Suicide prevention apps may prove vital for reducing Australia's suicide rates
A newly published review by the Black Dog Institute has found digital tools containing content related to suicidal ideation and/or behaviour shows stronger effects for reducing suicidal thoughts than those targeting depression.
Published today in The Lancet Digital Health, this research suggests digital, evidence-based interventions targeting suicide could form part of national and global efforts to prevent suicide.
With more than eight Australians a day taking their own lives, and up to 70 percent of those at risk of suicide not seeking help, the research comes at a critical time for the country's suicide prevention efforts.
These findings also provide potential solutions to the Productivity Commission's recommendations to reconfigure the mental health system, providing all Australians access to suitable mental healthcare.
Black Dog Institute NHMRC Research Fellow and the paper's lead author, Dr. Michelle Tye, and senior author, Black Dog Institute's Director and Chief Scientist, Scientia Professor Helen Christensen, believe digital tools targeting suicide are an important means of helping reach those most at risk, who traditionally might not seek face-to-face treatment.
"These results are promising in that digital tools may be an important form of health prevention for people experiencing suicidal thoughts, but whose perceived stigma, difficulty expressing concerns, or preference for self-reliance have meant that they have not accessed face-to-face care and support," said Dr. Tye.
"These tools are also likely to be a vital way to reach vulnerable people who may be geographically or socially isolated, or in regions where there are not adequate offline mental health services," said Professor Christensen.
"It is time that suicide prevention catches up with other industry transformations," Christensen said.
Researchers from the Black Dog Institute screened over 6,700 articles, and analysed data from 16 eligible randomised controlled trials of self-guided digital interventions that reported suicidal ideation, plans, and/or attempts as an outcome.
Digital programs directly targeting suicidality had the greatest impact in reducing suicidal ideation among participants, and were also effective at reducing depression symptoms—this effect was comparable to previous results seen in face-to-face therapies. Meanwhile, digital programs focused on addressing depression were less effective in reducing suicidal ideation.
"While depression can be a risk factor for suicide, it has not been established as a causal one, and there are many who experience suicidality without having depression," said Dr. Tye.
"Our review suggests people with suicidality may respond better to apps and online programs with tailored modules that directly address suicidality, rather than using depression-focused therapies to collectively treat suicidal ideation.
"Although digital interventions for suicide are still in their infancy, this review supports the position that they have the potential to improve suicidal outcomes in at-risk populations.
"We should be looking to embed these tools into health promotion campaigns and into health systems to encourage help-seeking, access to care, and to save lives."
The study was supported by the National Health and Medical Research Council, and involved researchers from Black Dog Institute.
More information: Michelle Torok et al. Suicide prevention using self-guided digital interventions: a systematic review and meta-analysis of randomised controlled trials, The Lancet Digital Health (2019). DOI: 10.1016/S2589-7500(19)30199-2