Relationship Between Expression of Gratitude and the Success of Email Counseling for Suicide Prevention

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Background: Studies focused on gratitude as a suicide prevention strategy that strengthens protective factors are increasing. However, previous studies did not examine the relationship between the actual occurrence of gratitude behavior and its suicide prevention effect. Aim: We examined whether the occurrence of gratitude behavior is related to suicide prevention. Methods: An advertisement inviting viewers to use free email-based psychological consultation services was placed on web pages that displayed the results of searches using suicide-related keywords. All emails received replies as part of gatekeeping activities, and the data obtained (responses to an online questionnaire and the content of the emails received) were analyzed. Results: In total, 197 consultation service users were analyzed; 33.3% were male and the median age range was 20–29 years. Logistic regression analysis showed an association between service users' expression of gratitude to the gatekeeper in their second consultation email and successful online gatekeeping (odds ratio = 4.62, 95% confidence interval = 2.52–8.48). There were no statistically significant associations with other independent variables. Conclusion: This study supports the hypothesis that gratitude functions as a protective factor for suicide.

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