Online suicide risk screening and intervention with college students: a pilot randomized controlled trial.

OBJECTIVE This pilot randomized controlled trial examined the effect of an online intervention for college students at risk for suicide, Electronic Bridge to Mental Health Services (eBridge), which included personalized feedback and optional online counseling delivered in accordance with motivational interviewing principles. Primary outcomes were readiness to seek information or talk with family and friends about mental health treatment, readiness to seek mental health treatment, and actual treatment linkage. METHOD Participants were 76 college students (45 women, 31 men; mean age = 22.9 years, SD = 5.0 years) at a large public university who screened positive for suicide risk, defined by at least 2 of the following: suicidal thoughts, history of suicide attempt, depression, and alcohol abuse. Racial/ethnic self-identifications were primarily Caucasian (n = 54) and Asian (n = 21). Students were randomized to eBridge or the control condition (personalized feedback only, offered in plain report format). Outcomes were measured at 2-month follow-up. RESULTS Despite relatively modest engagement in online counseling (29% of students posted ≥1 message), students assigned to eBridge reported significantly higher readiness for help-seeking scores, especially readiness to talk to family, talk to friends, and see a mental health professional. Students assigned to eBridge also reported lower stigma levels and were more likely to link to mental health treatment. CONCLUSIONS Findings suggest that offering students personalized feedback and the option of online counseling, using motivational interviewing principles, has a positive impact on students' readiness to consider and engage in mental health treatment. Further research is warranted to determine the robustness of this effect, the mechanism by which improved readiness and treatment linkage occurs, and the longer term impact on student mental health outcomes.

[1]  D. Lamis,et al.  Alcohol use, depressive symptoms, and impulsivity as risk factors for suicide proneness among college students. , 2013, Journal of affective disorders.

[2]  K. Zivin,et al.  Mental Health Service Utilization Among College Students in the United States , 2011, The Journal of nervous and mental disease.

[3]  Shanna E. Smith,et al.  New data on the nature of suicidal crises in college students: Shifting the paradigm. , 2009 .

[4]  Daniel Eisenberg,et al.  Stigma and Help Seeking for Mental Health Among College Students , 2009, Medical care research and review : MCRR.

[5]  Bethany A. Koestner,et al.  An Interactive Web-Based Method of Outreach to College Students at Risk for Suicide , 2008, Journal of American college health : J of ACH.

[6]  Daniel Eisenberg,et al.  Help-Seeking and Access to Mental Health Care in a University Student Population , 2007, Medical care.

[7]  W. Schlenger,et al.  Alcohol use disorders and the use of treatment services among college-age young adults. , 2007, Psychiatric services.

[8]  R. Kessler,et al.  A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R) , 2006, Psychological Medicine.

[9]  D. Hallfors,et al.  Feasibility of screening adolescents for suicide risk in "real-world" high school settings. , 2006, American journal of public health.

[10]  J. Schiffman,et al.  Performance of alcohol and safer sex change rulers compared with readiness to change questionnaires. , 2005, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[11]  M. Silverman,et al.  Aspects of suicidal behavior, depression, and treatment in college students: results from the spring 2000 national college health assessment survey. , 2005, Suicide & life-threatening behavior.

[12]  R. Kessler.  GENDER DIFFERENCES IN MENTAL DISORDERS IN THE U.S. NATIONAL COMORBIDITY SURVEY , 2004 .

[13]  Ronald Gangnon,et al.  Validity of the alcohol use disorders identification test in college students. , 2004, Alcoholism, clinical and experimental research.

[14]  Olga V. Demler,et al.  The US National Comorbidity Survey Replication (NCS‐R): design and field procedures , 2004, International journal of methods in psychiatric research.

[15]  H. Möller,et al.  Use of brief depression screening tools in primary care: consideration of heterogeneity in performance in different patient groups. , 2004, General hospital psychiatry.

[16]  純子 大森.  Health Belief: 概念分析 , 2004 .

[17]  R. Spitzer,et al.  The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener , 2003, Medical care.

[18]  R. Spitzer,et al.  Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. , 1999, JAMA.

[19]  M. Silverman,et al.  The Big Ten Student Suicide Study : A 10-Year Study of Suicides on Midwestern Unitersity Campuses , 2010 .

[20]  O. Aasland,et al.  Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. , 1993, Addiction.

[21]  Bruce G. Link,et al.  A modified labeling theory approach to mental disorders : an empirical assessment , 1989 .

[22]  Patient Health , 1964 .

[23]  C. Skinner,et al.  The health belief model. , 2008 .

[24]  B. Kable.  Mental health. , 2005, Australian family physician.

[25]  R. P. Gallagher,et al.  National Survey of Counseling Center Directors 2002 , 2001 .

[26]  W. Miller,et al.  Motivational Interviewing: Preparing People to Change Addictive Behavior , 1991 .