Can an I nternet‐based intervention reduce suicidal ideation, depression and hopelessness among secondary school students: results from a pilot study
Open accessAbstract
Aim: Little evidence exists regarding the efficacy of suicide prevention programmes among the youth. This pilot study aimed to test the effects of a specifically designed, eight‐module Internet‐based programme on suicidal ideation among secondary school students. Methods: The study employed a pre‐test/post‐test design. Outcomes of interest were suicidal ideation, depression and hopelessness. Participants were recruited via the school well‐being team, were assessed at baseline and immediately post‐intervention. The intervention was delivered weekly at the young persons' school. Results: Twenty‐one students completed all eight modules and a post‐intervention assessment, and constitute the observed case sample used for the analysis. Overall levels of suicidal ideation, depressive symptoms and hopelessness decreased significantly over the course of the study. Conclusions: This was a small pilot study with no control group. However, significant reductions were seen in suicidal ideation, depressive symptoms and hopelessness, indicating that Internet‐based interventions may hold promise when it comes to reducing suicide risk among youth. Further investigation is warranted.
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Increasing evidence suggests that it is safe to deliver suicide prevention efforts to pupils.
“However, increasing evidence suggests that it is safe to do [8, 9].”
From Study protocol for the Multimodal Approach to Preventing Suicide in Schools (MAPSS) project: A regionally based feasibility trial of an integrated response to suicide risk among UK secondary school pupils (2024) · cites this paper as [8]
The Implications section reports preliminary analysis finding no adverse effects from the school-delivered Reframe IT intervention. That supports a cautious safety claim for this intervention, but the paper describes the study as small and says evidence on youth suicide-prevention interventions remains limited; it does not establish increasing evidence that such efforts generally are safe for pupils. Page numbers are unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredReframe-IT has been found to be associated with reduced suicidal ideation, depression, and hopelessness in Australian children and young people.
“‘Reframe-IT’ has also been found to be associated with reduced suicidal ideation, depression, and hopelessness in Australian CYP [8, 12].”
Suicide prevention lessons, such as those included in MAPSS, have been evaluated in youth populations.
“Suicide prevention lessons, such as those included in MAPSS, have been evaluated in youth populations [8, 9]”
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Self-citationBailey, E., Rice, S., Robinson, J., Nedeljkovic, M., & Álvarez‐Jiménez, M. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.06.028 · Cited by 35 · see citing works
Self-citationRobinson, J., Hetrick, S. E., Cox, G., Bendall, S., Yung, A. R., Yuen, H. P., Templer, K., & Pirkis, J. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-155 · Cited by 30 · see citing works
“Findings show a reduction in suicidal ideation, depressive symptoms and hopelessness [38], and an increase in problem solving and coping skills (Hetrick et al, forthcoming) over the course of the program.”
BackgroundSelf-citationThe Relation between Descriptive Norms, Suicide Ideation, and Suicide Attempts among Adolescents
Reyes‐Portillo, J. A., Lake, A. M., Kleinman, M., & Gould, M. S. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12446 · Cited by 29 · see citing works
“The SIQ-JR has demonstrated construct validity in the community (Reynolds & Mazza, 1999; Robinson et al., 2016) and clinical samples (King, Hill, Naylor, Evans, & Shain, 1993; McGlinchey et al., 2017).”
BackgroundInfluentialByrne, S. J., Bailey, E., Lamblin, M., McKay, S., Pirkis, J., Mihalopoulos, C., Spittal, M. J., Rice, S., Hetrick, S., Hamilton, M., et al. (2022) · Trials · doi:10.1186/s13063-022-06072-8 · Cited by 26 · see citing works
“The Reframe IT intervention has been described elsewhere [33 – 35].”
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Comparison of Suicidal People Who Use the Internet for Suicide-Related Reasons and Those Who Do Not
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Media Influences on Suicidal Thoughts and Behaviors
Pirkis, J., Mok, K., Robinson, J., & Nordentoft, M. (2016) · doi:10.1002/9781118903223.ch42 · Cited by 20 · see citing works
Self-citationYu, T., Hu, D., Teng, F., Mao, J., Xu, K., Han, Y., Liu, Y., & Wu, M. (2021) · Psychology Health & Medicine · doi:10.1080/13548506.2021.1930073 · Cited by 19 · see citing works
“Even if, as far as we know, there was no empirical data to support this view(Robinson et al., 2016c).”
