Service use history of individuals enrolling in a Web-based suicidal ideation treatment trial: analysis of baseline data

Quincy J. J. Wong*, Aliza Werner-Seidler, Michelle Torok, Bregje Van Spijker, Alison L. Calear, Helen Christensen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)
8 Downloads (Pure)


Background: A significant recent innovation is the development of internet-based psychological treatments for suicidal thinking. However, we know very little about individuals experiencing suicidal ideation who seek help through Web-based services and, in particular, their previous health service use patterns. Objective: We aimed to examine service use history and its correlates among adults experiencing suicidal ideation who enrolled in a Web-based suicidal ideation treatment trial. Methods: We used baseline data of 418 individuals seeking Web-based treatment for their suicidal ideation recruited into a randomized controlled trial of a 6-week Web-based self-help program. Participants at preintervention reported demographic information, clinical characteristics, and health service use over the previous 6 months. Results: Participants had a high rate of service use in the 6 months before enrolling in the treatment trial (404/418, 96.7% of participants had contact with services). The two most common contact points were general practitioners (385/418, 92.1% of participants) and mental health professionals (295/418, 70.6% of participants). Notably, those with a previous single suicide attempt had lower odds of contact with any service than those with no attempt (odds ratio [OR] 0.21, 95% CI 0.05-0.86; P=.03). Those living in rural or remote areas had lower odds of contacting general practitioners (OR 0.35, 95% CI 0.13-0.91; P=.03) or mental health professionals (OR 0.44, 95% CI 0.23-0.83; P=.01) than those living in metropolitan areas. Conclusions: Individuals enrolling in an electronic health intervention trial have often received treatment from general practitioners or mental health professionals. These services can therefore play an important role in preventing the escalation of suicidal thinking. Enrollment in our Web-based treatment trial suggested, though, that face-to-face health services may not be enough. Our study also highlighted the need to improve the provision of coordinated and assertive care after a suicide attempt, as well as health service availability and utilization for those living in rural and remote areas.

Original languageEnglish
Article numbere11521
Number of pages10
JournalJournal of Medical Internet Research
Issue number4
Publication statusPublished - 2 Apr 2019
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • internet
  • treatment
  • service use
  • health service
  • suicidal ideation
  • suicide, attempted
  • suicide
  • facilities and services utilization
  • telehealth
  • Telehealth
  • Attempted
  • Health service
  • Suicidal ideation
  • Suicide
  • Facilities and services utilization
  • Treatment
  • Internet
  • Service use


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