Beneficial and harmful effects of educative suicide prevention websites: randomised controlled trial exploring Papageno <i>v</i>. Werther effects.

Abstract

<b>Background</b>Suicide prevention organisations frequently use websites to educate the public, but evaluations of these websites are lacking.<b>Aims</b>To examine the effects of educative websites and the moderating effect of participant vulnerability.<b>Method</b>A total of 161 adults were randomised to either view an educative website on suicide prevention or an unrelated website in a single-blinded randomised controlled trial (trial registration with the American Economic Association's registry: RCT-ID: 000924). The primary outcome was suicidal ideation; secondary outcomes were mood, suicide-prevention-related knowledge and attitudes towards suicide/seeking professional help. Data were collected using questionnaires before (<i>T</i>₁), immediately after exposure (<i>T</i>₂), and 1 week after exposure (<i>T</i>₃) and analysed using linear mixed models.<b>Results</b>No significant intervention effect was identified for the entire intervention group with regard to suicidal ideation, but a significant and sustained increase in suicide-prevention-related knowledge (<i>T</i>₃<i>v</i><i>T</i>₁<i>P</i> < 0.001, <i>d</i> = 1.12, 95% CI 0.96 to 1.28) and a non-sustained worsening of mood (<i>P</i> < 0.001, <i>T</i>₂<i>v</i><i>T</i>₁, <i>d</i> = -0.59, -0.75 to -0.43) were observed. Participants with increased vulnerability experienced a partially sustained reduction of suicidal ideation (<i>T</i>₃<i>v</i><i>T</i>₁, <i>P</i> <0.001, <i>d</i> = -0.34, -0.50 to -0.19).<b>Conclusions</b>Educative professional suicide prevention websites appeared to increase suicide-prevention-related knowledge, and among vulnerable individuals website exposure may be associated with a reduction of suicidal ideation.