Thanks for the analysis, Julia! I strongly upvoted it.
Have you considered estimating the cost-effectiveness of each of the 3 channels? This could help you decide which ones to scale up or down.
Meta-analyses of suicide prevention programs show effectiveness rates ranging from 10% to 40%, with significant heterogeneity based on:
Intervention type (universal vs. indicated)
Population (general vs. high-risk)
Implementation quality
Follow-up duration
I used 25% effectiveness as a central estimate. This assumes that among youths who would otherwise die by suicide, our intervention prevents death in 1 out of 4 cases.
Why 25%?
Gatekeeper training programs (similar to our workshops): 10-30% reduction in suicidal ideation
Crisis hotlines: 10-20% reduction in immediate suicide risk (short-term)
Combined interventions: Potentially higher, but limited long-term data
Do you think the risk of the students reached via all channels was decreased by 25 %? What you write above seems to have in mind the direct channels (Suicide Prevention Workshops, and Crisis Hotline Youth Callers), but I suspect the effectiveness will be significantly lower for the indirect one (School Awareness Packages). This accounts for 86.1 % (= 10,875⁄12,635) of the people you estimate to have reached, so I guess you are overestimating the cost-effectiveness. However, not as much as suggested by that fraction. I believe you are overestimating the students you reached via the indirect channel.
A. School Awareness Packages (Indirect reach)
Sent mental health resource packets to 145 schools
Assumed 300 students per school (conservative estimate for Japanese high schools)
Assumed 25% engagement rate (materials opened, read, or discussed)
Total: 10,875 youths
You are assuming the materials were delivered to all students, but you only contacted at most a few representatives of each school? If so, did they all share the materials with all students? You can add a factor representing the number of students who received the materials as a fraction of all students of the schools you contacted.
Thank you for your feedback. I agree with you that separating each channel and evaluating its cost effectiveness is better if my nonprofit decides to evaluate the program and decide on what to scale up or down. About overestimating the indirect outreach—very very true. But I needed to start with at least a number that is closer to reality and based on logical assumptions and the human indifference factor wasn’t helping the case (school simply not replying to our emails despite having received the packages or just sending a simple reply with no follow up).
As I also wrote above, there is a risk of duplicates, we might distribute materials and also be invited to a school to deliver a suicide prevention workshop (a training of sorts). In that case, the numbers would look much lower if we counted both channels separately, because the same people are being reached.
@Cat🔸 below wrote about analyzing youth suicide distribution across the regions and countering it with the school outreach in regions, which seems like also a more topical approach for the future analysis.
Thanks for the analysis, Julia! I strongly upvoted it.
Have you considered estimating the cost-effectiveness of each of the 3 channels? This could help you decide which ones to scale up or down.
Do you think the risk of the students reached via all channels was decreased by 25 %? What you write above seems to have in mind the direct channels (Suicide Prevention Workshops, and Crisis Hotline Youth Callers), but I suspect the effectiveness will be significantly lower for the indirect one (School Awareness Packages). This accounts for 86.1 % (= 10,875⁄12,635) of the people you estimate to have reached, so I guess you are overestimating the cost-effectiveness. However, not as much as suggested by that fraction. I believe you are overestimating the students you reached via the indirect channel.
You are assuming the materials were delivered to all students, but you only contacted at most a few representatives of each school? If so, did they all share the materials with all students? You can add a factor representing the number of students who received the materials as a fraction of all students of the schools you contacted.
Thank you for your feedback. I agree with you that separating each channel and evaluating its cost effectiveness is better if my nonprofit decides to evaluate the program and decide on what to scale up or down. About overestimating the indirect outreach—very very true. But I needed to start with at least a number that is closer to reality and based on logical assumptions and the human indifference factor wasn’t helping the case (school simply not replying to our emails despite having received the packages or just sending a simple reply with no follow up).
As I also wrote above, there is a risk of duplicates, we might distribute materials and also be invited to a school to deliver a suicide prevention workshop (a training of sorts). In that case, the numbers would look much lower if we counted both channels separately, because the same people are being reached.
@Cat🔸 below wrote about analyzing youth suicide distribution across the regions and countering it with the school outreach in regions, which seems like also a more topical approach for the future analysis.