Mobile App for Suicide Prevention

Overseen By Cheryl Cordeiro

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Butler Hospital

Disqualifiers: Psychotic, Manic symptoms

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

Compensation: Varies

Number of Visits: Unknown

Duration: 4 weeks

10 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new mobile app designed to help prevent suicide. The app, called the Mobile Application to Prevent Suicide (MAPS), provides personalized support by checking in with users several times a day and offering coping strategies when needed. It aims to reduce suicidal thoughts and behaviors and prevent hospital readmissions. Individuals who have experienced suicidal thoughts or actions in the past month and are comfortable using a smartphone might be a good fit for this trial. As an unphased study, this trial offers participants a unique opportunity to contribute to innovative research that could significantly impact mental health support.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this mobile app is safe for suicide prevention?

Research shows that the Mobile Application to Prevent Suicide (MAPS) is still undergoing testing to ensure safety and effectiveness. Studies on similar apps for suicide prevention have found that users generally handle them well. These apps typically include features like safety plans, coping strategies, and emergency contacts.

Although few studies have focused specifically on MAPS, those that have suggest it can lead to positive changes in users' attitudes and a stronger will to live. This is encouraging, but further research is needed to confirm its safety and effectiveness. So far, no major safety issues have been reported, but staying updated as more research emerges is important. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Mobile Application to Prevent Suicide (MAPS) because it offers a unique, tech-driven approach to suicide prevention. Unlike traditional methods, which often involve in-person therapy or medication, MAPS provides real-time support and monitoring through a smartphone app. This app prompts users to check in multiple times a day about their thoughts and feelings, offering personalized coping strategies based on their responses. It also facilitates instant communication with a clinician, providing a safety net that is both accessible and immediate. This innovative method could make support more accessible to individuals when they need it most, potentially reducing the incidence of suicide.

What evidence suggests that the Mobile Application to Prevent Suicide (MAPS) is effective for suicide prevention?

Research has shown that the effectiveness of mobile apps like MAPS, which participants in this trial may receive, remains unclear for preventing suicide. Some studies have produced mixed results, indicating that not everyone who uses these apps experiences fewer suicidal thoughts or actions. One review found that only about half of the apps included a template for making a safety plan, which is crucial for suicide prevention. Although digital tools are increasingly used for mental health, more consistent evidence is needed to determine their impact on reducing suicidal thoughts. MAPS aims to help by offering personalized support and easy access to safety plans, but further research is necessary to confirm its effectiveness. ^{1 2 6 7 8}

Are You a Good Fit for This Trial?

This trial is for young adults aged 18-26 who are comfortable with smartphones and have experienced suicidal thoughts or behaviors in the past month. They must be stable as per their treatment team and proficient in English. Those with severe psychotic or manic symptoms that could disrupt participation cannot join.

Inclusion Criteria

English proficiency

Deemed by the treatment team to be stable enough to complete study procedures

Suicidal ideation and/or suicidal behavior in the past month verified by the C-SSRS

Exclusion Criteria

Current psychotic or manic symptoms severe enough to interfere with study procedures

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the Mobile Application to Prevent Suicide (MAPS) intervention, including Safety Planning Intervention (SPI) and daily ecological momentary assessments

4 weeks

Daily virtual check-ins via app

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessments of suicidal ideation and behavior

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Mobile Application to Prevent Suicide (MAPS)
• Treatment as Usual + Ecological Momentary Assessment (TAU + EMA)

Trial Overview The study tests a new mobile app called MAPS designed to prevent suicide, comparing it against standard care plus regular self-reports of mood and behavior (TAU + EMA). It aims to see if MAPS is feasible, acceptable, safe, and can reduce suicidal thoughts or re-hospitalization.

How Is the Trial Designed?

Group I: Mobile Application to Prevent Suicide (MAPS) Experimental Treatment 1 Intervention

Participants receiving MAPS will receive the Safety Planning Intervention (SPI) which will be uploaded into the smartphone app. They will be prompted four times per day to complete a brief ecological momentary assessment "check-in" inquiring about their cognitions, affect, and behavior, including suicidal thoughts and behaviors. Based on these responses, they will be provided with coping strategies from their safety plans and from a database of coping strategies created by study staff. They will also have access to emergency phone numbers, the coping strategies database, and can communicate with their study clinician through a text-like interface in the app. They will receive this intervention for one month.

Who Is Running the Clinical Trial?

Butler Hospital

Lead Sponsor

Trials

133

Recruited

16,700+

American Foundation for Suicide Prevention (AFSP)

Collaborator

Trials

2

Recruited

20+

Published Research Related to This Trial

This study will track suicidal thoughts and related stress indicators in 150 adults at risk for suicide over 28 days using daily surveys and actigraphy to monitor sleep and activity patterns.

