Effectiveness of Online Self-Help for Suicidal Thoughts : Results of a Randomised Controlled Trial

Background: Many people with suicidal thoughts do not receive treatment. The Internet can be used to reach more people in need of support. Objective: To test the effectiveness of unguided online self-help to reduce suicidal thoughts. Method: 236 adults with mild to moderate suicidal thoughts were randomised to the intervention (n = 116) or a waitlist control group (n = 120). Assessments took place at baseline, and 2, 4 and 6 weeks later. Primary outcome was suicidal thoughts. Secondary outcomes were depressive symptoms, anxiety, hopelessness, worry, and health status. Results: The intervention group showed a small significant effect in reducing suicidal thoughts (d = 0.28). Effects were more pronounced for those with a history of repeated suicide attempts. There was also a significant reduction in worry (d = 0.33). All other secondary outcomes showed small but non-significant improvements. Conclusions: Although effect sizes were small, the reach of the internet could enable this intervention to help many people reduce their suicidal thoughts. Trial Registration: Netherlands Trial Register NTR1689 Citation: van Spijker BAJ, van Straten A, Kerkhof AJFM (2014) Effectiveness of Online Self-Help for Suicidal Thoughts: Results of a Randomised Controlled Trial. PLoS ONE 9(2): e90118. doi:10.1371/journal.pone.0090118 Editor: Hamid Reza Baradaran, Iran University of Medical Sciences, Iran (Republic of Islamic) Received September 8, 2013; Accepted January 24, 2014; Published February 27, 2014 Copyright: 2014 van Spijker et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This study was funded by the Netherlands Organisation for Health Research and Development (ZonMw), the Hague, project number 120510003. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: BvS, AK and AvS are authors of the web-based treatment program described in this manuscript. BvS and AK receive royalties from an adapted paper version of the self-help program described in this manuscript under the title ‘‘Piekeren over zelfdoding’’ (in Dutch), published by Boom: Amsterdam (2012). This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials. * E-mail: baj.van.spijker@gmail.com