BackUp: Development and evaluation of a smart-phone application for coping with suicidal crises

Kirsten Pauwels, Saskia Aerts, Ekke Muijzers, Eva De Jaegere, Kees van Heeringen, Gwendolyn Portzky, Kirsten Pauwels, Saskia Aerts, Ekke Muijzers, Eva De Jaegere, Kees van Heeringen, Gwendolyn Portzky

Abstract

Background: Suicide is a major public health issue and has large impact on the lives of many people. Innovative technologies such as smartphones could create new possibilities for suicide prevention, such as helping to overcome the barriers and stigma on help seeking in case of suicidal ideation. Due to their omnipresence, smartphone apps can offer suicide prevention tools very fast, they are easily-accessible, low-threshold and can help overcome some of the help-seeking barriers suicidal people experience. This article describes the development, testing and implementation of a mobile application for coping with suicidal crisis: BackUp.

Methods: Based on the analysis of literature and existing suicide prevention apps several tools were identified as relevant to include in a suicide prevention app. The selected tools (a safety planning tool, a hope box, a coping cards module, and a module to reach out) are evidence based in a face to face context, and could be easily transferred into a mobile app. The testing of existing apps and the literature also revealed important guidelines for the technical development of the application.

Results: BackUp was developed and tested by an expert panel (n = 9) and a panel of end users (n = 21). Both groups rated BackUp as valuable for suicide prevention. Suicidal ideation of the end user group was measured using the Beck Scale for Suicidal Ideation before and after testing BackUp, and showed a small but non-significant decrease. The majority of the testers used BackUp several times. All tools were evaluated as rather or very useable in times of suicidal crisis.

Conclusion: BackUp was positively evaluated and indicates that self-help tools can have a positive impact on suicidal ideation. Apps in particular create opportunities in approaching people that are not reached by traditional interventions; on the other hand they can contribute to suicide prevention in addition to regular care. However, more research is needed on the impact and effect of suicide prevention apps.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Opening screen of the BackUp…
Fig 1. Opening screen of the BackUp app.
Fig 2. My BackUps.
Fig 2. My BackUps.
Fig 3. BackUp box.
Fig 3. BackUp box.
Fig 4. BackUp cards.
Fig 4. BackUp cards.
Fig 5. My BackUp plan.
Fig 5. My BackUp plan.
Fig 6. Being BackUp.
Fig 6. Being BackUp.
Fig 7. Usage of BackUp during testing…
Fig 7. Usage of BackUp during testing period.
Fig 8. Evaluation of the tools by…
Fig 8. Evaluation of the tools by test panel.

