Using the US National Suicide and Crisis Lifeline as a case example, we discuss the tacit requirement that users of helplines disclose suicide-related thoughts and behaviors as a central barrier to suicide prevention interventions. This Comment outlines the need for self-guided digital suicide prevention interventions within helpline infrastructure.
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Acknowledgements
J.M. acknowledges support from the National Institute of Mental Health (K08 MH128640). D.D.L.C. acknowledges support from a grant from the National Institute of Mental Health (F31 MH130055).
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J.M. has accepted consulting fees from Boehringer Ingelheim and Shirley Ryan Ability Lab. No other disclosures are reported.
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: Nature Mental Health thanks Paul S. F. Yip and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.
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Meyerhoff, J., Coppersmith, D.D.L. & Fox, K.R. The ethical imperative of self-directed tools in crisis helplines to prevent suicide at scale. Nat. Mental Health 3, 269–270 (2025). https://doi.org/10.1038/s44220-025-00384-9
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DOI: https://doi.org/10.1038/s44220-025-00384-9
