Project evaluation

This section contains information on how to evaluate suicide prevention projects. A key document for evaluating initiatives within the LIFE Framework is A Manual to Guide the Development of Local Evaluation Plans. This document can be downloaded using the link below.

 View A Manual to Guide the Development of Local Evaluation Plans (1.30MB)

Using a Program Logic Approach (described in the Background section), the manual sets out a simple ‘step-by-step’ procedure for identifying appropriate indicators. Each step is illustrated with the use of a practical example of how the procedure can be applied to a particular suicide prevention project.

Overview of Suicide Prevention Project Evaluation

The following information is an overview of suicide prevention project evaluation. More information can be found in LIFE’s Research And Evidence In Suicide Prevention document.

Systematic evaluation of all suicide prevention projects, activities and programs is essential for the continued development of best practice. It will ensure that interventions are based on a solid foundation of evidence, that resources and effort are allocated appropriately, and that the required outcomes and impacts can be achieved.

Despite the large number of suicide prevention initiatives internationally and in Australia, few have been properly evaluated for their effectiveness and impact. There are several reasons for this, including:

• short program duration
• the diversity of risk populations being targeted by programs
• methodological difficulties (small sample sizes, lack of control groups and using retrospective evaluations).

Despite the immeasurable human tragedy of each suicide and the distress of those left in its wake, from a statistical point of view, death by suicide is a relatively rare event, with approximately 1 suicide death per 10,000 people in the Australian population per year.This causes a serious dilemma regarding the choice of the most appropriate measures to be used when evaluating suicide prevention programs.

Given that 0.01% of the Australian population dies by suicide each year, studies evaluating the effectiveness of suicide prevention programs require very large sample sizes to produce accurate and meaningful results (if the only measure of success used is suicide rate reduction). To prove that an intervention results in a 15% reduction in the national suicide rate, a study sample of almost 13 million people would be required.

• prevalence of suicide attempts
• suicide-related behaviours, thinking or communication
• changes in predisposing vulnerabilities (e.g. mental illness, hopelessness)
• changes in protective factors (e.g. coping skills, help-seeking behaviour, compliance with treatment for mental illness, social connectedness, mental health literacy).

In addition, current evidence shows that there are significant differences between people who attempt suicide and those who die by suicide, suggesting that studies involving people who attempt suicide may not be applicable to those who suicide. There is also limited evidence to support the notion of a pathway to suicide from suicidal thinking to completion, or on the effectiveness of factors that may protect against suicide-related behaviours.

Moreover, suicide rates are influenced by a multitude of variables, many of which cannot be controlled. In fact, bigger reductions in the incidence of suicide have been observed in some cases following naturally occurring socio-economic changes (e.g. major economic fluctuations, wars, changes in political situation) rather than through purposefully implemented national suicide prevention strategies.

Despite a large amount of research and literature in the area, suicide prevention remains an inexact process based on limited scientific evidence. Although there is evidence suggesting that some suicide prevention approaches may reduce suicide rates (eg restricting means, primary care physician education and gatekeeper training), there is an urgent need for continued development of well planned, evidence-based programs and research evaluating their effectiveness in Australia.

All suicide prevention initiatives should be guided by current evidence and include an evaluation component based on meaningful and measurable outcomes. This will allow the critical components of effective suicide prevention programs to be identified and refined, and to guide future suicide prevention efforts.

Suicide prevention programs should also monitor any negative or harmful effects that may occur, always ensuring that an intervention follows the guiding principle of ‘first, do no harm.’

Suicide prevention initiatives should be multimodal and complementary, targeting a wide range of high risk groups. The diverse approach to suicide prevention is essential because there is no single, readily identifiable, high-risk population that constitutes a sizeable proportion of overall suicides and yet is small enough to target easily and have an effect.

Many national suicide prevention programs focus on universal, population-wide interventions (e.g. public awareness education, mental health literacy programs), somewhat neglecting the selective and indicated approaches and sometimes overlooking certain high-risk groups. There is a need to strike a balance between population-based approaches, and interventions with high-risk groups that focus on identifying and managing suicide-related behaviours and mental illness.