title: The safety and acceptability of delivering an online intervention to secondary students at risk of suicide: findings from a pilot study.
abstract: BACKGROUND
  Suicide-related behaviour is a major problem among adolescents. Yet relatively few studies have tested the efficacy, acceptability and safety of interventions for this population. We developed and pilot tested an online intervention for at-risk school students, which has led to reduced suicidal ideation, hopelessness and depressive symptoms. The aims of this study were to examine the safety and acceptability of the programme, and to determine which components were found to be most helpful and enjoyable.
  
  
  METHODS
  This pilot study employed a pre-test/post-test design, with an 8-week intervention phase. Participants were assessed immediately before, and immediately after the intervention. Participants were also asked to complete a weekly questionnaire immediately after the intervention, and again 2 days later assessing suicidal ideation and distress.
  
  
  RESULTS
  Twenty-one young people completed the intervention. Overall, the intervention did not lead to increases in suicidal ideation or distress. Participants reported enjoying the programme, in particular watching the video diaries and completing the activities, and said they would recommend the programme to a friend. Overall, the cognitive components of the programme were found to be most helpful.
  
  
  CONCLUSIONS
  Overall, the programme appeared to be a safe and acceptable intervention for at-risk adolescents. This was a small, pilot study so we need to interpret the results with caution. However, the findings are promising and suggest that young people at risk of suicide can safely be included in trials as long as adequate safety procedures are in place. The programme is now being tested in a randomized controlled trial.
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Jo
authors.initials: J
authors.lastname: Robinson
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Sarah
authors.identifier: http://orcid.org/0000-0003-2532-0142
authors.initials: S
authors.lastname: Hetrick
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Georgina
authors.initials: G
authors.lastname: Cox
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bendall
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.|Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Yung
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Pirkis
mesh_terms: D000293:Adolescent; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D012574:Schools; D013334:Students / Q000523:psychology*; D059020:Suicidal Ideation; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D000092864:Suicide Prevention
keywords: adolescents; cognitive behavioural therapy; iatrogenic; internet; suicidal ideation