First Randomized-Controlled Trial of Digital Bibliotherapy Shows Potential of Social Connection and Perceived Shared Experience to Lower Suicidal Thoughts
LOS ANGELES, Sept. 9, 2022 /PRNewswire-PRWeb/ -- Social media is often criticized as harmful to mental health. But new research shows that reading one story a day online, written by someone with lived experience managing suicidal thoughts, can reduce suicidal thoughts and behaviors (STB) in the reader. The research was conducted by experts at Montefiore-Einstein, Harvard University and The Mighty, an online community that connects people facing health challenges. Findings from the research, "Digital Bibliotherapy as a Scalable Intervention for Suicidal Thoughts: A Randomized Controlled Trial," were published in the peer-reviewed Journal of Consulting and Clinical Psychology.
Bibliotherapy is a therapeutic approach in which a planned reading program facilitates the recovery of patients living with mental illness or emotional disturbance.#_ftn1 [] The new study assessed whether reading other people's first-hand stories about working through suicidal thoughts online via The Mighty – digital narrative-based bibliotherapy – could reduce the desire to die among people with STB.
Results showed that participants who received the bibliotherapy intervention reported modest but statistically significantly lower STB, relative to those on a waiting list for the therapy. Further, these benefits were found to be explained in part by higher feelings of shared experience and optimism among those who received the therapy.
Suicide is the 10th leading cause of death in the United States – and the second leading cause among ages 25-34 – but there are few effective ways to alleviate STB. Many interventions lack accessibility and affordability, but digital bibliotherapy could be accessible for many, crossing income, education and geographic barriers.
"What we've learned gives us a new line of attack in this long-standing public health crisis: an easy way to address key psychological factors, such as loneliness and hopelessness, that lead people to think about ending their lives," said study lead Dr. Peter J. Franz of Montefiore Medical Center, and the lead author of the paper. "It takes 10 minutes or less each day to read a story, yet digital narrative-based bibliotherapy makes a measurable difference, which may have a protective effect against STB. This could be layered into complementary therapies. And it's as highly scalable as the internet, able to reach millions of people simply and cost-effectively."
While this research shows the power of reading stories online in helping people with STB, future research could explore if this approach is effective in addressing other health issues shaped by similar factors.
"Bibliotherapy is well-established as a way to treat psychological distress, but this was the first randomized controlled trial of digital narrative-based bibliotherapy for those struggling with STB – and the first using content generated organically by users," said Dr. Matt Nock, Chair of Harvard's Department of Psychology and one of the world's leading experts on suicide. "This is a potentially important piece in the suicide-prevention puzzle. And – because mental health impacts overall health and vice-versa – these findings may be useful in addressing a broad range of conditions, particularly those involving feelings of isolation or hard-to-discuss subject matter."
The study was conducted using narratives from The Mighty, an online community that fosters conversations between people facing health issues and their peers, who share their experiences, expertise and relevant content.
Each day for 14 days, 266 study participants were asked to read one first-person account of working through suicidal feelings posted by community members on The Mighty. These participants recorded the impact this had on their desire to end their life. As a control, a group of 262 people who did not read stories also recorded their feelings of STB over the same period.
Results were compiled at the end of the study and after a two-week follow-up period. Key findings showed that:
- The study group, which read the online narratives, reported no change in their desire to die during the first two weeks of the study, while the control group reported a statistically meaningful increase in STB.
- These findings were sustainable: Study participants also reported significantly lower desire to die at the two-week follow-up than did those in the control group.
- Results also were highly repeatable. Once members of the control group subsequently were offered bibliotherapy, they also reported a significantly lower desire to end their lives, mirroring the results of the initial study group almost exactly.
- Participants who read narratives daily self-reported a lessened desire to die than those who read sporadically.
The research team also investigated reasons that the initial therapy group self-reported maintaining their levels of STB and found that this group reported higher feelings of shared experience and optimism during the trial than those in the control group.
"This study validates our belief that when people get the support and information they need they're better equipped to help improve health outcomes. That's what makes The Mighty work so well," said Mike Porath, Founder and CEO of The Mighty. "But it also signals where we go from here: If feelings of shared experience and optimism work for people with STB, then digital bibliotherapy also may work for people with chronic pain, issues particularly relevant to the LGBTQIA+ community or any health challenge where isolation, stigma or the need for interaction are factors. This is only the beginning, and the possibilities are exciting."
The Mighty was founded in 2014 by Porath and his wife, whose experience with their daughter's rare disease diagnosis sparked the idea to create a network where people could come together to discuss common health issues and exchange information, expertise, advice and experiences. Today, in addition to its 3.5 million members, the community also is home to partnerships with leading health and wellness companies, all sharing the goal of driving better health outcomes.
About the Study
The study involved 528 adults visiting a social media platform for mental health support. Participants were randomized to a treatment condition (n=266), in which they read one suicide narrative per day for 14 days, or to a waitlist control condition (n=262). The desire to end their lives was assessed daily for the 14-day trial period and during a two-week follow-up.
About The Mighty
The Mighty is a healthcare company and unique online community that empowers people to better manage their health challenges and disabilities through social connectedness. More than 3.5 million registered users regularly share first-hand stories, experiences and insights to help each other navigate medical situations and address real-world issues they face across more than 700 health conditions. Insights shared in the site's forums also help The Mighty's healthcare partners better understand community members' actual experiences, so they can learn how better to serve them. More information can be found at https://corp.themighty.com/ and on LinkedIn, Twitter, Instagram and Facebook.
Judy Hartling, The Mighty, 1 860-798-9014, [email protected]
SOURCE The Mighty