Mobile Intervention for Suicidal Thoughts

Overseen By Angela C Kirby, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Psychosis, Mania, Alcohol use disorder, others

Stay on Your Current Meds You can continue your current medications while participating

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 4 weeks

50 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on adding a mobile intervention to your existing treatment.

What data supports the effectiveness of the treatment Mobile Intervention for Suicidal Thoughts (MIST)?

Research on similar mobile apps, like SERO and BackUp, shows they can help people manage suicidal thoughts by providing tools like safety plans and mood tracking. These apps have been found to be usable and acceptable by patients, suggesting that mobile interventions like MIST could be effective in supporting individuals with suicidal thoughts. ^{1 2 3 4 5}

Is the Mobile Intervention for Suicidal Thoughts (MIST) safe for humans?

Research on mobile interventions for suicide prevention, like the SERO app and SmartCrisis 2.0, shows they are generally safe and well-received by users. Participants reported high satisfaction and found these interventions useful and easy to use, suggesting they are safe for human use. ^{1 3 6 7 8}

How is the mobile intervention for suicidal thoughts different from other treatments?

This mobile intervention is unique because it provides immediate, flexible, and accessible support through a mobile app, which can be more readily available than traditional in-person treatments or paper-based safety plans. It leverages technology to offer features like safety planning, mood tracking, and access to support networks, making it particularly suitable for individuals who prefer digital solutions over face-to-face interactions. ^{1 9 10 11 12}

What is the purpose of this trial?

One of the factors that contributes to suicide risk is what is known as a "suicidal belief system." This belief system is made up of several cognitions that been associated with suicide risk among military personnel. Modification of these cognitions may reduce suicidal thoughts and behaviors. The study team has developed a brief mobile intervention entitled the Mobile Intervention for Suicidal Thoughts (MIST) that uses evidence-based interpretation bias modification techniques to reduce these suicide cognitions. The goal of this project is to is to conduct a pilot trial of the MIST intervention to evaluate whether it is feasible an acceptable as an adjunct treatment for Veterans with suicidal ideation.

Research Team

Kirsten H Dillon, PhD

Principal Investigator

Durham VA Medical Center, Durham, NC

Eligibility Criteria

This trial is for veterans experiencing suicidal thoughts. It's designed to see if a mobile intervention can help change harmful belief systems related to suicide risk. Participants should be military personnel who are open to using their mobile device as part of the treatment.

Inclusion Criteria

Can read at least 6th grade level material, established by their demonstrated ability to read the consent form and answer basic questions about it

Veterans using the Durham VA Health Care System

Endorsing suicidal ideation without intent in the last 30 days, established via C-SSRS

Exclusion Criteria

Currently in a period of active psychosis or mania, established via the SCID-5

Endorsing suicidal intent, established via C-SSRS

Have used the MIST intervention before as part of another research study

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the MIST intervention along with treatment as usual and safety planning

4 weeks

Post-treatment visit (approximately one month after enrollment)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Study Completion

Final data collection and analysis for study outcomes

18 months

Treatment Details

Interventions

• Mobile Intervention for Suicidal Thoughts (MIST)

Trial Overview The study tests a new mobile app called MIST, which aims to modify beliefs and reduce suicidal thoughts. It will be used alongside usual treatments and compared with safety planning alone, without the app.

Participant Groups

Group I: Safety planning, treatment as usual, and MIST Experimental Treatment 3 Interventions

Participants will get a safety plan, treatment as usual, and the MIST intervention.

Group II: Safety planning and treatment as usual Active Control 2 Interventions

Participants will get a safety plan and treatment as usual.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

The mobile app developed as part of the SERO suicide prevention program aims to reduce suicides and suicide attempts by enhancing self-management for individuals at risk, incorporating strategies like safety planning and mood tracking.

The app's design was informed by collaboration among health professionals, individuals at risk, and their families, ensuring it addresses real needs and integrates essential suicide prevention strategies effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SERO - A New Mobile App for Suicide Prevention. Meier, L., Gurtner, C., Nuessli, S., et al.[2022]

The study evaluated the feasibility of two mental health apps, BackUp and mEMA, for treating depressed outpatients with suicidal ideation, involving 17 participants over a 3-month period.

Both apps were found to be usable and acceptable, scoring above the thresholds for usability and satisfaction, but the study did not meet the criteria for sufficient uptake, indicating that further exploration is needed for integrating these apps into routine mental healthcare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The feasibility of using smartphone apps as treatment components for depressed suicidal outpatients. Nuij, C., van Ballegooijen, W., de Beurs, D., et al.[2023]

The Virtual Hope Box (VHB) app was found to be more regularly used and preferred by high-risk patients and their clinicians compared to a traditional hope box, indicating its potential effectiveness in helping patients cope with negative thoughts and stress.

Patients reported that the VHB was beneficial, easy to set up, and expressed a strong likelihood of continued use and recommendation to others, suggesting its practicality as a therapeutic tool.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Virtual Hope Box smartphone app as an accessory to therapy: proof-of-concept in a clinical sample of veterans. Bush, NE., Dobscha, SK., Crumpton, R., et al.[2022]

The WellPATH app, used during a 12-week psychotherapy intervention for middle-aged and older adults after suicide-related hospitalization, showed high feasibility and acceptability, with participants and therapists expressing satisfaction with the app.

