MAPS App for Suicidal Thoughts

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

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

What data supports the effectiveness of the MAPS App for Suicidal Thoughts treatment?

Research suggests that mobile apps can be useful in managing suicidal thoughts by providing safety planning and self-monitoring tools, which are considered acceptable and usable by patients. Although the integration of such apps into routine treatment needs further exploration, they have shown potential in increasing safety and self-management for individuals at risk of suicide. ^{1 2 3 4 5}

Is the MAPS app for suicidal thoughts safe to use?

Research on similar apps shows they are generally safe and well-received by users, with high satisfaction and usability ratings. However, more studies are needed to fully understand their integration into regular treatment. ^{1 2 3 6 7}

How is the MAPS App treatment for suicidal thoughts different from other treatments?

The MAPS App treatment is unique because it uses a mobile application to help prevent suicide by providing features like mood tracking, safety planning, and access to support networks, which are not typically part of traditional in-person therapy. This app-based approach allows for continuous self-monitoring and management of suicidal thoughts, offering a flexible and accessible option for individuals at risk. ^{1 2 3 8 9}

What is the purpose of this trial?

The primary aim of the present study is leverage existing infrastructure to develop novel technological features for a novel personalized smartphone intervention system, called the Mobile Application to Prevent Suicide (MAPS), and to establish feasibility, acceptability, safety, and estimate key parameters for primary outcomes (i.e., suicidal ideation and behavior; re-hospitalization), and target mechanisms.

Eligibility Criteria

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

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

Treatment Details

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.

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.

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+

Findings from Research

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]

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]

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]

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]

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]

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 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]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

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

2. England pubmed.ncbi.nlm.nih.gov

Suicide prevention and depression apps' suicide risk assessment and management: a systematic assessment of adherence to clinical guidelines. [2022]

3. Netherlands pubmed.ncbi.nlm.nih.gov

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

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

Suicide Prevention Mobile Apps for Indian Users: An Overview. [2021]

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

Clinical Considerations for Digital Resources in Care for Patients With Suicidal Ideation. [2023]

6. Australia 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. [2015]

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

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

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

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

9. Netherlands 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. [2023]