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Hetrick, S. E., Gao, C. X., Filia, K. M., Menssink, J. M., Rickwood, D. J., Herrman, H., Hickie, I., McGorry, P., Telford, N., Parker, A. G., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.08.053 · Cited by 17 · see citing works
Maro, B. T., Cuthbert, S., Sofo, M., Tasker, K., Bowden, L., Donkin, L., & Hetrick, S. E. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16234844 · Cited by 17 · see citing works
Self-citationScalora, S. C., Anderson, M. R., Crete, A. A., Mistur, E. J., Chapman, A. L., & Miller, L. (2022) · Mental Health & Prevention · doi:10.1016/j.mhp.2022.200229 · Cited by 14 · see citing works
“…sizes for pilot studies on mental health targeted prevention interventions for emerging adults and adolescents vary widely from 0.15 - 0.97 for depression; 0.23 - 0.95 for anxiety (Bluth et al., 2016; Finlay-Jones et al., 2017; Gudi ˜ no et al., 2015; Levin et al., 2013; Robinson et al., 2016).”
InfluentialReis, S. L., Matthews, E. L., & Grenyer, B. F. S. (2021) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2020.488 · Cited by 14 · see citing works
Núñez, D. E., Meza, D., Andaur, J., Robinson, J., & Gaete, J. (2024) · BMC Psychology · doi:10.1186/s40359-024-02300-9 · Cited by 13 · see citing works
“Preliminary evidence suggests that this intervention is acceptable and feasible [24], and although it showed some reduction in suicidal ideation, depression, and hopelessness among adolescents [25], none of them at a significant level [15].”
Self-citationNúñez, D. E., Gaete, J., Meza, D., Andaur, J., & Robinson, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19073947 · Cited by 13 · see citing works
“The pilot study (pretest/post-test design with an 8-week intervention phase) developed in 11 secondary schools showed that the program was enjoyable, helpful, and acceptable by participants [46] and effective in reducing SI, DS, and hopelessness at post-intervention [47].”
BackgroundSelf-citationSocial Media Interventions for Adolescents and Young People with Depression and Psychosis
Santesteban‐Echarri, O., Álvarez‐Jiménez, M., Gleeson, J., & Rice, S. (2018) · Springer eBooks · doi:10.1007/978-3-319-69638-6_14 · Cited by 13 · see citing works
Branjerdporn, G., Erlich, F., Ponraj, K., McCosker, L. K., & Woerwag‐Mehta, S. (2023) · Children · doi:10.3390/children10111801 · Cited by 12 · see citing works
“Psychotherapy may be delivered face to face, but web-based programs are increasing in popularity [15].”
BackgroundNúñez, D. E., Villacura-Herrera, C., Gaete, J., Meza, D., Andaur, J., & Robinson, J. (2023) · Current Psychology · doi:10.1007/s12144-023-05422-2 · Cited by 11 · see citing works
“The scale has proved to be a good predictor of future suicide attempts when compared to other measures of distress (Robinson et al., 2016), and it is regarded as an appropriate outcome measure to evaluate interventions aimed at reducing SI in young people (Hetrick et al., 2021).”
Self-citationSolution Focused Brief Therapy Telemental Health Suicide Intervention
Finlayson, B. T., Jones, E. R., & Cravens, J. D. (2021) · Contemporary Family Therapy · doi:10.1007/s10591-021-09599-1 · Cited by 12 · see citing works
Guillén, V., Fonseca-Baeza, S., Fernández‐Felipe, I., Botella, C., Baños, R., García‐Palacios, A., & Marco, J. H. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100532 · Cited by 12 · see citing works
Meyerhoff, J., Kruzan, K. P., Kim, K. A., Orden, K. A. V., & Mohr, D. C. (2022) · Archives of Suicide Research · doi:10.1080/13811118.2022.2096520 · Cited by 10 · see citing works
“Several studies of DMHIs have shown reductions in depression symptom severity among individuals with suicidal ideation (Bush et al., 2015; De Jaegere et al., 2019; Hetrick et al., 2017; Hill & Pettit, 2019; Mewton & Andrews, 2015; Robinson et al., 2016; Spijker, Straten, & Kerkhof, 2014; Stallard, Porter, & Grist, 201…”
BackgroundDigital applications as tools for psychological adaptation of citizens to changes
Ронжес, О. (2023) · Scientific Studios on Social and Political Psychology · doi:10.61727/sssppj/2.2023.34 · Cited by 10 · see citing works
Jha, S., Jewer, S., Agyapong, V. I. O., & Orji, R. (2024) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2024.2323274 · Cited by 9 · see citing works
“Adolescents with suicide risk have often been excluded from studies of e-health interventions (Robinson et al., 2016; Stanley et al., 2009).”
