A systematic assessment of smartphone tools for suicide prevention
Open accessAbstract
BACKGROUND: Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps) to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies. METHODS: Apps referring to suicide or deliberate self-harm (DSH) were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature. RESULTS: One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27) and safety planning (n = 14). Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13). All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1), although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9). Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified. DISCUSSION: Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive evidence-based support. Apps with potentially harmful content were also identified. Despite the number of apps available, and their varied purposes, there is a clear need to develop useful, pragmatic, and multifaceted mobile resources for this population. Clinicians should be wary in recommending apps, especially as potentially harmful content can be presented as helpful. Currently safety plan apps are the most comprehensive and evidence-informed, for example, "Safety Net" and "Mood-Tools--Depression Aid".
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Mental health apps may contain harmful content.
“and may even contain harmful content (Larsen et al., 2016).”
From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Larsen et al., 2016
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Issues for eHealth in Psychiatry: Results of an Expert Survey
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Self-citationLarsen, M. E., Shand, F., Morley, K. C., Batterham, P. J., Petrie, K., Reda, B., Berrouiguet, S., Haber, P., Carter, G. L., & Christensen, H. M. (2017) · JMIR Mental Health · doi:10.2196/mental.7500 · Cited by 34 · see citing works
A systematic scoping review of adolescent mental health treatment using mobile apps
Gindidis, S., Stewart, S., & Roodenburg, J. (2018) · Advances in Mental Health · doi:10.1080/18387357.2018.1523680 · Cited by 35 · see citing works
Real-World Technology Use Among People With Mental Illnesses: Qualitative Study
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Emotionally adaptive support: a narrative review of affective computing for mental health
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Suicide prevention: Towards integrative, innovative and individualized brief contact interventions
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“While not specific to VRET, a recent meta-analysis has shown that mental health apps oftentimes include techniques for which there is no clear evidence (Lagan et al., 2021) and may even contain harmful content (Larsen et al., 2016).”
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Digital Technology for Suicide Prevention
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Analyzing the Challenges Facing Digital Mental Health (DMH) Between Aspiration and Reality
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“Fidelity to clinical guidelines or evidencebased practice could be assessed using an expert clinical review of the intervention, for example.(9) However, it was noted that a program may be entirely consistent with clinical guidelines but have poor outcomes, potentially due to low user engagement (e.”
BackgroundMethodSmartphones for Smarter Care? Self-Management in Schizophrenia
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The feasibility of using smartphone apps as treatment components for depressed suicidal outpatients
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- Authors
- Larsen, M. E., Nicholas, J., & Christensen, H.
- Affiliations
- Black Dog Institute (AU)
- Corresponding author
- Larsen, Mark Erik
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-04-13
- Volume
- 11
- Issue
- 4
- Pages
- e0152285
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4830444
- OpenAlex
- W2339369942
- Semantic Scholar
- b05c1f3c05d39e26892368ea8fceb6ea0ef29bf3
- Cited by
- 289
- References
- 24
- Citations by year
- 2026: 15 · 2025: 31 · 2024: 24 · 2023: 25 · 2022: 24 · 2021: 41 · 2020: 31 · 2019: 28 · 2018: 43 · 2017: 22 · 2016: 5
- FWCI
- 4.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Medical Research Council
- National Health and Medical Research Council (1042580, 1056964)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- suicide prevention, mobile health apps, mobile application, self-harm, crisis support, evidence-based interventions, app reviews, suicide risk
- MeSH terms
- Smartphone, Suicide Prevention, Humans, Self Care, Suicide, Telemedicine, Mobile Applications
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