This presentation discusses the Lowdown services, including an overview of support pathways for young people indicating suicide, an ethnic breakdown of the service users and the results of the evaluation from the perspective of the service provider and service users. It is clear that these services can play an increasingly important role over the next few years in filling well-documented service gaps, as well as complementing and moderating demand on existing primary care and mental health services. Presentation by Dylan Norton, Lifeline Aotearoa, Candace Bagnall, Ministry of Health at the 2009 SPINZ National Symposium: Culture and Suicide Prevention in Aotearoa: http://www.spinz.org.nz/page/108-events-archive+spinz-national-symposium-2009+symposium-coverage

1. Why www.thelowdown.co.nz?

2. Defining the problem – the context
• National Depression Initiative
- Very successful television campaign – 93%
prompted recall of advertisements for
total population, 96% for Maori and 91%
amongst young people aged 16-24 years
- Strong recall of the help seeking message
(60%)
- 58% had discussed the ads
- BUT less than 10% of helpline calls were
from young people, who tend not to visit
GPs either

3. Defining the problem – the context
• Extent of the problem amongst
youth (15-24 years)
- 1 in 11 young New Zealanders will
experience a major depressive disorder
over a 12 month period
- Youth have the highest hospitalisation rate
for intentional self-harm – twice as high as
those aged 25-34 years
- 100 young people die each year by suicide
- Depression is a factor in most suicide
attempts

4. What did we do about it?
• Young people wanted
- Easy navigation and good information
- Clean, low-key look – not too bright and
busy
- A trustworthy voice – of authority
- Stories from real people
- Interactive stuff
- Professional, personalised, back-up
support – they wanted to know who they
were talking to

5. What did we do about it?
• What young people got - website
- Designers produced leading edge website
- Excellent buy-in from young people,
including ‘talent’ who told their stories
- NZ music was profiled and made available
for download
- Fact sheets were written and checked with
expert advisory group
- Launch and events featuring celebrities
and musicians attracted lots of media

6. How well did the Lowdown work?
• Website evaluation results (online
survey)
- 90% very positive response from online
survey respondents on all aspects of web
function and layout
- Key message was about help – you can get
help, you can help others
- 95% would recommend the site to
someone in need
BUT
- Fewer than 14% of 15-24 year olds
recognised the Lowdown name

7. The Lowdown website

11. Lifeline Aotearoa support services
• SMS Text 5626
• Email team@thelowdown.co.nz
• Moderated message board
• Webcam service (latest communication channel)

12. Service Uptake: Jan 08 – June 09
• 119,464 total website visits.
• 148,802 text messages received and sent.
• 5265 emails received and sent.
• 1530 posts on the message board.

13. Number of unique service users
From Lifeline Aotearoa
data

14. Txt traffic by ethnicity: Jan 08 – Jun 09

15. Email traffic by ethnicity: Jan 08 – Jun 09

16. Text and Email users
• 47% of text contacts were classified by thelowdown
team as relating to depression
• 49% of email contacts were classified by thelowdown
team as relating to depression
• 31% of text contacts reported suicidal thoughts
• 28% of email contacts reported suicidal thoughts

17. Level of depression (txt)

18. Text and Email users
• Text and email users were both predominately female
(77% and 67% respectively)
• The main age grouping for text users was 15 – 21 years
(63% of users)
• Age profile for email users was much older than for text users
47% were aged 22 yrs & over compared with 16% of text users
• 77% of text users were students
• 40% of email users were students

19. Txt & e-mail brief intervention services
• Explore presenting issues and support
problem solving
• Non judgemental support
• Information
• Signposting other services

20. Txt & e-mail brief intervention services
• Support significant others
• Strengthen social support networks
• Support hope, self esteem and self efficacy
• Self help strategies
• Manage risk, respond to suicide

21. Message board
• Total threads since launch: 770
• Total reply posts since launch: 1067
• Every message moderated.
• Safe place to give and receive peer support.
• Suicide or self harm posts rejected.
• Rejected suicide posts followed up.

22. Risk incidents: Jan 08 – June 09:
• Txt risk incidents: 101
• Emergency services contacted: 52
• E-mail risk incidents: 8
• Emergency services contacted: 6

23. Outcomes after txtr/e-mailer located:

24. Evaluation
• Phoenix Research- Evaluation of Youth
Initiative
• January – December 2008
• Text, Email and Website
• On-line Panel and Service Users (18.5% Maori)

25. How well the service met needs
• 80% of Service Users indicated that the text
service met their needs extremely to quite
well
• 70-75% of Service Users indicated that the
email support services met their needs
extremely to quite well

26. Evaluation Quotes
• ‘Because with me, I was at high risk of suicide
– they called the police and that got the ball
rolling on getting me help’
• ‘I love this site because it is genuinely good, the
fact sheets, the self-test, just everything – I
have severe depression and finding this place is
like gold – I'm serious’

27. Quotes
• ‘Helped me see that I needed to get myself
help’
• ‘That what I was experiencing wasn't weird or
strange and that I wasn't alone in the way I
was feeling - also that there were so many
different ways for me to get help, i.e. I have
trouble using the telephone, so the message
board was great’