Reitegger, F., Peras, I., Wright, M., & Gasteiger‐Klicpera, B. (2024) · Adolescent Research Review · doi:10.1007/s40894-024-00237-z · Cited by 13 · see citing works
Kelleher, E., Moreno, M. A., & Wilt, M. (2018) · JMIR Research Protocols · doi:10.2196/resprot.9421 · Cited by 9 · see citing works
“A majority of the successful online intervention studies used structured online programs that included education and coping strategies as their means of intervention [3,8,18-21].”
Ashrafi, N., Neuhaus, V., Vona, F., Peperkorn, N., Shiban, Y., & Voigt‐Antons, J. (2024) · Lecture notes in computer science · doi:10.1007/978-3-031-60428-7_1 · Cited by 8 · see citing works
Lawrence‐Sidebottom, D., Huffman, L. G., Beam, A. B., McAlister, K. L., Guerra, R., Parikh, A., Roots, M., & Huberty, J. (2024) · JMIR Formative Research · doi:10.2196/54816 · Cited by 8 · see citing works
Tutus, D., Plener, P. L., & Niemitz, M. (2018) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000640 · Cited by 8 · see citing works
Suicide Behavior Among Vocational High School Students: The Role of School-Related Factors
Benatov, J., Klomek, A. B., & Chen‐Gal, S. (2021) · School Mental Health · doi:10.1007/s12310-021-09435-9 · Cited by 7 · see citing works
Gaete, J., Meza, D., Andaur, J., McKay, S., Robinson, J., & Núñez, D. E. (2025) · Prevention Science · doi:10.1007/s11121-025-01770-6 · Cited by 8 · see citing works
“During the first phase, a case series study using pre-test and post-test was conducted, and the results indicated that the program was associated with a decrease in suicidal thoughts, depression, and feelings of hopelessness (Robinson et al., 2016).”
Self-citationLu, J., Gao, W., Wang, Z., Yang, N., Pang, W. I. P., Lok, K.-I., & Rao, W. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1281696 · Cited by 6 · see citing works
Digital applications as tools for psychological adaptation of citizens to changes
Ронжес, О. (2023) · Scientific Studios on Social and Political Psychology · doi:10.61727/sssppj/2.2023.14 · Cited by 6 · see citing works
Muñoz−Sánchez, J., Álvarez, C. D., Sánchez-Prada, A., Parra−Vidales, E., Leo, D. D., & Franco, M. (2018) · JMIR Mental Health · doi:10.2196/mental.7784 · Cited by 6 · see citing works
“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].”
BackgroundAshworth, E., McCarthy, M., Wynne, S., Robinson, J., McKay, S., Lane, S., Richardson, G., Boardman, N., Henderson, K., Crosbie, V., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0302873 · Cited by 6 · see citing works
Self-citationPokharel, R., Pathrose, S. P., Jefferies, D., & Ramjan, L. M. (2025) · International Journal of Mental Health Nursing · doi:10.1111/inm.70038 · Cited by 6 · 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
Internet-based interventions to support recovery in youth: A systematic review
Dallinger, V. C., Krishnamoorthy, G., Burton, L. J., du Plessis, C., Pillai‐Sasidharan, A., & Ayres, A. C. (2022) · Digital Health · doi:10.1177/20552076221129094 · Cited by 5 · see citing works
“Publication Selection Bias Study Design Confounders Blinding Data Collection Attrition Global Assessment Bannink et al.32 2 1 3 3 1 2 Moderate Calear et al.33 1 1 3 3 1 3 Weak Dickter et al.34 2 3 1 1 3 1 Weak Hetrick et al.35 1 1 1 1 1 1 Strong Lillevoll et al.36 2 1 3 1 1 1 Moderate Manicavasagar et al.37 2 1 1 1 1…”
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
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Perspectives of college students on the causes and prevention of suicide in Nigerian universities
Aruah, D. E., Emeka, O. M., Eze, V. O., Okonkwo, U. U., & Agbo, G. C. (2020) · Journal of Psychology in Africa · doi:10.1080/14330237.2020.1842592 · Cited by 4 · see citing works
Online Therapy for Adolescent Mental Health
Khan, H. A., Bernstein, K. S., & Voorhees, B. W. V. (2018) · Springer eBooks · doi:10.1007/978-3-319-69638-6_16 · Cited by 4 · see citing works
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“…a cabo han dado cuenta que el internet , es una herramienta útil para ayudar a personas que atraviesan graves crisis emocionales (incluidas las suicidas), reduciendo el miedo, la vergüenza y el enfrentamiento al estigma social (Van Spijker, Van Straten y Kerkhof, 2014; Robinson et al., 2014).”
