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Reducing suicidal ideation: effectiveness of a web-based self-help intervention: a Randomised Trial

Projectomschrijving

Denken aan zelfdoding: in Nederland zijn er ongeveer 300.000 volwassenen die dat weleens doen. Veel mensen zoeken geen hulp, bijvoorbeeld uit schaamte of omdat ze denken dat ze niet geholpen kunnen worden. Om zoveel mogelijk mensen met suïcidale gedachten te kunnen bereiken, heeft de Vrije Universiteit Amsterdam (VU) een online cursus ontwikkeld. Deze cursus ‘Leven onder Controle’ is bedoeld om gedachten aan zelfdoding beter onder controle te krijgen. Deelnemers krijgen informatie over (het denken aan) zelfdoding en verschillende oefeningen. Deelnemers die meededen aan de cursus hadden tot 6 weken na de cursus minder gedachten aan zelfdoding dan deelnemers die op een wachtlijst voor de cursus stonden. Deze vermindering in suïcidale gedachten was ook drie maanden na de cursus aanwezig. Over het algemeen vonden deelnemers de cursus behulpzaam in het verminderen van hun gedachten aan zelfdoding en was de meerderheid tevreden over de cursus. Uit een kosteneffectiviteitsanalyse is gebleken dat het aanbieden van onbegeleide zelfhulp via internet kosteneffectief is. De cursus is nu beschikbaar via 113online.nl.

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Samenvatting van de aanvraag

Suicide and attempted suicide are a major problem for Dutch society: around 1500-1550 suicides a year (1,2% of all deaths) and around 14.000 attempted suicides treated in hospitals a year. Around 2.3% of Dutch inhabitants have attempted suicide once or more than once. Life time suicidal ideation in The Netherland is at least 8.2% Among adolescents non-fatal suicidal behaviour / deliberate self harm is alarming: up to 9% with suicidal behaviour and 25% with suicidal ideation registered in monitoring studies. Specific groups have high incidence rates of ideation and attempted suicide, e.g. young immigrant girls/women of Turkish and Surinamese descent, and some groups have high suicide rates (e.g. young Creole and Hindustan men from Suriname). Many persons with suicidal ideation or plans do not contact health care services. Half of all suicides are not in contact with health care services at that moment. Many people hesitate to look for help when in despair. Often suicidal persons prefer visiting websites and chatrooms over seeing a doctor. Or they visit their GP too late, after a long period of despair. People who are or who have been in contact with health care providers often do not contact their caregiver, out of shame or because they think that they cannot be helped anymore. Health care services cannot address the whole problem of suicidal behaviours. A preventive strategy therefore is needed to help people identify suicidal developments in an early stage and to learn how to deal with suicidal ideation in a less self-destructive way. That is why a web based self help intervention is proposed, that should be easily accessible for large groups of suicidal persons. This self-help intervention is based on recent developments in Behavioural Cognitive Therapy and Problem Solving approaches. This web-based self-help intervention will be tested on effectiveness in a randomised trial: 260 participants will be randomly allocated to this web-based self-help intervention and to an information-only condition. The self-help intervention consists of an 8 weak course providing self-examination, information, exercises, problem solving techniques, identification of, challenging of, and alternative suggestions for suicidogenic thougths, suggestions how to deal with interpersonal conflicts, etc. Visitors will be given information and arguments for contacting professional health care services. Visitors of the website may download new material every week, and they are requested to register mood, despair, worrying, sleeplessness, and suicide ideation on a regular base. Self - help interventions are effective in reducing anxiety, depression, worrying, sleeplessness, etc. Self-help interventions for suicidal ideation until now have not been studied as to effectiveness. In the study there will be four moments for measuring the effect of the suicidal ideation reduction course: before and immediately after the intervention, and follow up measures at 3 and 12 months after the course. Primary outcome is the reduction in suicidal ideation.

Onderwerpen

Kenmerken

Projectnummer:
120510003
Looptijd: 100%
Looptijd: 100 %
2007
2012
Onderdeel van programma:
Projectleider en penvoerder:
Prof. dr. A.J.F.M. Kerkhof
Verantwoordelijke organisatie:
Vrije Universiteit Amsterdam