Effectiveness of online self-help for suicidal thoughts: results of a randomised controlled trial

PLoS One. 2014 Feb 27;9(2):e90118. doi: 10.1371/journal.pone.0090118. eCollection 2014.


Background: Many people with suicidal thoughts do not receive treatment. The Internet can be used to reach more people in need of support.

Objective: To test the effectiveness of unguided online self-help to reduce suicidal thoughts.

Method: 236 adults with mild to moderate suicidal thoughts were randomised to the intervention (n=116) or a waitlist control group (n=120). Assessments took place at baseline, and 2, 4 and 6 weeks later. Primary outcome was suicidal thoughts. Secondary outcomes were depressive symptoms, anxiety, hopelessness, worry, and health status.

Results: The intervention group showed a small significant effect in reducing suicidal thoughts (d=0.28). Effects were more pronounced for those with a history of repeated suicide attempts. There was also a significant reduction in worry (d=0.33). All other secondary outcomes showed small but non-significant improvements.

Conclusions: Although effect sizes were small, the reach of the internet could enable this intervention to help many people reduce their suicidal thoughts.

Trial registration: Netherlands Trial Register NTR1689.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy
  • Female
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Suicidal Ideation*
  • Therapy, Computer-Assisted
  • Treatment Outcome
  • Young Adult

Associated data

  • NTR/NTR1689

Grant support

This study was funded by the Netherlands Organisation for Health Research and Development (ZonMw), the Hague, project number 120510003. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.