References

    1. World Health Organization. Preventing suicide: A global imperative. 2016. Available from: .
    1. Zorg en Gezondheid. Evolutie van sterfte door zelfdoding (2014). 2014. Available from: .
    1. Reynders A, Scheerder G, Molenberghs G, Van Audenhove C. Suïcide in Vlaanderen en Nederland: Een verklaring vanuit sociaal cognitieve factoren en hulpzoekend gedrag. Leuven: Lucas; 2011.
    1. Luxton DD, June JD, Kinn JT. Technology-based suicide prevention: Current applications and future directions. Telemedicine and e-Health. 2011;17(1): 50–54. doi:
    1. Donker T, Petrie K, Proudfoot J, Clarke J, Birch MR, Christensen H. Smartphones for smarter delivery of mental health programs: A systematic review. Journal of Medical Internet Research. 2013;15(11): e247 doi:
    1. Shand FL, Ridani R, Tighe J, Christensen H. The effectiveness of a suicide prevention app for indigenous Australian youths: Study protocol for a randomized controlled trial. Trials. 2013;14(1): 396.
    1. Vanhaelewyn B, Pauwels G, De Wolf P, Accou T, De Marez L. DigiMeter 2015 | Telefonie: Smartphone wordt steeds belangrijker. Available from: .
    1. Larsen ME, Nicholas J, Christensen H. A systematic assessment of smartphone tools for suicide prevention. PLOS ONE. 2016;11(4): e0152285 doi:
    1. Aguirre RTP, McCoy MK, Roan M. Development guidelines from a study of suicide prevention mobile applications (Apps). Journal of Technology in Human Services. 2013;31(3): 269–93.
    1. Kennard BD, Biernesser C, Wolfe KL, Foxwell AA, Craddock Lee SJ, Rial KV, et al. Developing a brief suicide prevention intervention and mobile phone application: A qualitative report. Journal of Technology in Human Services. 2015; 33 (4): 345–357. doi:
    1. Gregory JM, Sukhera J, Taylor-Gates M. Integrating smartphone technology at the time of discharge from a child and adolescent inpatient psychiatry unit. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2017. 26(1), 45–50.
    1. Luxton DD, McCann RA, Bush NE, Mishkind MC, Reger GM. MHealth for mental health: Integrating smartphone technology in behavioral healthcare. Professional Psychology: Research and Practice. 2011;42(6): 505–12.
    1. Tighe J, Shand F, Ridani R, Mackinnon A, De La Mata N, Christensen H. Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial. BMJ Open. 2017;7: e013518 doi:
    1. Berrouiguet S, Baca-García E, Brandt S, Walter M, Courtet P. Fundamentals for future mobile-health (mHealth): A systematic review of mobile phone and web-based text messaging in mental health. Journal of Medical Internet Research. 2016;18(6): e135 doi:
    1. de Beurs D, Kirtley O, Kerkhof A, Portzky G, O'Connor RC. The role of mobile phone technology in understanding and preventing suicidal behavior. Crisis: The Journal of Crisis Intervention and Suicide Prevention. 2015;36(2): 79–82.
    1. Christensen H, Batterham P, O’Dea B. E-health interventions for suicide prevention. International Journal of Environmental Research and Public Health. 2014;11(8): 8193–212. doi:
    1. Luxton DD, June JD, Chalker SA. Mobile health technologies for suicide prevention: Feature review and recommendations for use in clinical care. Current Treatment Options in Psychiatry. 2015: 349–362.
    1. Bush NE, Dobscha SK, Crumpton R, Denneson LM, Hoffman JE, Crain A, Cromer R, Kinn JT. A virtual Hope Box Smartphone App as an accessory to therapy: Proof-of-concept in a clinical sample of veterans. Suicide and Life-Threatening Behavior. 2014. May 15;45(1): 1–9. doi:
    1. Labelle R, Bihoud-de-Serre A, Leblanc FO. Suicide prevention and new technologies: Evidence based practice Mishara B, Kerkhof A, editors. Basingstoke: Palgrave Macmillan; 2013. Innovating to treat depression and prevent suicide: the Iphone @PSY ASSISTANCE application; p. 168–80.
    1. Wenzel A, Brown GK, Beck AT. Cognitive therapy for suicidal patients: Scientific and clinical applications Washington, DC: American Psychological Association; 2009.
    1. Stanley B, Brown GK. Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice. 2012;19(2): 256–264.
    1. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: A Meta-analytic review. PLoS Medicine. 2010;7(7): e1000316 doi:
    1. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science. 2015;10(2): 227–237. doi:
    1. De Jaegere E, Portzky G. Ethical guidelines for technology-based suicide prevention programmes WP 5 Ghent: Euregenas; 2013.
    1. Taylor PJ, Gooding P, Wood AM, Tarrier N. The role of defeat and entrapment in depression, anxiety, and suicide. Psychological Bulletin. 2011;137(3): 391–420. doi:
    1. Horgan Á, Sweeney J. Young students’ use of the Internet for mental health information and support. Journal of Psychiatric and Mental Health Nursing. 2010. March;17(2): 117–23. doi:
    1. Rickwood D, Deane FP, Wilson CJ, Ciarrochi J. Young people’s help-seeking for mental health problems. Advances in Mental Health. 2005;4(3): 218–51.
    1. Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry. 2010;10(1): 113.
    1. Beck AT, Steer RA, Ranieri WF. Scale for suicide ideation: Psychometric properties of a self-report version. Journal of Clinical Psychology. 1988;44(4): 499–505.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner