Evaluating the Feasibility and Effectiveness of an Australian Safety Planning Smartphone Application: A Pilot Study Within a Tertiary Mental Health Service

Melvin, Glenn; Gresham, Daniel; Beaton, Susan; Coles, Jan; Tonge, Bruce John; Gordon, Michael S.; Stanley, Bárbara

doi:10.1111/sltb.12490

Cited by 65 publications

(133 citation statements)

References 23 publications

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“…Six of the identified studies were conducted in Australia (33%) [35,38,41,42,44,49], four in the USA (22%) [36,37,39,45], and eight in Europe (44%) [40, 43, [36, 38-40, 50, 52], and two on self-monitoring using Ecological Momentary Assessment [46,52]. One intervention focussed on Dialectical Behaviour Therapy (DBT) [45], one on Acceptance and Commitment Therapy (ACT) [42], and one was a brief contact intervention involving text messages providing links to a range of therapeutic strategies [49].…”

Section: Phasementioning

confidence: 99%

“…No other high-risk groups (e.g., older adults, gender and sexual minorities) were specifically targeted in the identified studies. Five (28%) and two (11%) studies required participants to be clients of a mental health service [36,38,39,50,52] or school counsellor [35,41] respectively, through whom the intervention was administered. Only three studies (17%) had exclusion criteria related to high suicide risk [42][43][44].…”

Section: Phasementioning

confidence: 99%

“…Only three studies (17%) had exclusion criteria related to high suicide risk [42][43][44]. Ten studies (56%) excluded participants based on other mental health problems [35, 38, 41-45, 49, 50, 52], with nine (50%) excluding participants with psychosis-related disorders [35,38,41,42,44,45,49,52]. One study excluded participants who were currently accessing mental health treatment [37].…”

Section: Phasementioning

confidence: 99%

“…Six (33%) of the 18 studies reported no information about their risk management procedures [36,38,39,49,50,52]. Of the twelve that did provide information, seven (58%) described active involvement of the research team in risk management procedures [40,42,43,45,47,48,51], and four (33%) described contact with the participants' emergency contact or general practitioner (GP) [43,47,48,51].…”

Section: Phasementioning

confidence: 99%

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Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey

et al. 2020

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Background: People who are at elevated risk of suicide stand to benefit from internet-based interventions; however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this study was to examine the ethical issues and practical barriers associated with clinical studies of internet-based interventions for suicide prevention. Method: This was a mixed-methods study involving two phases. First, a systematic search was conducted to identify studies evaluating internet-based interventions for people at risk of suicide, and information pertaining to safety protocols and exclusion criteria was extracted. Second, investigators on the included studies were invited to complete an online survey comprising open-ended and forced-choice responses. Quantitative and qualitative methods were used to analyse the data. Results: The literature search identified 18 eligible studies, of which three excluded participants based on severity of suicide risk. Half of the 15 suicide researchers who participated in the survey had experienced problems obtaining ethics approval, and none had encountered adverse events attributed to their intervention. Survey respondents noted the difficulty of managing risk in online environments and the limitations associated with implementing safety protocols, although some also reported increased confidence resulting from the ethical review process. Respondents recommended researchers pursue a collaborative relationship with their research ethics committees. Conclusion: There is a balance to be achieved between the need to minimise the risk of adverse events whilst also ensuring interventions are being validated on populations who may be most likely to use and benefit from them (i.e., those who prefer anonymity). Further research is required to obtain the views of research ethics committees and research participants on these issues. Dialogue between researchers and ethics committees is necessary to address the need to ensure safety while also advancing the timely development of effective interventions in this critical area.

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Section: Phasementioning

confidence: 99%

Section: Phasementioning

confidence: 99%

Section: Phasementioning

confidence: 99%

Section: Phasementioning

confidence: 99%

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Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey

et al. 2020

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“…Despite this scientific evidence, a literature review [ 29 ] identified very few suicide-specific apps (n=24) that include safety planning (n=14) and that directly allow the user to seek support (n=13). Feasibility studies of these apps report a significant reduction of suicidal ideation in patients and a significative augmentation of suicide-related coping [ 30 ]. However, potentially harmful content might encourage self-harm and suicide [ 31 ], and many of the existing apps for suicide prevention have not been scientifically validated [ 22 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

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

Morgiève¹,

Genty²,

Azé³

et al. 2020

JMIR Mhealth Uhealth

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Background Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, emma, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. Objective The aim of this case report study was to describe how subjects at high risk of suicide use the emma app in real-world conditions. Methods The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test emma, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by emma (ie, responses to EMAs), (2) metadata on emma use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. Results EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by emma were highlighted by three case reports. Conclusions These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, emma should be integrated into existing emergency procedures. Trial Registration ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381

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Assessment and Management of Suicidal Risk

Melvin

Oquendo

Stanley

et al. 2023

Tasman’s Psychiatry

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Evaluating the Feasibility and Effectiveness of an Australian Safety Planning Smartphone Application: A Pilot Study Within a Tertiary Mental Health Service

Abstract: The BeyondNow safety planning smartphone application was shown to be feasible and effective as an adjunct to mental health treatment among patients at risk of suicide.

Cited by 65 publications

References 23 publications

Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey

Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey

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

Assessment and Management of Suicidal Risk

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