The findings aim to inform the development of targeted mental health interventions, enhancing the ability to provide timely support for individuals experiencing suicidal ideation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ecological momentary assessment of mental health in adults at suicide risk: An observational study protocol. Kim, H., Park, S., Kim, Y., et al.[2022]

A systematic review of 49 studies using Ecological Momentary Assessments (EMA) found significant associations between daily emotional states, such as negative and positive affect, and non-suicidal self-injury (NSSI) as well as suicidal thoughts, highlighting the importance of daily monitoring in understanding self-harm risk factors.

The review suggests that EMA can help clinicians identify daily predictors of suicide and self-harm, but emphasizes the need for standardized reporting and more advanced research methods, like machine learning, to better analyze these risk factors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicidal thoughts, suicidal behaviours and self-harm in daily life: A systematic review of ecological momentary assessment studies. Gee, BL., Han, J., Benassi, H., et al.[2022]

The emma app, designed for ecological momentary assessment and intervention for high-risk suicide patients, shows promise in collecting real-time data and providing personalized support, although usage rates varied significantly among participants.

Preliminary results from 14 participants indicate that while most found the app acceptable and useful, the completion rates for daily assessments were low, suggesting a need for a more engaging and customizable user experience to enhance adherence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study. Morgiève, M., Genty, C., Azé, J., et al.[2022]

A study involving 393 high-risk patients for suicide demonstrated that smartphone-based Ecological Momentary Assessment (EMA) is feasible, with 79.3% retention for active EMA after one month and 87.8% for passive EMA.

The findings suggest that while both active and passive EMA can enhance access to mental healthcare, user satisfaction and specific diagnoses (like eating disorders) significantly influence the likelihood of continued use of these applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Real-world feasibility and acceptability of real-time suicide risk monitoring via smartphones: A 6-month follow-up cohort. Porras-Segovia, A., Díaz-Oliván, I., Barrigón, ML., et al.[2022]

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]

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]

The study involved four groups at varying suicide risk, including 42 recent suicide attempters, and showed high participation and compliance rates with Ecological Momentary Assessment, indicating its feasibility for studying suicidal ideation.

Importantly, the repeated assessments did not increase the frequency of negative thoughts or suicidal ideation, suggesting that this method can safely monitor high-risk cognitive states without exacerbating them.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and validity of ecological momentary assessment in the investigation of suicide risk. Husky, M., Olié, E., Guillaume, S., et al.[2022]

The emma app, designed for suicide prevention, was used by 99 high-risk patients over 6 months, showing promising acceptability with a mean satisfaction score of 6.92 out of 10 and a Mobile App Rating Scale score of 3.3 out of 5 after 6 months.

Completion rates for daily assessments were lower than for weekly ones, but patients with suicidal ideation or depression were more likely to complete daily assessments, indicating that the app effectively engages those most in need.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptability and satisfaction with emma, a smartphone application dedicated to suicide ecological assessment and prevention. Morgiève, M., Yasri, D., Genty, C., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11870380/

Development of the Mobile Application to Prevent Suicide ... A 2020 review identified just seven studies (four published and three unpublished) that evaluated the effectiveness of app-based suicide ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12561950/

Effectiveness of Mobile Applications for Suicide Prevention Thus, the effectiveness of mobile applications in reducing suicidality remains inconclusive with previous findings showing inconsistent outcomes ...

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0165178124000350

Digital safety plan effectiveness and use: Findings from a ... Few studies have examined the effectiveness of self-guided smartphone apps for suicide safety planning, despite their increasing use.

4. mhealth.jmir.org mhealth.jmir.org/2020/1/e12516/

Mobile Health Technology Interventions for Suicide Prevention This review aimed to examine the effectiveness of currently available mobile health (mHealth) technology tools in reducing suicide-specific outcomes.

5. bmcmedicine.biomedcentral.com bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1461-z

Suicide prevention and depression apps' suicide risk ... Only 2/20 (10%) depression management apps and 24/46 (52%) suicide prevention apps offered users a template to develop a safety plan, and all ...

6. mental.jmir.org mental.jmir.org/2024/1/e52763/

Translating Suicide Safety Planning Components Into the ... Few studies (4/14, 29%) examined the effectiveness of mHealth apps for suicide-related outcomes. Positive shifts in attitudes and desire to live ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10013310/

Feasibility and acceptability of the mobile application for the ... This manuscript describes MAPS, a novel suicide prevention mobile application that leverages an EMA approach in concert with a patient's preexisting safety ...

8. mdpi.com mdpi.com/2076-328X/15/10/1345

Effectiveness of Mobile Applications for Suicide Prevention This meta-analysis aimed to evaluate the effectiveness of mobile applications designed to reduce suicide risk, focusing on studies published over the past five ...