The safety and acceptability of delivering an online intervention to secondary students at risk of suicide: findings from a pilot study
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Background: Suicide‐related behaviour is a major problem among adolescents. Yet relatively few studies have tested the efficacy, acceptability and safety of interventions for this population. We developed and pilot tested an online intervention for at‐risk school students, which has led to reduced suicidal ideation, hopelessness and depressive symptoms. The aims of this study were to examine the safety and acceptability of the programme, and to determine which components were found to be most helpful and enjoyable. Methods: This pilot study employed a pre‐test/post‐test design, with an 8‐week intervention phase. Participants were assessed immediately before, and immediately after the intervention. Participants were also asked to complete a weekly questionnaire immediately after the intervention, and again 2 days later assessing suicidal ideation and distress. Results: Twenty‐one young people completed the intervention. Overall, the intervention did not lead to increases in suicidal ideation or distress. Participants reported enjoying the programme, in particular watching the video diaries and completing the activities, and said they would recommend the programme to a friend. Overall, the cognitive components of the programme were found to be most helpful. Conclusions: Overall, the programme appeared to be a safe and acceptable intervention for at‐risk adolescents. This was a small, pilot study so we need to interpret the results with caution. However, the findings are promising and suggest that young people at risk of suicide can safely be included in trials as long as adequate safety procedures are in place. The programme is now being tested in a randomized controlled trial.
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Other features that participants reported liking included interactive activities and video components.
“Other features that participants reported liking included interactive activities (58, 62), and video components (62, 73).”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [62]
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“14 However, human assessments, such as 24/7 messaging services and screening of distress, are unfeasible for self-help eMental health services that do not have people at their disposal to make such assessments.”
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“Suicide prevention programs using emerging technologies [40-42] have also proven effective in the detection of suicide risk [38,43] and in reducing suicide ideation [18,44,45].”
BackgroundWho is worthy of help? Constructing the stereotype of the “ideal victim” of child sexual abuse
Eelmaa, S., & Murumaa-Mengel, M. (2022) · Nomos Verlagsgesellschaft mbH & Co. KG eBooks · doi:10.5771/9783748904403-261 · Cited by 5 · see citing works
Universal suicide prevention in schools
Carli, V., Iosue, M., & Wasserman, D. (2021) · doi:10.1093/med/9780198834441.003.0073 · Cited by 5 · see citing works
Treatment Approaches with Suicidal Adolescents
Spirito, A., Webb, M. A., Wolff, J. C., & Esposito-Smythers, C. L. (2022) · Springer eBooks · doi:10.1007/978-3-030-42003-1_21 · Cited by 4 · see citing works
de Oliveira, J. M., Dueñas, J.-M., Morales-Vives, F., & Gallardo‐Nieto, E. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1213751 · Cited by 4 · see citing works
Pedersen, M. R. (2022) · Nomos Verlagsgesellschaft mbH & Co. KG eBooks · doi:10.5771/9783748904403-279 · Cited by 2 · see citing works
The role of the internet in suicide prevention from the public health perspective
Westerlund, M., & Krysinska, K. E. (2021) · doi:10.1093/med/9780198834441.003.0076 · Cited by 2 · see citing works
Research Priorities in Suicide Prevention: Final Report
Reifels, L., Ftanou, M., Krysinska, K. E., Machlin, A., Robinson, J. D., & Pirkis, J. (2017) · Minerva Access (University of Melbourne) · Cited by 1 · see citing works
Self-citationMulti-modal approach to preventing suicide in schools: a regionally-based UK pilot study
Ashworth, E., Hanlon, C. A., McCarthy, M., Hunt, A. M., Wynne, S., Foster, R., Robinson, J., McKay, S., & Saini, P. (2026) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2026.1768052 · Cited by 1 · see citing works
“Changes to Reframe IT-UK were generally surface-level, such as using British actors for videos, modernising content (e.g., discussions of COVID-19 and removal of references to outdated technology), providing UK sources of support, and making completion of a safety plan compulsory at the beginning…”
Self-citationSocial media and suicide prevention: findings from a stakeholder survey •Original research article•
Robinson, J., Rodrigues, M. E. G., Fisher, S., Bailey, E., & Herrman, H. (2015) · Cited by 1 · see citing works
Self-citationTreatment Approaches with Suicidal Adolescents
Spirito, A., Webb, M. A., Wolff, J. C., & Esposito-Smythers, C. L. (2021) · Springer eBooks · doi:10.1007/978-3-030-41319-4_21-1 · Cited by 1 · see citing works
Wilson, J., Gee, B., Martin, N. C., Maxwell, S. L., Murdoch, J., Clarke, T., Clark, A., Turner, D., Notley, C. J., Katangwe‐Chigamba, T., et al. (2022) · Health and Social Care Delivery Research · doi:10.3310/hnin4621 · Cited by 1 · see citing works
Gaete, J., Núñez, D. E., Meza, D., Andaur, J., & Robinson, J. (2024) · Research Square · doi:10.21203/rs.3.rs-4824452/v1 · Cited by 1 · see citing works
Self-citationResearch on Classification and Feature Analysis of Weibo Data
Fu, Q. (2020) · International Conference on Computer Engineering and Application (ICCEA) · doi:10.1109/iccea50009.2020.00053
Suicide and the Role of Educational Institutions: A 30-Year Systematic ReviewPreprint
de Oliveira, J. M., Dueñas, J.-M., Morales-Vives, F., & Gallardo‐Nieto, E. (2021) · Research Square · doi:10.21203/rs.3.rs-1126336/v1
“Assessment of Suicide Educational Programs Overall, the programs were described as safe (Robinson et al., 2015), contributing to school safety (Breux & Boccio, 2019), and feasible to implement within a school setting (Kinchin et al., 2020).”
