Psychological Distress and Suicidal Ideation in Australian Online Help-Seekers: The Mediating Role of Perceived Burdensomeness

Abstract

Background

Psychological distress, an umbrella term encompassing emotional anguish and cognitive-behavioral symptoms of anxiety and depression, is closely linked to suicidal ideation. However, the mechanism of this relationship is unclear, dampening the utility of distress screening in suicide prevention.

Purpose

This study aimed to identify potential mediators of this relationship, and whether effects are sex-specific.

Method and participants

A sample of online help-seekers who had just completed the K10 psychological distress checklist on the Beyond Blue website [N = 1,528] consented to complete measures of help-seeking intentions, financial wellbeing, alcohol use, social connection (belongingness), sense of being a burden on others (burdensomeness); and suicidal ideation. Moderated mediation analysis examined the indirect effects of psychological distress on suicidal ideation through these risk factors, and whether effects were moderated by sex.

Results

The model accounted for 44% of the variance in suicidal ideation. The majority of participants had experienced very high psychological distress (77.3%) and at least some suicidal ideation (74.7%) in the past four weeks. A significant indirect effect of burdensomeness was found for both men and women. No other risk factors produced significant indirect effects.

Conclusions

Perceived burdensomeness appears to be central in determining how psychological distress might progress to suicidal thinking. The experience of distress may lead a person to believe that loved ones would be better off without them, prompting suicidal thinking.

Highlights

• Psychological distress screening is an early intervention opportunity for suicide.

• Intervention plans could be improved by including perceived burdensome measures.

• Online screening for distress is a potential bridge to offline-help seeking.

Keywords:

• Burdensomeness
• online mental health screening
• psychological distress
• suicidal ideation
• suicide prevention

ACKNOWLEDGMENTS

The authors thank the following at Beyond Blue: Georgie Harman, Susan Anderson and Bella Burns for their stewardship; Jason Borg, Mark Burke, Gail Coon, Andrew Hague, Malcolm Haynes, Celeste Jennings, Simon Lock, Dr Alicia McCoy, Tom Ross, Danielle Schembri, Chris Schildt, Darcy Sutton, and Samantha Webb for background and administrative support. We also gratefully acknowledge the participants in this study.

DISCLOSURE STATEMENT

CR and GB are employees of Beyond Blue. No potential conflict of interest was reported by the author(s).

AUTHOR NOTES

Christopher Rainbow, Beyond Blue, Melbourne, Australia. Peter Baldwin, Black Dog Institute, Sydney, Australia. Warwick Hosking and Peter Gill, College of Health and Biomedicine, Victoria University, Melbourne, Australia. Grant Blashki, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia. Fiona Shand, Black Dog Institute, Sydney, Australia.  Correspondence concerning this article should be addressed to Christopher Rainbow, Beyond Blue, GPO Box 1883, Melbourne VIC 3001, Australia. Email: [email protected]

DATA AVAILABILITY STATEMENT

Data available on request from the authors: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Notes on contributors

Christopher Rainbow

Christopher Rainbow, Beyond Blue, Melbourne, Australia.

Peter Baldwin

Peter Baldwin, Black Dog Institute, Sydney, Australia.

Warwick Hosking

Warwick Hosking and Peter Gill, College of Health and Biomedicine, Victoria University, Melbourne, Australia.

Peter Gill

Warwick Hosking and Peter Gill, College of Health and Biomedicine, Victoria University, Melbourne, Australia.

Grant Blashki

Grant Blashki, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia.

Fiona Shand

Fiona Shand, Black Dog Institute, Sydney, Australia.