Mobile apps for suicide prevention: what’s the evidence?

Mobile apps could provide “an uninterrupted crisis response tool” for people with suicidal thoughts and behaviors, although further research is needed to establish their effectiveness, concludes a study in the March/April issue of Harvard Review of Psychiatry. The journal is published in Wolters Kluwer’s Lippincott portfolio.

In particular, applications based on an approach called Momentary Ecological Intervention (EMI) may offer a useful tool for managing patients at risk of suicide, according to review by Enrique Baca-García, MD, Ph.D., of IIS -Fundación Jiménez Díaz, Madrid, Spain, and colleagues. They write, “These interventions can be useful adjuncts to traditional care, especially in situations where face-to-face care is not possible.”

“Suicide prevention in your pocket”? So far, mixed evidence on effectiveness

Suicide remains one of the leading causes of potential life lost globally, as suicide rates may increase during the ongoing COVID-19 pandemic. Mobile health interventions offer a great opportunity to provide “low-cost, 24/7 support” to people at high risk of suicide, especially those who have had previous suicide attempts or thoughts suicidal.

Momentary ecological interventions are a particularly promising approach, with the potential to provide one-time help to patients with suicidal thoughts and behaviors. “For example, NDEs can enable patients to adopt coping strategies when experiencing a breakdown or to interact with the environment in different ways, such as contacting professionals or family members during a crisis,” write Dr. Baca-García and his co-authors. Although NDEs have been used in other psychiatric disorders, less is known about their potential use for suicide prevention.

Dr. Baca-García and colleagues identified 27 studies of 19 different IME interventions designed for suicide prevention. At the time of the review, 10 of the 19 interventions had at least one study assessing effectiveness. Researchers assessed characteristics of IME interventions and evidence of their effectiveness in preventing suicide. Eight studies, evaluating seven interventions, targeted adolescents at risk of suicide.

Safety planning was the most common component of EMI interventions. “A safety plan consists of designing a series of strategies with the support of a clinician aimed at providing support during a suicidal crisis”, explain the researchers. Some apps, including Safety Maps, have taken advantage of digital media, for example displaying photos of loved ones, videos with relaxation techniques, or maps showing the quickest route to disaster relief. emergency.

Some NDE interventions incorporated different types of approaches, such as cognitive behavioral therapy, which teaches strategies to alleviate dysfunctional thoughts or behaviors; or dialectical behavior therapy, targeting healthy approaches to managing stress, emotions, and relationships.

Of the 10 NDE interventions with efficacy studies, five had evidence of decreased suicidal thoughts and behaviors. “These mixed results suggest that there is still a long way to go before [EMI interventions] can be systematically implemented in clinical practice,” write Dr. Baca-García and colleagues. Interventions based on cognitive or dialectical behavior therapy were more likely to reduce suicidal thoughts, although many of these tools also included elements of safety planning.

The studies reported high interest and good retention rates among participating patients. Teenagers and young adults could benefit the most from new technologies in mental health: they are comfortable with the use of digital technologies and are the age group most affected by suicidal thoughts and behaviors.

“The constant progress of technology leads us to believe in the great potential of [mobile health] interventions to contribute to the field of mental health,” Dr. Baca-García and his co-authors conclude. “And mobile apps, with their ability to serve as an uninterrupted crisis response tool, represent a promising field of action. for suicide prevention. efforts.”