Mobile apps for people at risk of suicide can decrease suicidal thoughts and behaviours about half the time, a study on these digital tools, which “deliver as-needed help in the moment”, has found.
Many interventions included safety planning for a time of crisis and the most effective were those based on cognitive or dialectical behaviour therapy, according to the review published in the March/April journal of Harvard Review of Psychiatry.
“Adolescents and young adults may benefit most from new technologies in mental health: they are comfortable in using digital technologies and are the age group most affected by suicidal thoughts and behaviours,” noted the researchers from the Health Research Institute at the Fundación Jiménez Díaz University Hospital in Madrid, Spain.
In SA, on average, 8% of all deaths among teenagers reported to academic hospitals are suicides, but the real figure is much higher, warns the SA Depression and Anxiety Group (Sadag).
A fifth (20%) of high school teenagers in this country attempt suicide and it’s on the rise, according to Sadag.
The latest evaluation of apps intended to prevent suicide found five of 10 evaluated for effectiveness reduced suicide risk using ecological momentary interventions (EMIs).
EMIs are defined as treatment provided to people in real time during their everyday lives, in natural (real-world) settings by clinicians and include mobile apps.
“These interventions can be useful complements to traditional care, especially in situations in which face-to-face care is not possible,” write Dr Enrique Baca-García and his colleagues from the Health Research Institute.
“For instance, EMIs may allow patients to adopt coping strategies when they experience a breakdown or to interact with the environment in different ways, such as by contacting professionals or family members during a crisis.”
Mobile health interventions have the advantage of providing “low-cost, 24.7 support” for people at high risk of suicide, including those who have previously made attempts or had thoughts.
But the researchers caution: “These mixed results suggest there is still a long way to go before [EMI interventions] can be routinely implemented in clinical practice.”
EMIs have been used for other psychiatric conditions, but are less known for suicide prevention, they write.
For their research they identified 27 studies of “19 different EMI interventions designed for suicide prevention”, 10 of which had at least one study evaluating their effectiveness.
Common to the interventions was safety planning: working out strategies with a clinician’s support for a time of suicidal crisis.
“Some apps including safety plans took advantage of digital media — for example, showing pictures of loved ones, videos with relaxation techniques or maps showing the quickest route to emergency help.”
Among participating patients in the studies there were high retention and good retention rates.
“The constant advance of technology leads us to believe in the great potential for [mobile health] interventions to contribute to the field of mental health,” Baca-García and his co-authors concluded.
Globally there are concerns suicides have picked up during the Covid-19 pandemic. The World Health Organisation (WHO) reports they are the fourth leading cause of death in adolescents aged 15 to 19.
Social media has the power to share knowledge on mental health and offer wide support, but social media apps have also been widely implicated in mental health distress and even provoking or promoting suicide.
The latest research shines a glimmer of light into this digital world.
• Be direct. Talk openly and matter-of-factly about suicide.
• Be willing to listen. Allow expressions of feelings. Accept the feelings.
• Be non-judgmental. Don't debate whether suicide is right or wrong, or whether feelings are good or bad. Don't lecture on the value of life.
• Get involved. Become available. Show interest and support.
• Don't dare them to do it.
• Don't act shocked. This will put distance between you.
• Don't be sworn to secrecy. Seek support.
• Offer hope that alternatives are available, but do not offer glib reassurance.
• Ask if you may contact a family member.
• Take action. Remove means such as guns or stockpiled pills.
• Don’t leave them alone. Get help from people specialising in crisis intervention and suicide prevention.
• If necessary, contact the police.
Source: SA Depression and Anxiety Group
— HOW TO HELP SOMEONE WHO IS THREATENING SUICIDE
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