Clinical trial NCT05458830: Breaking Down Barriers to a Suicide Prevention Helpline
Official title: Breaking Down Barriers to a Suicide Prevention Helpline: a Web-based Randomised Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Suicidal Ideation
Keywords: Barrier reduction intervention
Suicidal ideation
Self-help
Suicide prevention helpline
Randomised controlled trial
Help-seeking
Lead sponsor: 113 Suicide Prevention
Sponsor class: OTHER
First posted: 2022-07-14
Enrollment: 775
Sex: ALL
Minimum age (years): 16
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The study is designed as a randomised controlled trial for the anonymous users of an online self-test for suicidal thoughts in which individuals with severe suicidal thoughts and no interest in contacting the helpline will be randomly allocated either to a short barrier reduction intervention (BRI) or receive a general advisory text (care as usual). To minimise the burden on the high-risk and sensitive study population, the investigators aim that it is feasible to complete the intervention within 10 minutes.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Every month, around four thousand people fill in the anonymous self-test for suicidal thoughts on the website of the Dutch suicide prevention helpline 113 Suicide Prevention. The self-test includes the Suicidal Ideation Attributes Scale (SIDAS) and informs people about the severity of their suicidal thoughts. The vast majority (70%) of people who complete the test score higher than the cut-off point (≥ 21) for severe suicidal thoughts. Despite this, only around 10% of test-takers navigate to the webpage about contacting the helpline.

In this study the investigators test an intervention that aims to reduce barriers to contacting the helpline via chat or phone. People with severe suicidal thoughts and little motivation to contact the helpline will be randomly allocated either to a brief Barrier Reduction Intervention (BRI) or care as usual, a plain advisory text.

The aim of our study is two-fold: (i) to measure the effectiveness of a brief barrier reduction intervention (BRI) in the self-test motivating people with severe suicidal thoughts to contact the helpline, and (ii) to specifically evaluate the effectiveness of the intervention in increasing service utilisation by high-risk groups for suicide such as men and people of middle age.

Detailed description: Research suggests that people with suicidal thoughts often do not seek help, making them invisible for preventive measures and targeted support. Anonymous online help can be a low-threshold first step towards professional face-to-face help. In the Netherlands, the suicide prevention organisation '113 Suicide Prevention' provides around-the-clock anonymous support by phone and chat, as well as an online self-help course, self-assessment tests and brief online coaching and therapy. Apart from the homepage, the 'test yourself' page is the most visited section of the helpline's website. Every month, more than 4,000 people fill in the anonymous self-test for suicidal thoughts. This self-test includes the Suicidal Ideation Attributes Scale (SIDAS) and informs the test-taker of the severity of their suicidal thoughts. Although the vast majority of people who complete the test score higher than the cut-off point for severe suicidal thoughts, only approximately 10% of test-takers go on to navigate to the web-page about contacting the helpline. And although due to the anonymity of the helpline's services it is not possible to know if people follow up the advice of contacting the helpline, the difference in demographic distributions between the users of the self-test and the crisis helpline confirms the assumption that a substantial group does not continue using helpline service. While the percentage of men among the self-test users is 40%, it is only around 25% among the users of the helpline.

The study is designed as a randomised controlled trial for the anonymous users of an online self-test for suicidal thoughts in which individuals with severe suicidal thoughts and no interest in contacting the helpline will be randomly allocated either to a short barrier reduction intervention (BRI) or receive a general advisory text (care as usual). To minimise the burden on our high-risk and sensitive study population, the investigators aim that it is feasible for the participants to complete the intervention within 10 minutes.

The aim of our study is two-fold: (i) to measure the effectiveness of a brief barrier reduction intervention (BRI) in the self-test motivating people with severe suicidal thoughts to contact the helpline, and (ii) to specifically evaluate the effectiveness of the intervention in increasing service utilisation by high-risk groups for suicide such as men and people of middle age.

Eligibility criteria: Exclusion Criteria:

* participant is younger than 16 years old.
* participant scores below the cut-off point for severe suicidal thoughts (SIDAS score \< 21).
* participant scores above the cut-off point for severe suicidal thoughts (SIDAS score ≥ 21) and reports being likely to contact the suicide prevention helpline. They will be directly transferred to the contact details of the helpline.

Primary outcomes:
measure: The use of a direct link to the helpline
timeFrame: immediately after intervention
Secondary outcomes:
measure: Self-reported likelihood of contacting the helpline
timeFrame: immediately after intervention
Other outcomes:
measure: Severity of suicidal thoughts: Suicidal Ideation Attributes Scale (SIDAS)
timeFrame: Baseline measurement
measure: Gender
timeFrame: Baseline measurement
measure: Age group
timeFrame: Baseline measurement
measure: Receiving treatment for mental health problems
timeFrame: Baseline measurement
measure: Satisfaction with the self-test
timeFrame: immediately after intervention
Locations:
city: Amsterdam
country: Netherlands
facility: 113 Suicide Prevention
Study officials:
affiliation: 113 Suicide Prevention
name: Saskia Mérelle
role: PRINCIPAL_INVESTIGATOR
References: