Lessons learned from the evaluation of suicide.ca, the digital platform of Quebec's Digital Suicide Prevention Strategy (Preprint)

Abstract

This study illustrates, through the example of Quebec's Digital Suicide Prevention Strategy, how a single digital platform can be used to carry out universal, selective and indicated suicide prevention.

This study aims to document the use of the suicide.ca website, describe the profile of its users and estimate the impact of universal, selective and indicated prevention strategies deployed via the platform.

Analyses were conducted using data collected via Google Analytics (number of sessions, sources of traffic acquisition, landing pages), questionnaires from the platform's self-assessment module (Mental health Continuum Short Form, Kessler Psychological Distress Scale, Suicidal Ideation Attributes Scale – French Version, Patient Health Questionnaire, Mood Disorder Questionnaire, Social Phobia Inventory, DÉBA (Drug & Alcohol, Internet Use, Gambling), PTSD Checklist for DSM-5), the intervention service triage questionnaire (age, gender, Suicidal Ideation Attributes Scale – French Version), intervention reports completed by counselors, and post-intervention questionnaires completed by users.

127,495 visits were made to suicide.ca from October 15, 2020 to October 17, 2021. Only 40% of users started their visit on the home page, Ad-words campaigns accounted for 24.42% of traffic acquisition on the platform and 40% of visits from search engines, excluding AdWords ads, began with a fact sheet on a suicide risk factor. The platform's social media promotion was associated with traffic peaks. The proportion of users with severe suicidal ideation on the Suicidal Ideation Attributes Scale – French Version was 33.2% for the self-assessment module and 75% for the intervention service. Although the self-assessment users presented less severe suicidal ideations than the intervention service users, 87.8% of them obtained a Kessler-10 score indicating the probable presence of a mental health problem. Question about suicidality in the triage resulted in few dropouts. 33.8% of the intervention service users were considered by the counselors at high foreseeable risk for a suicide attempt in the near future and 5.8% were in imminent danger of a suicide attempt. Counselors reported that the user felt better after the intervention in 56% of contacts. As for self-management tools, between 23% and 58% of users who downloaded the mobile application did not create a user account.

There was a wide range of sources for acquiring traffic to the platform. AdWords campaigns and fact sheets on suicide risk factors are important sources of traffic acquisition on the platform. The platform reaches people with varying degrees of suicidal risk. The user account was a barrier to the use of mental health self-management tools. Counselors generally feel that their interventions have a positive impact. Intervention service users are generally satisfied with the service they received.