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Frontier Economics

Frontier Economics conducted a break-even analysis of Shout, looking at how many suicides need to be prevented each year to cover the annual cost of running the service, and found:

  1. Shout delivers value for money on suicide prevention alone, before considering the wider benefits the service generates in relation to other mental health conditions or the emotional benefits to individuals of preventing a suicide.
  2. At a value for life of £2m, if Shout prevented just 3.3 suicides each year, it would break even. Testimonies, including those from the Metropolitan Police and Shout texters, indicate that the service exceeds this and has saved at least 18 lives in its first three years, equating to more than five lives a year. However, given that it is highly unlikely that this anecdotal evidence captures all instances where lives were saved - especially given the high number of interventions, coupled with reporting back to Shout from texters or emergency services on whether a life has been saved is not done on a comprehensive basis - the actual figure could be much higher.
  3. Shout provides a service that is especially valued by young people, meaning that the threshold for breaking-even could in fact be lower, given the greater number of life years saved by preventing the suicide of a young person.
  4. Shout provides support to many people at risk of suicide who would likely not otherwise be captured by alternative mental health programmes and systems.

We conclude that there is very strong evidence to show that Shout saves significantly more lives through suicide interventions than would be needed to ‘break-even’ on its total costs. This does not take into account the additional life years saved from the youthful demographic they serve, or any other benefits for other mental health conditions.” -

Matthew Bell, Director, Frontier Economics

The Institute of Global Health Innovation, Imperial College London

The Institute of Global Health Innovation, Imperial College London, developed an economic model to determine whether Shout is cost-saving, comparing the total annual costs to health and emergency services in the scenarios that the Shout service is and is not available. The analysis found that:

  • At a cost of £10 per conversation, Shout is cost-saving to health and emergency services, even under the assumption that there is a reduction in attempted or completed suicides in only 15% of those that contact Shout.
  • In addition to these potential cost savings for the public sector, Shout is likely to offer further savings to the rest of the economy through potential lost earnings, victim support, reducing distress and encouraging help-seeking behaviour.
  • There is a plethora of anecdotal evidence and clinical justification for the immense value of Shout to the community and economy which also credits Shout with saving lives. This encompasses qualitative feedback from texters, their families and the emergency services.

“Shout is an exciting innovation that is already changing the shape of mental health provision in the UK. This report shows how the simple, text-based service is providing immediate, life-saving support to people at high risk of suicide. At the same time the 540,000 people who have contacted the service are increasing our understanding of who is experiencing mental health crises, where there are gaps in services and how we can offer better support. With demand for help rising year by year, especially from young people, Shout is needed now more than ever.”

Lord Ara Darzi.png

PROFESSOR THE LORD DARZI OF DENHAM, OM, KBE, PC, FRS. Co-Director, Institute of Global Health Innovation, Imperial College London

Evidence from the Metropolitan Police Service

Given the stringent nature of the intervention procedure that is in place between Shout and the Metropolitan Police, in accordance with the Investigatory Powers Act, estimating that only 1% of interventions result in a life saved is conservative. Metropolitan Police information shows that for about 1 in 3 interventions in London during the first half of 2022, the texter required medical assistance.

Shout’s clinical review of these particular interventions judged texters to be in a life-threatening situation in at least half of the cases. Many of these cases included texters having taken overdoses.

As such, the actual number of suicides Shout has prevented, and the subsequent savings to the economy, could be much greater.

“Shout has helped me keep myself going when I didn't want to be here anymore. I have accessed Shout countless times and can honestly say it has saved my life.”

Feedback from teenage female texter

Jack's story

12-year-old Jack (not real name) started experiencing severe anxiety during the Covid-19 pandemic. He spent more time on his own, no longer connecting with his friends and struggling with online schooling. He became anxious about the future and things had become so difficult for him that, one evening, he decided to end his life. That night, in a pivotal moment while standing on a bridge, Jack texted Shout.

Jack's parent said: “The volunteer who responded to Jack that night guided him to a calmer place, working with him to stop, take stock, and find the courage to phone the emergency services, who came and helped him.”