Reducing suicidal ideation through protective media content in India: randomised controlled trial

Background Responsible media reporting of suicide is a population-level suicide prevention intervention, yet there is no experimental evidence from low-income settings. Aims We assessed the effects of exposure to educative suicide prevention content and stories of surviving a suicide crisis in the print media on reducing suicidality in India. Method A three-arm randomised controlled trial (Clinical Trials Registry of India, ref: CTRI/2022/09/045439) was conducted in Chennai, India, between August 2023 and March 2024. Participants were young adults (18–29 years), recruited through social media advertisements, randomised 1:1:1 to a control group and two intervention groups. Data were analysed during June–September 2024. All three groups were exposed to three 600-word purpose-designed Tamil-language print media articles on digital tablets. Intervention group 1 was exposed to three print media articles containing educative suicide prevention content. The same articles given to intervention group 2 were modified to contain brief accounts of young adults who had coped with experiences of suicidal ideation. The control group was exposed to three print media articles on diabetes. Suicidal ideation was measured using the 23-item Survival and Coping Beliefs subscale of the Reasons for Living Scale at baseline, post-test and 14-day follow-up. Results Of 375 participants, randomisation resulted in 125 being assigned to the control group and 124 and 126 to intervention groups 1 and 2, respectively; 16 were lost to follow-up. At post-test, participants randomised to intervention group 1 demonstrated small improvements in suicidal ideation at post-test (standardised mean difference (SMD) = 0.15, p = 0.019) and follow-up (SMD = 0.17, p = 0.038). Larger effects were observed among participants with greater vulnerability (post-test, SMD = 0.25, p = 0.039; follow-up, SMD = 0.32, p = 0.023). There were no improvements in suicidal ideation in intervention group 2 at post-test, yet a marginal (SMD = 0.16, p = 0.053) effect was observed at follow-up. Conclusions Exposure to educative print media articles can result in small improvements in suicidal ideation that would represent a substantial population-level impact.