An evaluation trial of ‘iConsiderLife’: A self-help, crisis and suicide prevention decision-support program to assist in reducing distress in adults.

An automated (self-help) decision-support crisis and suicide prevention program (called iConsiderLife) will be evaluated by investigating the ways in which adults use iConsiderLife. The iConsiderLife program is one of the My Digital Health platform programs. Adults visiting one of the My Digital Health sites will be able to find a link to iConsiderLife within the ‘Crisis and General Support Services’ page. This page provides the general public with information and links to crisis (e.g., Life Line) and mental health service providers. In response to clicking the iConsiderLife link or hearing about the iConsiderLife program, adults will be invited to participate in the study. Adults wishing to participate in the iConsiderLife evaluation study will be provided with immediate access to the single-session program, following the provision of their informed consent to participate in the study and answering several brief demographic / personal questions. Adults who do not wish to participate in the evaluation study will be provided with a list of alternative sources of support. In addition, adults wishing to participate in the trial will not have to create an account in order to access the program. iConsiderLife is designed to provide adults who are currently distressed or experiencing a crisis with a simple, step-by-step, problem solving approach design, to assist in reducing this distress in real time. There are six main strategy sections. The six main strategy sections include: 1) A section with encourages the participant to speak with family, friends, healthcare professionals, crisis support services and emergency services about how they are currently feeling. 2) A section that explores the common thoughts and experiences that distressed or suicidal people have. 3) A section that provides the person with several distress reducing activities (e.g., breathing control, mindfulness of breath). 4) A section that asks the person to consider and reflect upon the people and things that are/have been important to them (e.g., people, pets, hobbies). This section focuses on reasons for living. 5) A section that provides lists a range of distraction and provides brief instructions on how to get started. 6) A section that asks people to reflect on a range of questions that are aimed at increasing hope. Depending on how the person responds they are provided with additional information in relation to the current strategy or taken to the next strategy section. For example, if a person was not interested in undertaking any distress reducing activities, they would click on 'no' (i.e., to the question asking them if they interested in trying out a distress reducing activity) and then they would be taken to the next strategy (i.e., reflection / reasons for living). If the person was interested in doing the reflection activities, they would click on the 'yes' button and then they would be taken to the specific reflection-based exercises for this strategy grouping. Overall, if a person was to say ‘no’ to each question within the program, it would take them approximately 3 minutes to complete. iConsiderLife has been designed as a ‘single-session’ program to assist people in 'real time' and participants are not required to create an account to use the program. People are able to come back and undertake another single-session should they require it but as the program does not require an account to be created, it cannot remember who they are once they have closed their browser. Therefore, people who do return to use iConsiderLife sometime into the future will need to start from the beginning. People are asked their age, gender, what country they reside in, postcode if Australian, whether or not they are currently under the influence of alcohol and other drugs, and their current level of distress (scale from 0 – 100). Once people reach the end of iConsiderLife, or opt out early because they are no longer feeling as distressed, the person is asked to re-rate their distress level and they are then provided with some additional feedback / information. The flow (e.g., what sections people visit the most) and their before and after distress ratings will be explored to examine the usefulness of the program.