Suicidal thoughts? Therapy-oriented website might help reduces self-harm feelings among nearly one-third of visitors, researchers found.

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Mental health researchers behind have demonstrated that the site could be beneficial in decreasing suicidal thoughts.

Researchers asked more than 3,000 website visitors how they felt before they got to the website compared with after a few minutes after arriving. Nearly one-third were significantly less suicidal, and the intensity of their negative emotions had also decreased. Findings were published in the Journal of Medical Internet Research, an open-access publication.

Lead author Ursula Whiteside, a clinical psychologist at the University of Washington (UW) School of Medicine, said the results offer hope for people struggling to cope. The site exposes visitors to dialectical behavioral therapy (DBT), a form of psychotherapy that combines behavioral science and Buddhist principles on mindfulness and acceptance. It was developed by UW psychology professor Marsha Linehan.

Ursula Whiteside
Ursula Whiteside is a psychologist in the UW Department of Psychiatry.

“We set out to build a free resource based not only in science but also with the voices and stories of people who had experienced suicidal thoughts,” Whiteside said. “We wanted clinicians to feel empowered to help those who are struggling.”

The home page presents a panel of video-linked images of individuals with lived experience  and resources to explore DBT skills.

The site was launched in 2014 on Sept. 10, World Suicide Prevention Day, and had more than 250,000 unique visitors as of December 2018. Site funding came from the National Institute of Mental Health and the American Foundation of Suicide Prevention. Whiteside said one website priority was to make new research accessible right away, since the public has little access to DBT therapy.

The survey of users was conducted from March 5, 2015, and Dec. 3, 2017. Of the 3,670 unique survey responses, 514 (14% of survey sample) identified as men ages 36 to 64; 460 (13%) identified as mental health professionals and 308 (8%) as other healthcare professionals, with 40 (1%) identifying as both.

Users were asked to rate their suicidal thoughts or negative feelings on a scale of 1-5 (5 being the most suicidal or negative).  More than 70% of survey respondents recalled having some suicidal thoughts when they arrived at the website. Of those who reported suicidal thoughts (2,644) at baseline, 29% reported a reduction of one point or more in suicidal thoughts during a site visit. The vast majority, 63%, experienced no change, and 8% rated suicidal thoughts 1 or more points worse. Of those who reported worse scores after the visit, 2% were more than one point worse 1% (N = 21) were 3 or 4 points worse.

Researchers found that significant reductions in suicidal thoughts and negative emotions were consistent across subgroups, including middle-aged men, who represent 38% of all suicides. However, reductions for middle- age men were not as large as that of the rest of the sample; therefore the website could be more tailored toward men, researchers wrote.

Co-author Julie Richards, a fourth-year doctoral student in the University of Washington Department of Health Services and a researcher with Kaiser Permanente Washington Health Research Institute, said the website gives healthcare providers a resource for their patients.

"Most people who die by suicide never receive specialized mental health care, so online tools are helpful for providing resources to patients experiencing emotional pain when they are needed,” Richards said.

Researchers noted that nearly half of all people who die by suicide in the United States see some type of healthcare provider in the month before their death.  They said newly released screening and care guidelines have the potential to increase the number of suicidal patients detected in healthcare settings. Unfortunately, they said, most providers – particularly those in primary-care settings, where the majority of patients are seen before death by suicide – lack relevant training and immediate resources to support patients.

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Tags:suicidepsychiatry & behavioral healthdepressionbehavioral therapypsychology

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