Supporting Technology Engagement for Suicide Prevention: An Open Trial with College Students At-Risk for Suicide

Background: With the marked increase of suicidal thoughts and behaviors among students, counseling centers are struggling to meet the mental health demand on college campuses. Digital mental health interventions (DMHIs) have significant promise for increasing treatment availability and addressing barriers specific to this population. However, evaluations of DMHI effectiveness have been limited by low uptake and treatment adherence. Objective: Using focus group data from students at-risk for suicide, we developed Supporting Technology Engagement for Prevention (STEP), an intervention designed to increase student engagement in DMHIs. This open trial evaluated the feasibility, acceptability, and initial promise of STEP plus an empirically-based DMHI (Therapist Assisted Online [TAO]) with at-risk students. Method: Participants were 30 ethnoracially diverse college students, ages 18 to 29, reporting elevated depression or anxiety symptoms and active suicidal ideation. Participants received STEP+TAO for 7 weeks. Satisfaction, engagement with TAO (uptake and adherence), and mental health symptoms were assessed at pre-intervention, 3-weeks, and 7-weeks. Results: TAO uptake was high, with most students (93%, n = 28) completing at least one session. Adherence was also high, with 63% (n = 19) completing at least 50% of sessions and 50% (n = 15) completing at least 80%. Most participants (80%, n = 24) reported being at least moderately satisfied. Significant reductions in depression, anxiety, and suicidal ideation were also observed. Discussion: Results suggest that STEP is acceptable, feasible, and associated with high DMHI uptake and adherence and decreased mental health symptoms among at-risk students. Findings demonstrate potential of enhancing treatment engagement among at-risk students who would otherwise not seek help.