Using Information and Communication Technologies to Prevent Suicide Among Secondary School Students in Two Regions of Chile: A Randomized Controlled Trial

Abstract

Background: There is an increasing concern for addressing suicide among adolescents in Latin America. Recent mental health policies encourage the development and implementation of preventive interventions for suicide. Such initiatives, however, have been scarcely developed, even in countries with solid mental health services such as Chile. The use of information and communications technology (ICT) might contribute to create accessible, engaging, and innovative platforms to promote well-being and support for adolescents with mental health needs and suicide risk.Objective: To evaluate a program based on ICT to prevent suicide and enhance mental health among adolescents in Chile. Method: A cluster randomized controlled trial (RCT) will be conducted including 428 high-school students aged 18–14 years in two regions of Chile. Study procedures will take place as follows: (1) design of the intervention model and creation of prototype; (2) selection and randomization of the participating public schools; (3) implementation of the 3-month intervention and evaluation at baseline, post-intervention period, and a 2-month follow-up. Suicidal ideation at the 2-month follow up is the primary outcome in this study. Secondary outcomes include negative psychological outcomes (e.g., stigma, depression, anxiety) as well as a number of protective psychological and social factors. Indicators regarding the study implementation will be also gathered. Discussion: Here we describe a novel program based on technological devices and aimed to target youth suicide in Chile. This is the first clinical trial of such a program in Latin America, and to our knowledge, the first of its kind in any middle income country.Trial Registration: gov Identifier: NCT03514004

Improving Mental Health Care in Developing Countries Through Digital Technologies: A Mini Narrative Review of the Chilean Case

“…The Mascayano et al (34) project aims to develop and evaluate an online intervention for preventing suicide and improving mental health among adolescents. The program uses a web-based platform and a mobile application to cultivate a virtual community.…”

Experts by Experience: Qualitative Evaluation of Adolescent Participation in the Development of a Technological Intervention to Prevent Youth Suicide in Chile

“…The interventions' features range from traditional suicide prevention strategies (e.g., chat and phone line with trained mental health professionals and short articles with evidence-based information and tips), which seek to reduce the mental health access barriers, to more novel components (e.g., forums, a central “wall” to post anonymously, the creation of avatars instead of using photographs) that are focused on facilitating interactions between participants and encouraging their sense of belonging. Further details about the project and trial, which was the first of its kind in Latin America, can be found in Mascayano et al ( 30 ).…”

Empowering Families to Address Suicide in Rural Colombia

“…A growing body of literature documents the relationship between suicide and socioeconomic variables, such as poverty, financial crisis, and unemployment (Bantjes et al, 2016; Chan, 2013; Coope et al, 2014; Fliege et al, 2009; Haw et al, 2015; Platt, 2011). In addition, literature documents that one of the major factors that increase suicide rates in small and rural regions is the gap between the population in need and the limited availability to public health services in critical times (Mascayano et al, 2018). Access to public mental health services in Quindío occurs mainly through primary public health care clinics or urgent care at the major public hospitals.…”

“…Suicide prevention strategies that are developed and implemented in high-income countries cannot be implemented on a large scale in LMICs, such as Latin America countries, without local adaptation (Mascayano et al, 2018; Zalsman et al, 2016). Given the vast geographic, cultural, and historical differences in Colombia, the suicide prevention programs should be designed with a regional approach.…”

“…Strategies to prevent suicide require tailoring measures to the cultural and social context of each region. The inclusion of evidence-based information, practices, and interventions with a comprehensive approach is crucial for the process of developing prevention plans (Mascayano et al, 2018). In addition to effective suicide prevention strategies, the local health care and mental health professionals, families, people bereaved by suicide, religious leaders, educators, police, and local governments must be included in the development and implementation phases of these plans (Mishara, 2009; WHO, 2016).…”