Reducing the Burden of Suicidal Thoughts through Online Cognitive Behavioural Therapy Self Help

Abstract

Many people who struggle with suicidal thoughts do not receive adequate help, either because they don’t look for help, or they don’t discuss their suicidal ideation with their general practitioner (GP) or health care provider. Shame, hopelessness, fear of rejection, fear of being admitted to a psychiatric institution, believing in spontaneous recovery of the problem, wanting to handle the problem alone, believing that treatment will not be effective, thinking the problem is not severe, and fear of stigma, all these factors may play a role (Bruffaerts et al., 2011). As a result, suicidal thinking may not be targeted in GP contacts or in mental health care. Suicidal persons do, however, look for anonymous and confidential support through crisis hotlines and organizations such as the Samaritans. Anonymity and confidentiality are key issues in providing support to those people with suicidal ideation who for what- ever reason don’t disclose their suicidal worries to others in face-to-face interaction. Telephone and Internet services may be important in inter- rupting their suicidal development. The magnitude of the problem is enormous: the year-prevalence of suicidal thoughts is around 3 per cent in The Netherlands, and the lifetime prevalence is estimated to be 11 per cent. The burden of disease of suicidal ideation is considerable expressed in Disability Adjusted Life Years: about 166,500 years in full health are lost due to suicidal thoughts (a provisional estimate based on Dutch year-prevalence rates) (van Spijker et al., 2011).