13.4 Efficiency

Measuring efficiency in the suicide prevention context faces two key challenges:

• Lack of outcome data
• Difficulties assessing the cost of suicide, and consequent economic benefit of prevention

Considerable information is available regarding the inputs and outputs of NSPP-funded projects. As identified in Chapter 6, 16,222 individual and 2,425 group activities were delivered by the 47 projects that provided MDS data over the six months to March 2013.

However as detailed in Chapter 8, outcome measurement using validated tools has been rare among NSPP-funded projects. Only three of the 47 projects conducted evaluations that measured outcomes using validated tools (see Section 8.3). Challenges associated with outcome measurement are identified in Chapter 8, and Chapter 12 identifies ways to improve outcome measurement in future.

A further key challenge is that there is limited information available about the financial cost of suicide in Australia (see Appendix E), making it difficult to determine the economic benefit of prevention. Indeed, the report on the Senate Inquiry into Suicide, The Hidden Toll¹¹⁵, sought to address this deficit by recommending that the Australian Government commission a detailed independent economic assessment of the cost of suicide and attempted suicide in Australia.

Efficiency was therefore examined from the following perspectives:

• Apparent cost efficiency of projects calculated by relating costs to outputs (ie, hours of service delivered) to enable analysis and comparison of average cost-per-hour of service delivery
• Sustainability of projects
• Potential efficiency improvements, based on consultations with project representatives and the Department

This analysis found that:

• The cost per hour of service provision varied across projects.
• Projects that provided relatively more hours of direct service provision (to individuals or groups) tended to have a lower cost per hour and hence appear to be more efficiently delivering services.
• Projects that spend relatively more time on travel and event/activity planning, appear to have higher costs, ie, travel and event/activity planning appear to be key driver of costs.

In relation to sustainability, more than half of the projects indicated that they receive no funding other than the NSPP. Where projects did receive funding from other sources, the amounts received were relatively small. The vast majority of project representatives did not believe that their project would be sustainable without continued NSPP funding. Project representatives reported high levels of satisfaction with regards to the level of communication and responsiveness of the DoHA officers responsible for the administration of their project. Suggestions for improving DoHA administration of projects included:

• Improved contract management, eg, speedier notification of contract awards and greater engagement of DoHA contract managers with projects
• More streamlined reporting that is less repetitive and more inclusive of project activities
• Greater care in data management so that resubmission of data is not required

¹¹⁵ Commonwealth-Government, The Hidden Toll: Suicide in Australia. Report of the Senate Community affairs Reference Committee. 2010, Commonwealth of Australia: Canberra, p14