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

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.

What data supports the effectiveness of the treatment Mobile Application to Prevent Suicide (MAPS) for suicide prevention?

Research shows that using smartphone apps for Ecological Momentary Assessment (EMA) is feasible and can help monitor suicide risk in real-time, making mental healthcare more accessible. Studies found high participation and compliance rates, suggesting that these apps can effectively track and assess suicidal thoughts without increasing their frequency. ^{1 2 3 4 5}

Is the mobile app for suicide prevention safe for humans?

Research on mobile apps for suicide prevention, like the Emma app, shows they are generally safe and can help monitor and manage suicide risk. These apps use self-monitoring techniques to understand daily risk factors, and studies have found them to be feasible and acceptable for users. ^{1 3 4 6 7}

How is the Mobile Application to Prevent Suicide (MAPS) treatment different from other suicide prevention treatments?

MAPS is unique because it uses a mobile app to provide real-time monitoring and support for individuals at risk of suicide, incorporating strategies like mood tracking and access to support networks, which are not typically available in traditional treatments. ^{1 3 4 7 8}

What is the purpose of this trial?

The primary aim of this grant is to conduct pilot testing on a novel personalized mobile intervention for suicide - Mobile Application to Prevent Suicide (MAPS) - and to establish feasibility, acceptability, safety, and primary outcomes (i.e., suicidal ideation and behavior; re-hospitalization).

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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 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]

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]

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 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]

References

1. England pubmed.ncbi.nlm.nih.gov

Real-world feasibility and acceptability of real-time suicide risk monitoring via smartphones: A 6-month follow-up cohort. [2022]

2. Ireland pubmed.ncbi.nlm.nih.gov

Feasibility and validity of ecological momentary assessment in the investigation of suicide risk. [2022]

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

A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study. [2022]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Acceptability and satisfaction with emma, a smartphone application dedicated to suicide ecological assessment and prevention. [2022]

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

Ecological momentary assessment of mental health in adults at suicide risk: An observational study protocol. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Suicidal thoughts, suicidal behaviours and self-harm in daily life: A systematic review of ecological momentary assessment studies. [2022]

7. Netherlands pubmed.ncbi.nlm.nih.gov

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

8. Canada pubmed.ncbi.nlm.nih.gov

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