An evaluation of the feasibility, value and impact of using participatory modelling to inform the development of a regional system dynamics model for youth suicide prevention.

Abstract

Background: Suicide remains a leading cause of death for young Australians. We need robust analytical tools to help us understand and respond to the dynamic complexity underlying suicide and suicidal behaviour. Participatory systems modelling leverages empirical data together with the experiential knowledge of stakeholders to inform model building, evaluation, and implementation. Efforts to evaluate collaborative deliberative processes such as participatory system modelling remain sparse. The aim of this study was to evaluate the feasibility, value and impact of adopting a participatory systems modelling approach for developing a youth suicide prevention system dynamics model in North-West Melbourne, Australia.

Methods: Three participatory workshops were conducted with an expert stakeholder group including young people with lived and living experience of self-harm/suicidal behaviour, family members, healthcare professionals, and policy-makers. Data collection was informed by an evaluation framework, including (i) briefing questionnaires, (ii) workshop recordings and field notes and (iii) evaluation questionnaires. Data from each source were analysed separately, using codebook and reflexive thematic analysis, and synthesized to identify patterns in meaning and broad concepts under the evaluation categories of feasibility, value and impact.

Results: We found that the feasibility of undertaking an inclusive and accessible participatory systems modelling project was influenced by stakeholder cultural diversity, meaningful involvement of those with lived and living experience, accessibility of technical aspects of modelling and managing group dynamics. The value of adopting a participatory approach in developing a complex systems model was demonstrated in the collaborative learning that took place between the expert stakeholder group and the research team. Central to this was the experiential knowledge of young people who helped shape our understanding of the contextual drivers of self-harm and suicidal behaviour. Stakeholders' knowledge of the regional health system informed the structure, logic and assumptions of the systems model.

Conclusions: This is one of very few evaluations of a participatory systems modelling project involving young people with lived and living experience of self-harm/suicidal behaviour and bereaved families. Our study offers novel theoretical and practical insights into the processes adopted to ensure the safe and inclusive involvement of diverse perspectives in developing a youth suicide prevention system dynamics model.