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The Self-help Online against Suicidal thoughts (SOS) trial: study protocol for a randomized controlled trial.

Charlotte Mühlmann1, Trine Madsen2, Carsten Hjorthøj3

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Online self-help interventions can reduce suicidal thoughts for at-risk individuals. The Danish Self-help Online against Suicidal thoughts (SOS) trial investigated this, offering a 6-week internet-based program.

Keywords:
Cognitive behavioral therapyInternet interventionOnline interventionRandomized controlled trialSelf-helpSuicidal ideationSuicidal thoughts

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Area of Science:

  • Psychiatry
  • Digital Health
  • Public Health

Background:

  • Suicidal thoughts affect millions globally, with barriers to accessing support including cost, stigma, and limited treatment options.
  • Online self-help programs offer a potential solution to overcome these barriers.
  • Previous research indicates promising results for online interventions in reducing suicidal ideation.

Purpose of the Study:

  • To evaluate the effectiveness of an online self-help intervention for reducing suicidal thoughts in individuals at risk.
  • To provide a partial replication of a previously conducted Dutch trial.

Main Methods:

  • A randomized, waiting-list controlled trial involving 438 participants recruited via the Danish suicide hotline.
  • Participants were allocated 1:1 to either a 6-week internet-based self-help intervention or a 32-week waiting-list control group.
  • Primary outcomes included the frequency and intensity of suicidal thoughts, with secondary outcomes assessing depression, hopelessness, quality of life, and healthcare costs. Assessments were conducted via online self-report questionnaires at multiple time points.

Main Results:

  • The study is designed to determine if the online intervention leads to significant reductions in suicidal thoughts compared to the control group.
  • Analysis will also examine effects on secondary outcomes and investigate adverse events.

Conclusions:

  • If effective, this study will reinforce the value of online self-help interventions as accessible tools for managing suicidal thoughts.
  • Findings will contribute to evidence-based digital mental health solutions for suicide prevention.