title: Reducing suicidal thoughts in the Australian general population through web-based self-help: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Suicidal thoughts are common in the general population, causing significant disability. However, a substantial number of people struggling with suicidality do not access appropriate services. Online self-help may help overcome barriers to help-seeking. This study aims to examine the effectiveness of an online self-help program targeted at reducing suicidal thoughts compared with an attention-matched control condition in the Australian adult population. This trial is based on a Dutch self-help program, which was found to be effective in reducing suicidal thoughts.
  
  
  METHODS
  A total of 570 community-dwelling adults (18 to 65 years old) with suicidal thoughts will be recruited via various media and randomly assigned to the 6-week online program aimed at reducing suicidal thoughts or a 6-week attention-matched control program. Primary outcome measure is the severity of suicidal thoughts. Secondary outcome measures include suicide plans, capacity to cope with suicidal thoughts, reasons for living, symptoms of depression, hopelessness, anxiety/worry, rumination, panic, perceived burdensomeness and thwarted belongingness, acquired capability, alcohol consumption, insomnia, and various cost-effectiveness measures.
  
  
  CONCLUSIONS
  Although the original Dutch trial found web-based self-help to be effective in reducing suicidal thoughts, randomized controlled trials (RCT) of online programs for suicidal thoughts are rare. The present study extends previous research by running the first English language RCT of this sort. As a result of the original study, the current RCT includes refinements to the design, including greater levels of participant anonymity and longer follow-up periods. Limitations of this trial include the potential for high drop-out and the inability to ascertain whether any suicides occur during the study.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry (ANZCTR) Registration number: ACTRN12613000410752 (15 April 2013). Universal Trial Number (UTN): U1111-1141-6595 (15 April 2013).
authors.affiliation: National Institute for Mental Health Research, The Australian National University, Building 63, Canberra, ACT, 2601, Australia. Bregje.vanspijker@anu.edu.au.|Black Dog Institute, The University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick, NSW, 2031, Australia. Bregje.vanspijker@anu.edu.au.
authors.forename: Bregje A J
authors.initials: BA
authors.lastname: van Spijker
authors.affiliation: National Institute for Mental Health Research, The Australian National University, Building 63, Canberra, ACT, 2601, Australia. Alison.Calear@anu.edu.au.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Calear
authors.affiliation: National Institute for Mental Health Research, The Australian National University, Building 63, Canberra, ACT, 2601, Australia. Philip.Batterham@anu.edu.au.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Batterham
authors.affiliation: Orygen Youth Health Research Centre, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia. Andrew.Mackinnon@unimelb.edu.au.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Mackinnon
authors.affiliation: National Institute for Mental Health Research, The Australian National University, Building 63, Canberra, ACT, 2601, Australia. John.Gosling@anu.edu.au.
authors.forename: John A
authors.initials: JA
authors.lastname: Gosling
authors.affiliation: Department of Clinical Psychology and the EMGO Institute for Health and Care Research, Faculty of Psychology and Education, VU University Amsterdam, van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands. Ajfm.Kerkhof@vu.nl.
authors.forename: Ad J F M
authors.initials: AJ
authors.lastname: Kerkhof
authors.affiliation: Black Dog Institute, The University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick, NSW, 2031, Australia. D.Solomon@blackdog.org.au.
authors.forename: Daniela
authors.initials: D
authors.lastname: Solomon
authors.affiliation: Black Dog Institute, The University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick, NSW, 2031, Australia. H.Christensen@blackdog.org.au.
authors.forename: Helen
authors.initials: H
authors.lastname: Christensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D006801:Humans; D020407:Internet; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018401:Sample Size; D012657:Self-Help Groups; D059020:Suicidal Ideation; D000092864:Suicide Prevention