in the UK.
Main scientific achievements
The first ever UK conceptual model mapping the causal pathways for the development of mental ill-health and suicidal behaviour in young people, young people’s help-seeking journey through health and non-health settings, including mental health service pathways. The conceptual model has been translated into a stock and flow diagram illustrating how different elements (e.g. help-seeking, psychological distress, access to mental health services) interact over time to help us understand the dynamic relationships between various components within the system.
Dissemination
The SEYMOUR dissemination strategy has reached (and will continue to reach) beneficiaries via: i) academic publications in open access scientific journals and/or self-archiving in the UoB Research Archive; ii) presentations at international conferences and scientific meetings dedicated to suicide prevention and data science; iii) social media platforms (X and LinkedIn); iv) policy outputs (following publication of main results); v) outreach and knowledge transfer events, videos with stakeholders sharing their experience of taking part in the SEYMOUR workshop, and the project website.
This WP involved the development of a computer simulation model (through a participatory systems modelling approach) of mental health service pathways and suicidal behaviour among young people in North-West Melbourne. An expert stakeholder group conceptually mapped the causal pathways for the development of suicidal behaviour in young people, and their help-seeking journey through health and non-health settings (e.g. community services) including mental health service pathways.
Main scientific achievements
1. A computer simulation model of mental health service pathways and suicidal behaviour among young people in North-West Melbourne which can be used as a decision support tool to inform service planning and resource allocation.
2. One of very few evaluations of participatory systems modelling involving young people with lived and living experience of self-harm/suicidal behaviour and professionals.
3. The first ever conceptual framework for understanding the active ingredients of a successful PSM for developing complex systems models.
Work package 2
This WP involved the calibration and validation of the computer simulation model developed in WP1 using local and national datasets.
Main scientific achievements
The first fully calibrated computational model for youth suicide prevention in North-West Melbourne. Once model validation has been completed, simulation analyses will demonstrate which intervention scenarios will lead to the most significant reductions in rates of suicide, attempted suicide and self-harm hospitalisations in young people in North-West Melbourne.
Work package 3
Qualitative interviews with the expert stakeholder group explored their experience of taking part in the participatory model building workshops. Using a realist approach to evaluation, data from stakeholders was used to validate, falsify and modify the original conceptual framework focusing on: in what circumstances, for whom and why PSM works when developing complex systems models.
Main scientific achievements
The findings of WP3 offer novel methodological and theoretical insights that enhance our understanding of how collaborative decision-making processes, such as PSM, can be applied in diverse contexts (considering contextual barriers and facilitators) and for various stakeholder groups.
Work package 4
This WP involved the development of a new conceptual model of mental health service pathways and suicidal behaviour among young people in the UK.
Main scientific achievements
The first ever UK conceptual model mapping the causal pathways for the development of mental ill-health and suicidal behaviour in young people, young people’s help-seeking journey through health and non-health settings, including mental health service pathways. The conceptual model has been translated into a stock and flow diagram illustrating how different elements (e.g. help-seeking, psychological distress, access to mental health services) interact over time to help us understand the dynamic relationships between various components within the system.
Dissemination
The SEYMOUR dissemination strategy has reached (and will continue to reach) beneficiaries via: i) academic publications in open access scientific journals and/or self-archiving in the UoB Research Archive; ii) presentations at international conferences and scientific meetings dedicated to suicide prevention and data science; iii) social media platforms (X and LinkedIn); iv) policy outputs (following publication of main results); v) outreach and knowledge transfer events, videos with stakeholders sharing their experience of taking part in the SEYMOUR workshop, and the project website.
The application of participatory systems modelling to suicide prevention policy and planning is still in its infancy. SEYMOUR has led to the development of two complex models which can help us understand the dynamic complexity of the aetiological factors underlying suicidal behaviour in young people within a complex health and social care services system across two countries. The novel conceptual framework for understanding the active ingredients of a successful PSM, offers new insights into best practice processes to ensure the safe and inclusive involvement of multiple, diverse, and even contrasting perspectives in collaboratively developing complex systems models. This framework can serve as the architecture blueprint of the PSM approach which can be transferable and applicable to studies across other fields. At the heart of innovation is the fact that SEYMOUR has bridged the gap between methodological approaches, such as participatory research and simulation modelling. The findings of this research have the potential to advance methodological approaches in the field of suicide research in EU, build capacity in complex systems science, to understand complexity behind public health problems. The two computational models have the potential to be adopted as evidence-based decision support tools to guide effective policy action and resource allocation in suicide prevention in Australia and the UK. This is important as youth suicide remains a major public health concern and reducing deaths by suicide is one of the indicators within the UN’s Sustainable Development Goal 3.