E-Health Interventions for Suicide Prevention

Abstract

Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals’ posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.

Web-Based Cognitive Behavioral Therapy Intervention for the Prevention of Suicidal Ideation in Medical Interns

“…Specifically, web-based tools have important benefits over in-person treatment that correspond to the identified barriers to mental health care for physicians including: 1) enhanced confidentiality; 2) low cost; 3) easy accessibility; 4) flexibility in timing of access; and 5) self-management tools 5, 14-16 . To date, five randomized controlled trials have demonstrated a reduction in suicidal thoughts among adult individuals in the general population and primary care settings using web-based cognitive behavioral therapy programs 17 . Recent work has also demonstrated the efficacy of web-based preventative interventions for populations at high risk for mental health problems 18,19-20 , but this preventative approach has not yet been tested in training physicians.…”

Improved Designs for Cluster Randomized Trials

“…There is increasing interest in the use of digital technologies to deliver behavioral and mental health interventions, owing to their low delivery costs and tailorability (11,19,57). Strategies such as fractional factorial designs should be more widely considered for such studies because the technology can easily facilitate control over the combination of intervention components delivered.…”

Suicide prevention strategies: Which one to consider?

“…Internet can be used to self-screening as well as to report to the psychiatric services providers that ultimately reduces the suicidality and further attempts. 39 Both guided & unguided web applications can be used to intervene the suicide. 39,40 Another approach to indentify the risky people by assessing the social media contents such as status updates, posts, comments those are indicative of mental disorders or suicidal ideation.…”

“…39,40 Another approach to indentify the risky people by assessing the social media contents such as status updates, posts, comments those are indicative of mental disorders or suicidal ideation. 39,40 Web-based video and podcasting, outreach communications via e-mail, smartphones applications, computer and web-based gaming, text analysis and so forth strategy can be implemented to identify the risky person and to direct them to the services providers. 40 …”