On the 27th of February 2026, Margot van der Burgt will defend her PhD thesis titled ‘Breaking down barriers: understanding and promoting help-seeking in suicide prevention’, in the Aula of the Vrije Universiteit Amsterdam at 13:45h.
This thesis is a collection of studies related to the Dutch suicide prevention helpline 113 Zelfmoordpreventie, with an emphasis on help-seeking behaviour. Margot studied the effectiveness of the first suicide prevention campaign in the Netherlands and the impact of a multilevel intervention programme called SUPRANET Community. When the COVID-19 pandemic emerged, researchers questioned how this disruptive global crisis and its associated social distancing measures would affect the already vulnerable population of the helpline.
The final part of this dissertation is focused on motivating hesitant, high-risk website visitors to contact the suicide prevention helpline. 113’s website offers an anonymous self-test for suicidal thoughts. This self-test includes the Suicidal Ideation Attributes Scale (SIDAS), which educates users about the severity of their suicidal thoughts. Only a very small group of people with severe suicidal thoughts navigate to the web page about contacting the help line, after taking this self-test. Margot and colleagues have examined if hesitant self-test users with severe suicidal thoughts can be encouraged to contact the helpline by offering tailored information that addresses their self‑reported barriers, using a so-called barrier reduction intervention.
“The broad findings in my dissertation support the use of low-threshold, scalable online interventions as an entry point to care and highlight the importance of addressing stigmas.”
Loneliness
During the first COVID-19 lockdown, Margot and colleagues studied conversation topics in the helpline. People contacting the helpline struggled with the interruption or changes in professional care, loneliness and difficulties finding distraction from suicidal thoughts and rumination. A longitudinal follow-up study conducted in collaboration with the Flemish helpline, showed that later in the pandemic loneliness was the most frequent mentioned coronavirus-related problem. Stricter government lockdown measures were associated with a higher number of COVID-19–related conversations.
Barrier reduction intervention
The evaluation of a short and text-based intervention showed that a barrier reduction intervention has the potential to be an easy, low-cost and highly scalable method to increase helpline use among people with severe suicidal thoughts but little motivation to seek help. Although brief intervention could not motivate people to use a direct link to the helpline immediately after the intervention, respondents did score higher on satisfaction with the self-test and indicated that they were more likely to contact the helpline at a later point in time.
Addressing stigmas
Suicidal thoughts and behaviours are complex phenomena that arise form a multitude of factors. Suicide is difficult to predict and results from an interplay between numerous biological, psychological, social and environmental factors. Understanding barriers that individuals face when seeking help for suicidal thoughts is crucial for effective suicide prevention. It is important to recognise that offering low threshold help alone is not enough if there are still people who are too hesitant to accept it.
Margot explains: “The broad findings in my dissertation support the use of low-threshold, scalable online interventions as an entry point to care and highlight the importance of addressing stigmas.” Research in the field of suicide is inherently challenged by methodological limitations and ethical complexities. But this research also showed the willingness of a difficult-to reach and highly vulnerable population to share their experiences and contribute to scientific knowledge, underscoring the importance of including individuals with lived experience when designing and implementing research on suicidality.
On the 27th of February 2026, Margot van der Burgt will defend her PhD thesis titled ‘Breaking down barriers: understanding and promoting help-seeking in suicide prevention, in the Aula of the Vrije Universiteit Amsterdam at 13:45h. Margot’s thesis is supervised by A.T.F. Beekman and co-supervised by R. Gilissen and S.Y.M. Mérelle. More information on this dissertation can be found on the website of VU Amsterdam.
Margot van der Burgt was a PhD student at 113 Suicide Prevention and at the department of Psychiatry Amsterdam UMC. She currently works as a Public Health researcher at GGD Gelderland-Zuid.
