The usual political practice is to spread limited resources around so that there is something to announce in every electorate before an election, but the evidence shows that increased spending on suicide prevention has not reduced the suicide rates in young people. What we need now is to break the cycle of developmental trauma, to commission viable pilot services to take on the more severe end of the spectrum. 1,000 young people in NSW will cost $2.3 million each – what if we could turn some of them around? We have an opportunity cost situation – what is the cost of not taking action and investing now? In young people, every year of development really matters.
There can be no quick universal treatment coverage because it takes time to train the necessary skills, and the best treatment requires multiple components of care by a team, spread out over a couple of years, to ensure that the young person develops a good sense of self, has anxiety under control (and so avoid substance misuse), completes education, finds work, and is in a better frame of mind when entering romantic relationships. The pilot services need to have critical mass to undertake comprehensive mental and physical assessments, medical investigations, psychological and physical health treatments, and to be a training site for a wide range of treatments and disciplines, and to support communities of practice outside the service. The most relevant existing models are the headspace Early Psychosis model, (with its 16 components of care and fidelity processes) and the NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS, treating 7,500 refugees annually with every type of trauma).