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Soto‐Sanz, V., Ivorra-González, D., Alonso, J., Castellví, P., Marín, J. R., & Piqueras, J. A. (2019) · Dialnet (Universidad de la Rioja) · Cited by 3 · see citing works
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The role of the internet in suicide prevention from the public health perspective
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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-citationNurulfa, R., & Kļaviņa, A. (2026) · Frontiers in Education · doi:10.3389/feduc.2026.1755129 · Cited by 1 · see citing works
Multi-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
“However, the cultural transferability of MAPSS from Australia to the UK cannot be assumed.”
InfluentialSelf-citationSocial media and suicide prevention: findings from a stakeholder survey •Original research article•
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Treatment Approaches with Suicidal Adolescents
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Digital Health Intervention Towards Suicidal Ideation Among Adolescents
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“Recursos adicionales: Discusiones grupales monitoreadas _ CBT 1 Reframe IT Robinson et al. (2016) Reconocimiento emocional y tolerancia al malestar, reestructuración cognitiva, activación conductual, técnicas de relajación y resolución de problemas.”
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Self-citationCox, G., & Robinson, J. (2015) · Evidence-Based Mental Health · doi:10.1136/eb-2015-102112
“▸ Given the relationship between depression and suicide-related behaviour, additional research needs to assess whether these therapies may also be effective in the treatment of suicidal-related behaviour.(4)”
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PROSPECTS FOR THE FORMATION OF METHODS OF INVESTIGATION OF SUICIDE BY USING INTERNET TECHNOLOGIES
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Intervenciones preventivas para la conducta suicida en estudiantes: revisión sistemática
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Multi-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-citationBailey, E., Mühlmann, C., Rice, S., Nedeljkovic, M., Álvarez‐Jiménez, M., Sander, L., Calear, A. L., Batterham, P. J., & Robinson, J. (2020) · Figshare · doi:10.6084/m9.figshare.12299264
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
Self-citation
- Authors
- Robinson, J., Hetrick, S., Cox, G., Bendall, S., Yuen, H. P., Yung, A., & Pirkis, J.
- Affiliations
- The University of Melbourne (AU)
- Venue
- Early Intervention in Psychiatry
- Publisher
- Wiley
- Published
- 2014-03-31
- Volume
- 10
- Issue
- 1
- Pages
- 28-35
- ISSN
- 1751-7885 (ISSN-L)
- 1751-7893
- OpenAlex
- W2128484357
- Cited by
- 108
- References
- 55
- Citations by year
- 2026: 10 · 2025: 3 · 2024: 9 · 2023: 9 · 2022: 9 · 2021: 14 · 2020: 9 · 2019: 9 · 2018: 11 · 2017: 6 · 2016: 6 · 2015: 9 · 2014: 3
- FWCI
- 9.44
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Early Intervention in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, other-oa)
- Funders
- American Foundation for Suicide Prevention
- National Health and Medical Research Council (NHMRC) Program Grant
- Colonial Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- online intervention, suicidal ideation, depression, hopelessness, suicide prevention, high school students, youth, school-based intervention, suicide risk
- MeSH terms
- Adolescent, Depression, Female, Humans, Male, Pilot Projects, Schools, Students, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Internet, Suicidal Ideation, Hope
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