Testing the Impact of the #Chatsafe Intervention on Young People's Ability to Communicate Safely About Suicide on Social Media: A Randomized Controlled Trial

INTRODUCTION: Suicide-related content online may contribute to social transmission of suicide-related behaviors and interventions designed to improve communication safety may reduce risk and increase help-seeking in young people. METHODS: We conducted a randomized controlled trial (RCT) evaluating the #chatsafe intervention among young people aged 16-25 years. Participants were randomly assigned (1:1) to the #chatsafe intervention or the PROSPEct sexual health intervention (control), each comprising 24 pieces of social media content delivered over 8 weeks. Outcomes were measured at three timepoints and the primary outcome was change in safety when communicating online about suicide. RESULTS: Nine hundred and six participants were included (453 per arm). Post-intervention, mean safety scores changed by 0.04 in the #chatsafe arm and -0.23 in the control arm. The primary analysis showed a non-significant mean difference of 0.27 (95% CI 0.00-0.54, p = 0.051). No significant between-arm difference was observed at 4 weeks post-intervention. Significant improvements were evident in secondary outcomes for confidence in safe online communication and willingness to intervene in the #chatsafe arm. CONCLUSIONS: This first RCT of #chatsafe demonstrates that social media can be used safely and acceptably to improve young people's confidence and willingness to intervene against suicide online, pointing to a potential scalable, under-utilized lever in suicide prevention. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) Identifier: ACTRN12622001397707.