To understand what works in what situations, it is important to review both the intended and unintended outcomes of interventions.84 This section reviews the unintended outcomes of NSPP-funded activities. A thematic analysis of project documentation and free-text responses within the MDS identified a number of unintended outcomes, both positive and negative, that impact the assessment of program effectiveness. The unintended outcomes are outlined below.
8.6.1 Positive unintended outcomesThree main categories of positive unintended outcomes were identified:
- Positive reciprocity
- Extended reach and/or goal expansion
- Adverse community circumstances leading to project 'down time' which can be used to project advantage.
Positive reciprocityPositive reciprocity was demonstrated when project participants/recipients or other stakeholders 'gave back' to the project in some way. Examples include:
- Project recipients became volunteers for projects.
- Project participants contributed (unplanned) interviews to enrich the content of DVDs.
- Commercial organisations and celebrities provided pro bono assistance with suicide prevention media campaigns.
- Grateful recipients of counselling raised funds for service providers.
Extended reach and/or goal expansionA second positive unintended outcome was observed for several projects which reported wider reach than intended or expansion of goals. Examples include:
- More people were trained than originally anticipated.
- More referrals were received than expected (including for example, people who had been bereaved longer ago than expected, and more referrals via word of mouth than expected).
- Supporting young people to deal with their mental health issues resulted in some cases, in them being more able to engage in school and/or training programs although these outcomes were not particular targets of the program.
- In one case, a project assisted with the emergency response to a flood. This included connecting the community with service providers, but for a different purpose than originally intended.
Adverse circumstances leading to project 'down time'In some projects, adverse natural circumstances such as fires, floods or the rainy season can lead to the project workers having time to review materials, create new networks or support people and raise profile in ways that are not part of usual business. Not being physically able to conduct visits or workshops may mean there is time for advocacy or education work that may not be achieved whilst 'usual business' takes precedence.
In some cases, waiting for a new staff member to be appointed can also be a time for reflection and reorganisation, planning and materials review. Although there may be interruption to service provision at these times, the opportunity for reinvigorating aspects of the project was sometimes welcome. Top of page
8.6.2 Negative unintended outcomesTwo main types of negative unintended outcomes were identified:
- Encouraging better help-seeking behaviour leading to inability to meet need
StigmaStigma, which projects identified as a key barrier to help-seeking, is not only a recognised barrier in suicide prevention but also in mental health and other areas of the health and human services systems.85 In some cases, projects reported that their activities may unintentionally result in an increased experience of stigma for participants involved.
Several organisations, which provided suicide prevention services at, or close to a Probation and Parole Office or a mental health organisation, reported that there was a perception among the public that all service users had been involved with the criminal justice system or had a mental illness. They suggested that as a result some people may have been reluctant to use the services because of this perceived association.