Social media-based professional intervention vs. resource provision for suicidal youth: protocol of a randomized controlled trial (Preprint)

<sec> <title>BACKGROUND</title> Despite a high prevalence of suicidal ideation and behavior, adolescents and young adults (AYA) often underutilize mental health services due to both structural and personal barriers. At the same time, the massive expansion of social media has introduced new threats to mental health, while also creating vital spaces where AYA can express psychological distress, seek support, and access mental health information. Designed as a bridge to care and a counterbalance to digital risks, the ELIOS project connects suicidal AYA with a team of professional trained web-clinicians (nurses or psychologists supervised by a psychiatrist) through social media platforms. ELIOS is currently being evaluated within the ORIAS trial to assess its efficacy. </sec> <sec> <title>OBJECTIVE</title> Assess the efficacy of the ELIOS system over simple resource provision for suicidal AYA. </sec> <sec> <title>METHODS</title> ORIAS is single-center, open-label, two-arm randomized controlled trial with balanced parallel groups. It will recruit 386 participants aged 18–25 who spontaneously reach out via the Elios Messenger account with recent suicidal ideation. Eligible AYA are randomized to receive either the Elios intervention or conventional mental health resources (control group). The Elios intervention consists of web-clinicians offering initial support, risk evaluation, counseling, and progressive referral to mental health care. The primary outcome is the reduction in suicidal ideation intensity at three months, measured using the Columbia Suicide Severity Rating Scale. Secondary outcomes include suicide attempts, use of healthcare services, psychological distress, attitudes toward help-seeking, participant satisfaction, and usage metrics of the intervention at three months. </sec> <sec> <title>RESULTS</title> No results </sec> <sec> <title>CONCLUSIONS</title> Elios is the first suicide prevention system embedded directly within the social media environment and daily digital practices of AYA. By offering easy, personalized, and timely access to professional help, Elios aims to address help-seeking barriers and reduce suicidality. While the ORIAS trial highlights the inherent challenges of conducting traditional interventional research within dynamic social media settings, it is poised to generate high-quality evidence on the feasibility, acceptability, and effectiveness of digital suicide prevention interventions. These findings could inform and support the broader integration of similar models within public health systems. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT04642157; https://clinicaltrials.gov/study/NCT04642157?cond=NCT04642157&amp;rank=1 </sec>