BackgroundMulti-Modal Approach to Preventing Suicide in Schools (MAPSS): A regionally-based UK pilot studyPreprint
Ashworth, E., Hanlon, C. A., McCarthy, M., Hunt, A., Wynne, S., Robinson, J., McKay, S., & Saini, P. (2025) · Research Square · doi:10.21203/rs.3.rs-6932924/v1
Self-citationByrne, S. J., Bailey, E., Lamblin, M., McKay, S., Pirkis, J., Mihalopoulos, C., Spittal, M. J., Rice, S., Hetrick, S. E., Hamilton, M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19298495
Self-citationByrne, S. J., Bailey, E., Lamblin, M., McKay, S., Pirkis, J., Mihalopoulos, C., Spittal, M. J., Rice, S., Hetrick, S. E., Hamilton, M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19298498
Self-citationByrne, S. J., Bailey, E., Lamblin, M., McKay, S., Pirkis, J., Mihalopoulos, C., Spittal, M. J., Rice, S., Hetrick, S. E., Hamilton, M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19298492
Self-citationByrne, S. J., Bailey, E., Lamblin, M., McKay, S., Pirkis, J., Mihalopoulos, C., Spittal, M. J., Rice, S., Hetrick, S., Hamilton, M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19298483
Self-citationByrne, S. J., Bailey, E., Lamblin, M., McKay, S., Pirkis, J., Mihalopoulos, C., Spittal, M. J., Rice, S., Hetrick, S. E., Hamilton, M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19298486
Self-citationMcKay, S., Lamblin, M., Bellairs-Walsh, I., Veresova, M., Kenny, B., Bailey, E., Byrne, S. J., Yuen, H. P., Pirkis, J., Mihalopoulos, C., et al. (2026) · BMC Pediatrics · doi:10.1186/s12887-026-06838-y
“The results for Reframe-IT contrast with earlier studies in Australia and internationally that demonstrated reductions in suicidal ideation (the primary aim of the program) and secondary benefits for depressive symptoms for intervention users [27–29, 53, 54].”
InfluentialSelf-citationGaete, J., Núñez, D. E., Ramírez, S., Meza, D., & Robinson, J. (2026) · Archives of Suicide Research · doi:10.1080/13811118.2026.2672043
Self-citationDabrowski, A., Mackley, G., Fernando, C., Rahim, H. A., & Siena, J. A. (2026) · Frontiers in Education · doi:10.3389/feduc.2026.1812649
- Authors
- Robinson, J., Hetrick, S., Cox, G., Bendall, S., Yung, A., & Pirkis, J.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- Robinson, Jo
- Venue
- Early Intervention in Psychiatry
- Publisher
- Wiley
- Published
- 2014-03-31
- Volume
- 9
- Issue
- 6
- Pages
- 498-506
- ISSN
- 1751-7885 (ISSN-L)
- 1751-7893
- OpenAlex
- W2105116898
- Cited by
- 71
- References
- 36
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 6 · 2023: 2 · 2022: 12 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 7 · 2017: 6 · 2016: 4 · 2015: 3 · 2014: 3
- FWCI
- 6.26
- Type
- journal article
- Language
- en
- Open access
- Locations
- Early Intervention in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- American Foundation for Suicide Prevention
- NHMRC
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- suicide prevention, adolescents, online intervention, suicidal ideation, intervention safety, acceptability, video diaries, depressive symptoms, hopelessness, high school students
- MeSH terms
- Suicide Prevention, Adolescent, Depression, Female, Humans, Male, Patient Acceptance of Health Care, Pilot Projects, Schools, Students, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Suicidal Ideation
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