MAPS App for Suicidal Thoughts

No longer recruiting at 1 trial location

Overseen By Cheryl Cordeiro

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Butler Hospital

Disqualifiers: Severe 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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new smartphone app designed to help individuals with suicidal thoughts manage their feelings and actions. The app, called the Mobile Application to Prevent Suicide (MAPS), is compared to a standard method involving regular check-ins without the app's additional features. Individuals who have experienced suicidal thoughts or behaviors in the past month and own a smartphone might be suitable participants. The trial aims to assess the app's effectiveness, safety, and user satisfaction. As an unphased trial, it offers participants the chance to contribute to innovative research that could enhance mental health support for many.

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 might be best to discuss this with the trial coordinators or your doctor.

What prior data suggests that the MAPS app is safe for users?

Research has shown that mobile apps like the Mobile Application to Prevent Suicide (MAPS) can safely assist individuals with suicidal thoughts. Studies on similar apps indicate they offer support by providing coping strategies and quick access to emergency contacts. Users have found these apps easy to use and helpful, with no major safety issues reported.

While MAPS and similar apps are designed to help, they are not substitutes for professional treatment. If someone is struggling, contacting a healthcare provider or a crisis line is crucial. ^{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 managing suicidal thoughts. Unlike traditional therapies that require in-person sessions, MAPS provides immediate support through a smartphone app, allowing users to access coping strategies and emergency contacts anytime. The app also features real-time check-ins, which help tailor support based on the user's current emotional state. This innovative use of technology could offer more accessible, personalized care for individuals struggling with suicidal thoughts.

What evidence suggests that the MAPS app could be effective for preventing suicidal thoughts?

Research has shown that mobile apps like the Mobile Application to Prevent Suicide (MAPS), which participants in this trial may receive, can help lower suicidal behavior. For instance, one study found that a similar app reduced suicide attempts after hospital discharge by 58.3%. Early results suggest that MAPS can identify suicide risk and provide real-time, personalized support, such as sending coping strategies and emergency contacts directly to a user's phone. However, some studies have shown mixed results regarding the effectiveness of mobile apps in preventing suicide. Despite this, MAPS aims to offer timely help and support, potentially reducing suicidal thoughts and actions. Participants in another arm of this trial will receive EMA Monitoring Only, which includes the Safety Planning Intervention and ecological momentary assessment prompts, but without access to other MAPS features. ^{3 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for adults aged 18-70 who have experienced suicidal thoughts or behaviors in the past month. Participants must own a smartphone and be able to read, write, and understand English to complete study tasks. It's not suitable for individuals with severe psychotic or manic symptoms.

Inclusion Criteria

Owns a smartphone

Able to read, write, and understand English well enough to complete study procedures

I have had thoughts or actions of suicide in the last month.

Exclusion Criteria

Current psychotic or manic symptoms severe enough to interfere with completion of 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 ecological momentary assessment prompts for one month

4 weeks

Daily virtual check-ins via app

Follow-up

Participants are monitored for safety and effectiveness after treatment, including emergency department visits and rehospitalization

6 months

What Are the Treatments Tested in This Trial?

Interventions

• EMA Monitoring Only
• Mobile Application to Prevent Suicide (MAPS)

Trial Overview The trial is testing a new personalized smartphone app called MAPS designed to prevent suicide. The study will assess how practical and acceptable this technology is, its safety, and its potential impact on reducing suicidal thoughts, behaviors, and 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.

Group II: EMA Monitoring Only (EMO) Active Control 1 Intervention

Participants in this condition will receive the Safety Planning Intervention (SPI) and will receive ecological momentary assessment prompts on the same schedule as the MAPS condition. However, they will not have access to any other MAPS features.

Who Is Running the Clinical Trial?

Butler Hospital

Lead Sponsor

Trials

133

Recruited

16,700+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Brown University

Collaborator

Trials

480

Recruited

724,000+

Published Research Related to This Trial

Out of 69 assessed depression and suicide prevention apps, only 5 (7%) included all six recommended suicide prevention strategies, highlighting a significant gap in adherence to evidence-based guidelines.

