The evidence regarding the overall efficacy of the systems approach is important in identifying what strategies should be prioritized to achieve the biggest impact. The findings of the population preventable fraction calculations indicate that the systems approach could lead to significant reduction in suicide attempts and suicide deaths in Australia. Potential synergistic effects between strategies included in the approach could further increase the impact of implemented strategies.

Social media plays an instrumental role in enabling and facilitating social movements. However, this role depends on the complex social issues in a civic community and dynamics of power in movement politics. Existing literature provides little insight into the formative role of social media in social movements; instead, it tends to focus on the informational role and episodic effect of social media in community activism. We present the case of Bersih, a social media-enabled social movement that pushed for electoral reform in Malaysia. The non-partisan community-driven movement exerted public pressure on institutions and gained formal recognition. In this study, we reveal the significant role social media plays in empowering citizens by enabling them to facilitate and coordinate collective action towards producing change in their community. This research is significant in articulating the precise nature of the role of ICT in addressing complex social problems.

IntroductionFor individuals presenting to the emergency department (ED) for a suicide attempt, the period after discharge from hospital is marked by heightened vulnerability for further suicide attempts. Effective care following a suicidal crisis has the potential to significantly decrease this risk. The current study aims to examine the impact of the LifeSpan multilevel suicide prevention model on experiences of care following a suicidal crisis. Perspectives from healthcare consumers (individuals who have presented to the ED following a suicidal crisis), carers, and health professionals will be explored. The LifeSpan model is currently being evaluated as a high-fidelity trial in four geographically defined regions in New South Wales, Australia.Methods and analysisThis study will use a mixed methods prospective cohort design. Quantitative data collection includes a structured survey, administered to healthcare consumers from LifeSpan sites and control sites. Two cohorts of healthcare consumers will be recruited 12 months apart with baseline assessment occurring within 18 months of the ED presentation, and follow-up 12 months after the initial assessment. Survey participants will be recruited online and through participating EDs, mental health organisations and aftercare services. Qualitative interview data from healthcare consumers, carers who have accompanied a loved one to the ED following a suicidal crisis and health professionals who provide care to people at risk of suicide will be collected concurrently with the recruitment of the first cohort of survey participants. Purposive and convenience sampling techniques will be used for recruitment of interview participants. The primary outcome for this study will be healthcare consumers’ experiences of service provided at the ED. Analysis will be undertaken of the change over time within LifeSpan sites, as well as between LifeSpan sites and control sites, using mixed effects repeated measures models as principal means of data analysis.Ethics and disseminationThis research has been approved by the Hunter New England Human Research Ethics Committee (HREC/17/HNE/144). Results will be disseminated via conferences and peer-reviewed journals.Trial registration numberACTRN12617000457347.

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While there are a number of systematic reviews on school-based mental health programs, there appears to be heterogeneity in their overall findings and conclusions, possibly due to the tendency to combine evidence from primary school and high school programs. To investigate the evidence for the effectiveness of targeted (for specific groups) and universal (for all students) mental health programs delivered in secondary schools, a systematic review of systematic reviews was conducted. A systematic search for reviews published from 2015 included outcomes for depression and anxiety—the most common mental health conditions—and quality appraisal of original studies in majority secondary school settings. A total of 395 references were screened and 14 systematic reviews were included. Of reviews that were assessed in full, most were excluded for not clearly separating studies in secondary school settings from primary school settings. Findings were generally positive but heterogenous in terms of quality and long-term outcomes. Interventions were mainly based on cognitive behavioural therapy (CBT), with results showing that targeted interventions are generally effective in the short-term for both anxiety and depression, while universal programs may be effective in some situations, typically in the short term and when programs were CBT-based; where reviews focused on universal resilience programs there were no significant effects. The overview shows a need for systematic reviews focused on secondary school settings, which consider contextual and individual factors that can influence the implementation and effectiveness of programs.