Beneficial and harmful effects of educative suicide prevention websites: randomised controlled trial exploring Papageno v. Werther effects

Background Suicide prevention organisations frequently use websites to educate the public, but evaluations of these websites are lacking. Aims To examine the effects of educative websites and the moderating effect of participant vulnerability. Method A total of 161 adults were randomised to either view an educative website on suicide prevention or an unrelated website in a single-blinded randomised controlled trial (trial registration with the American Economic Association's registry: RCT-ID: 000924). The primary outcome was suicidal ideation; secondary outcomes were mood, suicide-prevention-related knowledge and attitudes towards suicide/seeking professional help. Data were collected using questionnaires before (T ₁), immediately after exposure (T ₂), and 1 week after exposure (T ₃) and analysed using linear mixed models. Results No significant intervention effect was identified for the entire intervention group with regard to suicidal ideation, but a significant and sustained increase in suicide-prevention-related knowledge (T ₃ v. T ₁, P<0.001, d=1.12, 95% Cl 0.96 to 1.28) and a non-sustained worsening of mood (P<0.001, T ₂ v. T ₁, d= -0.59, -0.75 to -0.43) were observed. Participants with increased vulnerability experienced a partially sustained reduction of suicidal ideation (T ₃ v. T ₁, P<0.001, d= -0.34, -0.50 to -0.19). Conclusions Educative professional suicide prevention websites appeared to increase suicide-prevention-related knowledge, and among vulnerable individuals website exposure may be associated with a reduction of suicidal ideation.