JMIR Publications

ABSTRACT

Background:

Nearly half of people who die by suicide see a healthcare provider in the month before their death. With the recent release of new care guidelines for suicidal patients, detection of suicidal patients will likely increase in health care settings. Providers need access to suicide-specific resources that can be used as part of immediate, brief interventions with a suicidal patient. Online suicide-prevention resources have the potential to address challenges.

Objective:

To describe the rationale and development of the NowMattersNow.org website as resource for individuals with suicidal thoughts, and to evaluate the utility of the site via user experience survey.

Methods:

Launched in 2014, NowMattersNow.org is a video-based free public resource that provides evidence-based teachings, examples, and resources for managing suicidal thoughts and intense emotions focused largely around skills from Dialectical Behavior Therapy. The confidential website was developed to address gaps in access to services for suicidal patients in healthcare systems, not to replace mental health treatment for suicidal individuals. From March 2015 to December 2017, a user experience survey measured self-reported changes on a 1 (not at all) to 5 (completely overwhelming) scale regarding intensity of suicidal thoughts and negative emotions while on the website. Longitudinal regression analyses using generalized estimating equations evaluated the magnitude and statistical significance of user-reported changes in suicidal ideation and negative emotion. In secondary analyses, we evaluated whether user-reported changes varied for specific subgroups, including men age 36-64, healthcare providers, and other health care providers.

Results:

During the period of analysis, there were 138,386 unique website visitors. We analyzed surveys (N=3670) collected during that time, including individuals identifying as men age 36-64 (N=512), mental health providers (N=460), and other healthcare providers (N=308). Twenty-eight percent of survey completers rated their suicidal thoughts as a 5 or “completely overwhelming” when they entered the website. We observed significant reductions in self-reported intensity of suicidal thoughts (-0.21, P < .001) and negative emotions (-0.32, P < .001) overall during a visit to the website, including decreases for users with the most severe suicidal thoughts (-6.4%, P < .001), most severe negative emotions (-10.9%, P < .001), and for middle-aged men (-0.13, P = <.001). Results remained significant after controlling for length of visit to website (prior to the survey) and technology type (mobile, desktop, and tablet).

Conclusions:

Survey respondents reported measurable reductions in intensity of suicidal thoughts and emotions, including users who rated their suicidal thoughts as completely or almost completely overwhelming and among middle-age men. While results from this user-experience survey administered at one point in time to a convenience sample of users must be interpreted with caution, results provide preliminary support for the potential effectiveness of the NowMattersNow.org website as a tool for short-term management of suicidal thoughts and negative emotions.