Online self-help for suicidal thoughts: 3-month follow-up results and participant evaluation

Background: As a substantial proportion of people with suicidal thoughts does not receive treatment, the internet can be a utilized to reach more people who need support. Aims: To examine maintenance of effects of online self-help for suicidal thoughts at 3-month follow-up within the intervention group of a randomized controlled trial (of which between-group 6-week post-test results have previously been reported, showing a small effect of 0.28 for suicidal thoughts in favour of the intervention group), and to investigate acceptability of the intervention through participant evaluation. Methods: 236 adults with mild to moderate suicidal thoughts were randomized to the intervention (n = 116) or a waitlist control group (n = 120). Assessments took place at baseline, post-test (6 weeks later), and follow-up (3 months after post-test). This paper reports on the intervention group and follow-up assessment only. Results: Effects established at 6-week post-test were generally maintained at 3-month follow-up in the intervention group. Participant evaluation revealed that a majority thought their suicidal thoughts had decreased during the study, that adherence to the intervention was below average, and that levels of satisfaction were acceptable. Limitations: The control group could not serve as a comparator as they had received access to the intervention at post-test. Conclusions: Effects of online self-help for suicidal thoughts can be maintained for up to three months. Participant evaluation indicated that online self-help for suicidal thoughts is acceptable, but there is also room for improvement

The online treatment of suicidal ideation:A randomised controlled trial of an unguided web-based intervention

Suicide is a major public health issue, and treatment of suicidal thoughts may contribute to its prevention. Provision of online treatment of suicidal ideation may reduce barriers that suicidal individuals experience in face-to-face treatment. We therefore aimed at evaluating the effectiveness of a web-based intervention targeting a reduction of suicidal ideation. We carried out a two-arm, parallel-design, randomised controlled trial in the general population in Flanders (Belgium) (registered as NCT03209544). Participants who were 18 years or older and experienced suicidal ideation were included. The intervention group (n = 365) received access to the unguided web-based intervention, and the control group (n = 359) was placed on a waitlist. Assessments were carried out at baseline and at 6 and 12 weeks. Participants reported high levels of suicidal ideation, depression, hopelessness, worrying, and anxiety at baseline. Compared to the control group, participants in the intervention group experienced a significant decline in suicidal ideation, depression, hopelessness, worrying, and anxiety both at post-test and at follow-up. An important limitation of the study was a high dropout rate, in particular in the intervention group. Our findings suggest that the online self-help intervention was more effective in reducing suicidal ideation and suicide-related symptoms than a waitlist control in a severely affected population. It can help in filling the gap between crisis help and face-to-face treatment

Effectiveness of a web-based self-help program for suicidal thinking in an australian community sample:Randomized controlled trial

Background: Treatment for suicidality can be delivered online, but evidence for its effectiveness is needed. Objective: The goal of our study was to examine the effectiveness of an online self-help intervention for suicidal thinking compared to an attention-matched control program. Methods: A 2-arm randomized controlled trial was conducted with assessment at postintervention, 6, and, 12 months. Through media and community advertizing, 418 suicidal adults were recruited to an online portal and were delivered the intervention program (Living with Deadly Thoughts) or a control program (Living Well). The primary outcome was severity of suicidal thinking, assessed using the Columbia Suicide Severity Rating Scale. Results: Intention-to-treat analyses showed significant reductions in the severity of suicidal thinking at postintervention, 6, and 12 months. However, no overall group differences were found. Conclusions: Living with Deadly Thoughts was of no greater effectiveness than the control group. Further investigation into the conditions under which this program may be beneficial is now needed. Limitations of this trial include it being underpowered given the effect size ultimately observed, a high attrition rate, and the inability of determining suicide deaths or of verifying self-reported suicide attempts