Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 16, 2025
Open Peer Review Period: Jan 16, 2025 - Mar 13, 2025
Date Accepted: Aug 19, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
What Worked? Understanding the Reasons for Reductions in Suicidal Thoughts and Negative Emotions After Visiting NowMattersNow.org
ABSTRACT
Background:
As individuals experiencing suicidal thoughts increasingly turn to the internet for support, digital tools offer a scalable and accessible means to address this urgent need. Platforms like NowMattersNow.org, grounded in Dialectical Behavior Therapy (DBT) principles, have demonstrated reductions in suicidal ideation and negative emotions, suggesting the potential of web-based interventions in suicide prevention. However, further investigation is needed to identify which features of the website contribute most effectively to these outcomes.
Objective:
This study examines the impact of NowMattersNow.org, a web-based resource providing Dialectical Behavior Therapy-based skills and personal stories, on reducing suicidal thoughts and negative emotions in users. The goal was to identify reasons for these reductions and evaluate the resource’s effectiveness as online self-help.
Methods:
Data were collected from 3,185 respondents who completed a 7-item retrospective survey measuring changes in suicidal ideation and emotional distress. The survey, triggered after a preset time on the site, used a 1-5 scale to measure 'Intensity of suicidal thoughts' and 'Intensity of negative emotions' at baseline and post-visit. Longitudinal regression analyses evaluated the statistical significance of changes in these measures, while cross-tabulation identified reasons users found the site helpful.
Results:
Respondents reported a 0.5-point reduction in suicidal ideation (average 3.0 to 2.5) and a 0.62-point reduction in negative emotions (3.66 to 3.04). Among those with high baseline suicidal thoughts, 54.1% improved after viewing. LGBTQI individuals, those with substance use issues, and users reporting unusual experiences showed greater improvements compared to other groups. The most frequently cited reasons for improvement included “It distracted me,” “I felt less alone,” and “I learned something.”
Conclusions:
The findings suggest that NowMattersNow.org is an accessible, scalable digital intervention that shows promise for reducing suicidal ideation and emotional distress, particularly in vulnerable populations. Key elements, such as fostering social connectedness, distraction, and educational content, appear to be critical components of its effectiveness, indicating that web-based self-help tools like NowMattersNow.org can provide short-term management of suicidal thoughts and negative emotions. Clinical Trial: NA
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