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

Bregje A.J. Van Spijker, Aliza Werner-Seidler, Philip J. Batterham, Andrew Mackinnon, Alison L. Calear, John A. Gosling, Julia Reynolds, Ad J.F.M. Kerkhof, Daniela Solomon, Fiona Shand, Helen Christensen*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalJournal of Medical Internet Research
Volume20
Issue number2
DOIs
Publication statusPublished - 14 Feb 2018

Funding

1Centre for Mental Health Research, Australian National University, Canberra, Australia 2Black Dog Institute, Department of Medicine, University of New South Wales, Randwick, Australia 3EMGO Institute for Health Care Research, VU University Amsterdam, Amsterdam, Netherlands 4Department of Clinical Neuro and Developmental Psychology, VU University Amsterdam, Amsterdam, Netherlands Sincere thanks to Anna Frayne and Kale Dyer, who provided support in the management of the trial. This study was supported by a grant from the Australian National Health and Medical Research Council (NHMRC; GNT1046317) and forms part of the program of research conducted by the NHMRC Centre of Research Excellence in Suicide Prevention (GNT1042580). The funder does not have any role or ultimate authority in the study design; collection, management, analysis, and interpretation of data; writing of the report; or the decision to submit the report for publication. AC is supported by NHMRC Early Career Fellowship 1122544. PB is supported by NHMRC Early Career Fellowship 1083311. HC is supported by NHMRC Fellowship 1056964.

FundersFunder number
Australian National Health and Medical Research Council
Columbia
NHMRC
NHMRC Centre of Research Excellence in Suicide PreventionGNT1042580
National Science Foundation1042580
National Health and Medical Research CouncilGNT1046317, 1122544, 1056964, 1083311

    Keywords

    • Psychosocial interventions
    • Randomized controlled trial
    • Suicide

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