Suicidal Ideation and Risk Reduction Associated with Participation in a Therapist-Supported Digital Mental Health Intervention

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Abstract Background Suicide is a significant public health concern with increasing prevalence. Novel interventions that reduce stigma and increase accessibility, such as therapist-supported digital mental health interventions, are urgently needed. Methods This preregistered retrospective cohort, single-arm, and intent-to-treat study with 778 patients examined suicidal ideation (SI) trajectories using multilevel models during and up to 6-months after an 12-week therapist-supported digital mental health intervention (Meru Health Program [MHP]) as assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9). Estimates of associated suicide attempts and deaths by suicide were calculated using published data linking PHQ-9-assessed SI to records of suicide attempts and deaths by suicide. Results MHP participants reporting SI “not at all” significantly increased between baseline and end-of-treatment (78.02–91.00%). Effect sizes of SI changes between baseline and end-of-treatment, 3-month, and 6-month follow-ups were 0.33 (95%CI=0.27-0.38), 0.32 (95%CI=0.27-0.38), and 0.32 (95%CI=0.27-0.438), respectively. Results also indicated an estimated 30.49% reduction (95%CI=25.15%-35.13%) in suicide attempts and death by suicide across treatment. Conclusion This real-world study provides preliminary evidence that participants of the MHP show significant reductions in SI and estimated suicide attempts and deaths by suicide across treatment that are maintained 6-months following treatment. The next steps are to conduct a randomized control trial to confirm these results.

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