Developing suicide prevention tools for young people

Suicide prevention tools for young people should be customizable, transparent, accessible and visually appealing, according to research published in JMIR Formative Research. Developers should work with users to create appropriate content and make sure sensitive language is used.

Suicide is the fourth leading cause of death among young people aged 15-29 years worldwide and suicide rates are increasing. Suicide prevention strategies can be helpful but there are barriers to young people accessing them. Providing support digitally can go some way to overcoming these barriers but can also pose risks by making inappropriate or harmful content accessible.

During this study, the research team wanted to explore how suicide prevention features within mental health apps should be designed and developed for young people. They did this by organising a workshop during which technical staff from an existing mental health app called Tellmi presented 14 possible adaptations that may improve support for its high-risk users. During the study researchers found that:

• The aims of the app must be clear and consistent – users need to know exactly what support they can expect to receive and this should be communicated clearly to them
• Providing high-risk users with the ability to customize the app could help them stay in control of the support they receive, while also ensuring that the content they see is appropriate and relevant
• Any activities suggested within the app need to be accessible because of how difficult it can be to engage with complex or demanding content during a mental health crisis
• Developers should collaborate with users to develop sensitive content and use appropriate language to avoid stigmatizing or triggering users

The workshop included input from mental health academics, mental health practitioners with expertise in suicide prevention, young people with lived experience of suicidal ideation, computer scientists and technical staff from the Tellmi app.

Dr Lucy Biddle, Associate Professor in Qualitative Mental Health Research and member of the study team, said:

“Digital tools such as smartphone apps can help facilitate suicide prevention among young people. However, they also carry risks as young people using these apps have reported being triggered by negative interactions with peers.

“An evaluation of the Tellmi app identified that it helps users find new ways of managing their difficulties. Peer support within the app also helps them feel less alone and more connected with those experiencing similar issues. However, Tellmi’s support for young people experiencing severe distress, including suicidal thoughts, is less developed.

“The workshop we organised emphasized that supporting the target population of high-risk users must be carefully considered due to the unique challenges they may face. Our participants argued that support should be developed while working directly with high-risk users. For example, content that needed sustained engagement should take into consideration that users may be struggling with motivation.

“While the needs of app users were focal in workshop discussions, the role of those providing support was also considered. This included the experience and skills required of them to be able to help users, as well as how they themselves could be supported in this challenging role.”

Tellmi

Tellmi (previously MeeToo) is a pre-moderated UK-based peer-support app where people aged 11-25 years can anonymously discuss issues ranging from worries to life challenges. It has procedures to support high-risk users, nevertheless, Tellmi is interested in improving the support they provide to users with more acute mental health needs, such as young people struggling with suicide and self-harm ideation.