Several popular apps provided incorrect crisis helpline numbers, raising concerns about the safety and reliability of mental health resources available to users, particularly given that some apps had over a million downloads.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide prevention and depression apps' suicide risk assessment and management: a systematic assessment of adherence to clinical guidelines. Martinengo, L., Van Galen, L., Lum, E., 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]

The CASPAR study aims to evaluate the feasibility of using mobile health applications for safety planning and daily self-monitoring in 80 patients with major depressive disorder or dysthymia at risk for suicidal behavior.

By integrating mobile safety plans and symptom tracking into routine care, the study seeks to enhance understanding of the suicidal process and improve treatment outcomes for high-risk patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smartphone-based safety planning and self-monitoring for suicidal patients: Rationale and study protocol of the CASPAR (Continuous Assessment for Suicide Prevention And Research) study. Nuij, C., van Ballegooijen, W., Ruwaard, J., et al.[2023]

Smartphone apps have the potential to provide personalized support for individuals with suicidal thoughts, utilizing real-time data and smartphone sensors, but most are still in the research phase rather than widely used in clinical practice.

Clinicians can enhance suicide prevention efforts by carefully selecting safe and effective mental health apps to create personalized digital toolkits for patients, ensuring the tools are relevant and engaging.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical Considerations for Digital Resources in Care for Patients With Suicidal Ideation. Alon, N., Perret, S., Segal, R., et al.[2023]

An online monitoring tool for tracking depressive symptoms, suicidality, and side effects was developed and found to be user-friendly by young participants, who completed it multiple times.

Both clients and clinicians reported the tool as useful, although clinicians suggested it could be shortened for better integration into clinical practice, indicating a need for further research on its implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and pilot testing of an online monitoring tool of depression symptoms and side effects for young people being treated for depression. Hetrick, SE., Dellosa, MK., Simmons, MB., et al.[2015]

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 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 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]

A review of 43 suicide prevention apps available on the Android platform for Indian users revealed that less than half included evidence-based content, highlighting a gap in the reliability of information provided to users.

While most apps offered regional suicide helpline numbers, only a small percentage included motivational prompts to encourage users to reach out for help, indicating a need for improvement in app design to enhance user engagement and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide Prevention Mobile Apps for Indian Users: An Overview. Sudarshan, S., Mehrotra, S.[2021]

Citations

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

Development of the Mobile Application to Prevent Suicide ... The goal of this study was to explore preferences regarding the Mobile Application to Prevent Suicide (MAPS), an ecological momentary intervention smartphone ...

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

Feasibility and acceptability of the mobile application for the ... MAPS is a smartphone app using ecological momentary assessment to identify suicide risk and deliver real-time treatment, personalized to each patient.

3. medicine.yale.edu medicine.yale.edu/news-article/yale-ohio-state-study-mobile-phone-app-reduced-suicidal-behavior-among-high-risk-patients/

Yale Study: Mobile Phone App Reduced Suicidal Behavior ... The study, published Aug. 8 in JAMA Network Open, found that the app, OTX-202, reduced the recurrence of post-discharge suicide attempts by 58.3 ...

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

Digital safety plan effectiveness and use: Findings from a ... Among users of a self-guided safety planning app, increases in suicide-related coping uniquely predicted decreases in suicidal ideation. · App-related variables ...

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

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

6. 988lifeline.org 988lifeline.org/

988 Lifeline - If you need emotional support, reach out to the ... At the 988 Suicide & Crisis Lifeline, we understand that life's challenges can sometimes be difficult. Whether you're facing mental health struggles…

7. apaservices.org apaservices.org/practice/business/technology/tech-column/mobile-apps-suicide-prevention

Mobile apps designed to help prevent suicide - APA Services Our panel of psychologists share their ratings and reviews of apps to help patients who are experiencing suicidal ideation: Virtual Hope Box, Suicide Safe, and ...

8. play.google.com play.google.com/store/apps/details?id=com.moodtools.crisis.app&hl=en_US

Suicide Safety Plan - Apps on Google Play Suicidal thoughts can seem like they will last forever – but these thoughts and feelings pass with time. Having a plan in place that can help guide you ...

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

Suicide prevention and depression apps' suicide risk ... There are an estimated 800000 suicides per year globally, and approximately 16000000 suicide attempts. Mobile apps may help address the ...