Suicidal thoughts? Therapy-oriented website can help

Mental health researchers behind the website nowmattersnow.org 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 site compared to a few minutes on the website. Nearly one-third were significantly less suicidal, and the intensity of their negative emotions had also decreased. Results 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 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.

"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 relatable experiences on suicide and negative emotions 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 she wanted any research she and her colleagues were doing to be 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 the 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, with Kaiser Permanente Washington Health Research Institute, said the website gives healthcare providers a resource for their patients.

"The vast majority of people who die by suicide never receive specialized mental health care," she 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—have no relevant training and lack immediate resources to support patients.