The feasibility and utility of gratitude intervention for suicidal internet users

Background: Gratitude has received attention as a protective factor that contributes to suicide prevention, and several studies have shown that gratitude intervention in hospitalized patients has a suicide prevention effect. Aim: We conducted a gratitude intervention for suicidal internet users, and examined the feasibility and effectiveness of the intervention. Methods: This is a single-arm study of gratitude intervention ("counting blessings") among Japanese internet users with high suicidal ideation (N = 225). The experiment consisted of a baseline period of approximately 4 weeks and an intervention period of approximately 4 weeks. The main factor measured was suicidal ideation. Results: The dropout rate was 16.5% during the baseline period and 24.5% during the intervention period. Commitment to gratitude intervention was significantly associated with reduced suicidal ideation, after controlling for mean suicidal ideation in the baseline period and other demographic variables. Limitations: This study did not include a control group and a follow-up period. Conclusions: Gratitude intervention has the potential to develop into a suicide prevention tool that can be used by suicidal internet users who do not necessarily have access to psychiatric care.