title: Suicide prevention through online gatekeeping using search advertising techniques: a feasibility study.
abstract: BACKGROUND
  Nurturing gatekeepers is an effective suicide prevention strategy. Internet-based methods to screen those at high risk of suicide have been developed in recent years but have not been used for online gatekeeping.
  
  
  OBJECTIVE
  A preliminary study was conducted to examine the feasibility and effects of online gatekeeping.
  
  
  METHODS
  Advertisements to promote e-mail psychological consultation service use among Internet users were placed on web pages identified by searches using suicide-related keywords. We replied to all emails received between July and December 2013 and analyzed their contents.
  
  
  RESULTS
  A total of 139 consultation service users were analyzed. The mean age was 23.8 years (SD = 9.7), and female users accounted for 80% of the sample. Suicidal ideation was present in 74.1%, and 12.2% had a history of suicide attempts. After consultation, positive changes in mood were observed in 10.8%, 16.5% showed intentions to seek help from new supporters, and 10.1% of all 139 users actually took help-seeking actions.
  
  
  CONCLUSIONS
  Online gatekeeping to prevent suicide by placing advertisements on web search pages to promote consultation service use among Internet users with suicidal ideation may be feasible.
authors.affiliation: 1 Department of Psychology and Education, Faculty of Human Sciences, Wako University, Machida, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Sueki
authors.affiliation: 2 NPO OVA, Tokyo, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Ito
mesh_terms: D000293:Adolescent; D000328:Adult; D000329:Advertising / Q000379:methods*; D042241:Early Diagnosis; D034742:Electronic Mail; D005240:Feasibility Studies; D005260:Female; D020793:Gatekeeping; D006297:Health Services Accessibility; D000066505:Help-Seeking Behavior; D006801:Humans; D057226:Information Seeking Behavior; D033182:Intention; D020407:Internet; D008297:Male; D008605:Mental Health Services; D010342:Patient Acceptance of Health Care; D012017:Referral and Consultation; D018570:Risk Assessment; D059020:Suicidal Ideation; D055815:Young Adult; D000092864:Suicide Prevention
keywords: Internet; online gatekeeping; search advertising; suicide prevention; web