Breaking Down Barriers to a Suicide Prevention Helpline: Protocol for a Web-Based Randomized Controlled Trial.

Area of Science:

• Public Health
• Mental Health Services Research
• Digital Health Interventions

Background:

• Suicide is a leading global cause of death, with men disproportionately affected.
• Individuals experiencing suicidal ideation often face significant barriers to seeking help.
• A Dutch suicide prevention helpline's anonymous self-test reveals high rates of severe suicidal thoughts, yet few users contact the helpline.

Purpose of the Study:

• To evaluate a brief barrier reduction intervention (BRI) integrated into a suicide ideation self-test.
• To determine the BRI's effectiveness in motivating individuals with severe suicidal thoughts to contact a suicide prevention helpline.
• To assess the BRI's impact on service utilization among high-risk groups, including men and middle-aged individuals.

Main Methods:

• A randomized controlled trial involving individuals with severe suicidal thoughts identified via an online self-test.
• Participants were randomized to receive either a tailored BRI or usual care (general advisory text).
• Primary outcome was the use of a direct link to contact the helpline; secondary outcomes included self-reported likelihood of contact and satisfaction.

Main Results:

• A pilot study identified key barriers to helpline contact, including perceived ineffectiveness of counseling, fear of the conversation, and emotional concerns.
• The BRI aims to address these specific barriers with tailored messages.
• The primary outcome measure focuses on the direct uptake of helpline services post-intervention.

Conclusions:

• This study will elucidate the efficacy of a BRI in enhancing suicide prevention helpline engagement.
• A successful BRI could offer a scalable, cost-effective, and feasible strategy for increasing helpline use worldwide.
• Findings may inform the development of digital interventions to support individuals at risk of suicide.