@article{ref1,
title="Impact of online mental health screening tools on help-seeking, care receipt, and suicidal ideation and suicidal intent: evidence from internet search behavior in a large U.S. cohort",
journal="Journal of psychiatric research",
year="2020",
author="Jacobson, Nicholas C. and Yom-Tov, Elad and Lekkas, Damien and Heinz, Michael and Liu, Lili and Barr, Paul J.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: Most people with psychiatric illnesses do not receive treatment for almost a decade after disorder onset. Online mental health screens reflect one mechanism designed to shorten this lag in help-seeking, yet there has been limited research on the effectiveness of screening tools in naturalistic settings.   MATERIAL AND METHODS: We examined a cohort of persons directed to a mental health screening tool via the Bing search engine (n = 126,060). We evaluated the impact of tool content on later searches for mental health self-references, self-diagnosis, care seeking, psychoactive medications, suicidal ideation, and suicidal intent. Website characteristics were evaluated by pairs of independent raters to ascertain screen type and content. These included the presence/absence of a suggestive diagnosis, a message on interpretability, as well as referrals to digital treatments, in-person treatments, and crisis services.   RESULTS: Using machine learning models, the results suggested that screen content predicted later searches with mental health self-references (AUC = 0·73), mental health self-diagnosis (AUC = 0·69), mental health care seeking (AUC = 0·61), psychoactive medications (AUC = 0·55), suicidal ideation (AUC = 0·58), and suicidal intent (AUC = 0·60). Cox-proportional hazards models suggested individuals utilizing tools with in-person care referral were significantly more likely to subsequently search for methods to actively end their life (HR = 1·727, p = 0·007).   DISCUSSION: Online screens may influence help-seeking behavior, suicidal ideation, and suicidal intent. Websites with referrals to in-person treatments could put persons at greater risk of active suicidal intent. Further evaluation using large-scale randomized controlled trials is needed.<p /> <p>Language: en</p>",
language="en",
issn="0022-3956",
doi="10.1016/j.jpsychires.2020.11.010",
url="http://dx.doi.org/10.1016/j.jpsychires.2020.11.010"
}