Case studies indicated that using WellPATH helped patients reduce negative emotions and improve their ability to regulate emotions, suggesting potential benefits for suicide prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Emotion Regulation Tablet App for Middle-Aged and Older Adults at High Suicide Risk: Feasibility, Acceptability, and Two Case Studies. Kiosses, DN., Monkovic, J., Stern, A., et al.[2022]

The telehealth suicide safety planning intervention (SPI) was found to be highly acceptable and feasible among high-risk Veterans, with participants rating it positively on acceptability (M=17.50), appropriateness (M=17.25), and feasibility (M=18) on a scale of 1 to 20.

Participants reported enhanced suicidal disclosure and improved management of urges, indicating that the SPI effectively supported their mental health needs while also addressing barriers like privacy and technology issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Qualitative Study of Telehealth Delivery of Suicide-Specific Group Treatment "Project Life Force". Patel, SR., Sullivan, SR., Mitchell, EL., et al.[2023]

The Safety Planning Intervention (SPI) is effective in reducing suicidal ideation and behavior, as well as improving depression and treatment engagement among adults experiencing suicide-related distress, based on a systematic review of 26 studies.

The SPI is adaptable and can be delivered in various formats (in-person or online) and as a standalone or combined intervention, making it a flexible tool in suicide prevention practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of the Safety Planning Intervention for Adults Experiencing Suicide-Related Distress: A Systematic Review. Ferguson, M., Rhodes, K., Loughhead, M., et al.[2022]

The pilot phase of the SmartCrisis 2.0 trial demonstrated that a smartphone-based safety plan for patients with recent suicidal behavior is feasible and well-accepted, with a participation rate of 77% and high satisfaction ratings (overall satisfaction score of 9.6 out of 10).

Patients found the safety plan useful (7.4/10) and easy to use (8.9/10), with common coping strategies including walking and exercise, indicating that the app could be a valuable tool in clinical practice for supporting mental health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study. Porras-Segovia, A., De Granda-Beltrán, AM., Gallardo, C., et al.[2023]

MYPLAN is a mobile application developed to help individuals at risk of suicide create personalized safety plans, making it more accessible than traditional paper versions.

Since its launch in 2013, MYPLAN has been positively received, with nearly 8,000 downloads in Denmark and Norway, indicating its potential utility in supporting at-risk individuals, especially among younger populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

MYPLAN - A Mobile Phone Application for Supporting People at Risk of Suicide. Skovgaard Larsen, JL., Frandsen, H., Erlangsen, A.[2022]

Out of 66 mobile apps reviewed for suicide prevention, 42 were specifically designed for individuals with suicidal thoughts, and 89% included at least one feature aimed at reducing suicide risk, indicating a strong focus on user engagement and safety.

The average usability score of these apps was 3.5 out of 5, suggesting that while many apps are engaging and usable, there is a need for more clinically evaluated options, especially for healthcare providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

User Engagement and Usability of Suicide Prevention Apps: Systematic Search in App Stores and Content Analysis. Wilks, CR., Chu, C., Sim, D., et al.[2021]

Digital interventions, such as apps, showed a reduction in suicidal ideation scores among 3,356 participants across 14 studies, suggesting they may be more effective than simply waiting for treatment.

However, there was no evidence that these interventions reduced self-harm or suicide attempts, and many studies had design biases, indicating that more research is needed to confirm their safety and effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. Witt, K., Spittal, MJ., Carter, G., et al.[2022]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

SERO - A New Mobile App for Suicide Prevention. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

The feasibility of using smartphone apps as treatment components for depressed suicidal outpatients. [2023]

3. Canada pubmed.ncbi.nlm.nih.gov

Mobile Health Technology Interventions for Suicide Prevention: Protocol for a Systematic Review and Meta-Analysis. [2020]

4. England pubmed.ncbi.nlm.nih.gov

A Virtual Hope Box smartphone app as an accessory to therapy: proof-of-concept in a clinical sample of veterans. [2022]

5. England pubmed.ncbi.nlm.nih.gov

An Emotion Regulation Tablet App for Middle-Aged and Older Adults at High Suicide Risk: Feasibility, Acceptability, and Two Case Studies. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Qualitative Study of Telehealth Delivery of Suicide-Specific Group Treatment "Project Life Force". [2023]

7. England pubmed.ncbi.nlm.nih.gov

The Effectiveness of the Safety Planning Intervention for Adults Experiencing Suicide-Related Distress: A Systematic Review. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study. [2023]

9. Italy pubmed.ncbi.nlm.nih.gov

[Internet- and Mobile-based interventions aimed at suicide risks: a review of the literature.] [2022]

10. Canada pubmed.ncbi.nlm.nih.gov

MYPLAN - A Mobile Phone Application for Supporting People at Risk of Suicide. [2022]

11. Canada pubmed.ncbi.nlm.nih.gov

User Engagement and Usability of Suicide Prevention Apps: Systematic Search in App Stores and Content Analysis. [2021]

12. England pubmed.ncbi.nlm.nih.gov

Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. [2022]