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. 2019 Apr 2;6(4):e11521.
doi: 10.2196/11521.

Service Use History of Individuals Enrolling in a Web-Based Suicidal Ideation Treatment Trial: Analysis of Baseline Data

Quincy Jj Wong  1   2 , Aliza Werner-Seidler  1 , Michelle Torok  1 , Bregje van Spijker  3 , Alison L Calear  3 , Helen Christensen  1
Affiliations

Service Use History of Individuals Enrolling in a Web-Based Suicidal Ideation Treatment Trial: Analysis of Baseline Data

Quincy Jj Wong et al. JMIR Ment Health. .

Abstract

Background: A significant recent innovation is the development of internet-based psychological treatments for suicidal thinking. However, we know very little about individuals experiencing suicidal ideation who seek help through Web-based services and, in particular, their previous health service use patterns.

Objective: We aimed to examine service use history and its correlates among adults experiencing suicidal ideation who enrolled in a Web-based suicidal ideation treatment trial.

Methods: We used baseline data of 418 individuals seeking Web-based treatment for their suicidal ideation recruited into a randomized controlled trial of a 6-week Web-based self-help program. Participants at preintervention reported demographic information, clinical characteristics, and health service use over the previous 6 months.

Results: Participants had a high rate of service use in the 6 months before enrolling in the treatment trial (404/418, 96.7% of participants had contact with services). The two most common contact points were general practitioners (385/418, 92.1% of participants) and mental health professionals (295/418, 70.6% of participants). Notably, those with a previous single suicide attempt had lower odds of contact with any service than those with no attempt (odds ratio [OR] 0.21, 95% CI 0.05-0.86; P=.03). Those living in rural or remote areas had lower odds of contacting general practitioners (OR 0.35, 95% CI 0.13-0.91; P=.03) or mental health professionals (OR 0.44, 95% CI 0.23-0.83; P=.01) than those living in metropolitan areas.

Conclusions: Individuals enrolling in an electronic health intervention trial have often received treatment from general practitioners or mental health professionals. These services can therefore play an important role in preventing the escalation of suicidal thinking. Enrollment in our Web-based treatment trial suggested, though, that face-to-face health services may not be enough. Our study also highlighted the need to improve the provision of coordinated and assertive care after a suicide attempt, as well as health service availability and utilization for those living in rural and remote areas.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12613000410752; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364016 (Archived by WebCite at http://www.webcitation.org/6vK5FvQXy); Universal Trial Number U1111-1141-6595.

Keywords: facilities and services utilization; health service; internet; service use; suicidal ideation; suicide; suicide, attempted; telehealth; treatment.

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Conflict of interest statement

Conflicts of Interest: BvS is an author of the original Dutch Web-based suicidal ideation program referred to in this paper. BvS is also an author of, and receives royalties from, an adapted paper version of the program (van Spijken B, Kerkhof A. Piekeren Over Zelfdoding. Amsterdam: Boom; 2012). BvS and HC are authors of the English translation of the Web-based program used in the Healthy Thinking Trial referred to in this paper. The remaining authors declare no conflicts of interest.

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