Community-based participatory research with police: Development of a tech-enhanced structured suicide risk assessment and communication smartphone application.

Abstract

Objective: Police officers initiate psychiatric holds following determination of suicide risk. Such referrals constitute direct decriminalization of mental illness at the single most efficient criminal justice system diversion point. However, system-level problems with this process highlight a need to further understand and improve this service connection juncture. The goal of the present study was to inform the development of a smartphone application designed to enhance police referrals of individuals experiencing suicide crises into treatment via culturally responsive structured professional judgment. Hypotheses: Given the developmental and qualitative nature of this study, there were no formal hypotheses tested. Research questions included the following: Would police officers broadly endorse concerns about the care referral process? Would officers support the use of technology to assist with those concerns? And would officers raise concerns about the demands on time and expertise that would be placed on them to conduct thorough risk assessments? Method: Researchers used community-based participatory research (CBPR) methods to obtain police stakeholder-driven data through four focus groups with 47 police officers (76.6% male, 59.6% White, with a mean of 10.7 years of police employment) sampled from patrol and hostage negotiation units. Participants shared information about specific problems arising in the process through which police refer people to medical care, and they gave feedback on the beta version of a culturally responsive mobile app designed to streamline officers’ evidence-based and culturally informed determinations of suicide risk. Results: Results, qualitatively coded using grounded theory methodology, yielded key considerations for police use of culturally responsive apps to divert individuals in suicidal crisis into treatment, including the need to maintain a balance between risk assessment and communication, allow for variance in time constraints, allow for flexibility in response and report options, account for inaccurate reports of suicide risk factors, maximize utility of the app’s risk report output, incorporate sensitivity around cultural questions, and consider officers’ safety in their use of the app in the field. Conclusions: The results illustrate a theoretically based (CBPR) approach to cross-disciplinary technology development to facilitate evidence-based assessments by law enforcement.

The Effectiveness of Mobile Apps for Monitoring and Management of Suicide Crisis: A Systematic Review of the Literature

“…Along with the suicide prevention strategies currently available, apps for suicide prevention have the potential to contribute to the reduction in suicide attempts and deaths through several types of interventions [ 16 ]. Screening for suicide risk, developing coping skills and emotional regulation strategies, providing emergency contact details, facilitating access to psychotherapy, encouraging people at risk to obtain support from family and friends, training others to recognize individuals at potential risk, and developing a safety plan are all possible interventions that apps can provide for suicide prevention [ 17 , 18 , 19 , 20 ]. However, evidence of the effectiveness of apps in reducing suicide ideation, plans and attempts remains unclear, and most of the apps currently available lack clinically validated evidence of their efficacy [ 16 ].…”

Introduction to the special issue on technology in the legal and criminal justice systems.

“…The article by Weaver et al (2021) identified how to leverage digital technology and culturally responsive assessments to enhance police referral of individuals experiencing suicide crises into treatment rather than incarceration and detailed the specific development of a suicide risk assessment and communication smartphone app for use by police. Referrals into treatment instead of incarceration could contribute to the decriminalization of mental illness at the point of contact with police, which is the most efficient diversion point in the criminal justice system.…”