Lead Investigator: Dr Sanne Oostermeijer (The University of Melbourne)

Co-Investigators: Anthony Jamieson, Judith Wright, Dr. Anna Ross, Rhiannon Morley, Poni Tongun, A/Prof Amy Morgan, Prof Nicola Reavley

Young people in youth justice detention are at much higher risk of suicidal thoughts and behaviours than their peers in the community. These young people are removed from their family and communities and do not have access to the usual community-based suicide prevention measures. The risk of suicide has been estimated to be 3 to 18 times higher compared to their peers and the prevalence of current suicidal ideation may range from anywhere between 9.6 – 52%. Despite this, there has been very little evidence about how Youth Justice staff — who spend the most time with detained young people — should identify, respond to and support those at risk. Previous research was limited, and guidance rarely drew on the lived experience of young people or their families. This project addressed that evidence gap by producing the first Australian expert‑consensus guidelines on suicide prevention for youth justice detention settings that explicitly included people with both professional and lived‑experience expertise.

Our study involved a Delphi expert consensus method. An overall panel of 45 experts from four Australian jurisdictions took part: 25 professional experts (youth justice staff, supervisors and health services staff) and 20 lived‑experience experts (those experienced in providing support to detained young people such as a peer, parent and/or caretaker acting as an advocate). Panellists rated 313 knowledge and action statements on how youth justice staff can best support detained young people with suicidal thoughts and behaviours. These included items about universal strategies, identifying and assessing a young person, and providing support to a young person at risk of suicide. Items rated as “essential” or “important” by at least 90% of the panel were included in the final guidelines.

In total, 237 of the 313 items (76%) were endorsed as best practice which have been compiled into a guideline document titled “Supporting detained young people with suicidal thoughts & behaviours: Expert recommendations for youth justice facilities in Australia”.

Endorsed actions span across universal suicide prevention within youth justice detention, noticing changes and identifying psychosocial risks, assessing risk, recommendations on how to talk with and support a young person at risk, tailoring collaborative care, types of restrictive interventions and staff self‑care.

The panel strongly endorsed actions that foster a safer, more therapeutic environment — for example, building trust, spending meaningful time with young people, and promoting family contact. Staff are recognised as playing a critical role in identifying whether a young person is experiencing suicidal thoughts and behaviours, as well as offering and providing ongoing support. Practical strategies were endorsed to help staff notice mood or behaviour changes, approach and talk with young people at risk, and how to offer appropriate support.

Many restrictive interventions commonly used within youth justice detention to manage risk (handcuffs, isolation, unclothed searches, offering to share a bedroom with a peer) were rejected by many, if not most, panellists. Observation and checking for dangerous objects were accepted as safety measures, but these were recommended only as last resort measures.

Finally, the guidelines include recommendations for managerial support, debriefing and self‑care for staff after involvement in suicide‑related incidents, to help mitigate any long-term impact on their mental health and wellbeing.

These guidelines are the first of their kind and provide Australian youth justice Departments and youth justice detention facilities new and up-to-date evidence-based guidance to support their suicide prevention policy and procedures. Currently, these guidelines are being developed into a staff training course for staff in Victoria. This new training will be evaluated for feasibility and initial efficacy, including impacts on staff’s knowledge, confidence and intentions towards young people at risk of suicide in youth justice detention.