Rather than encourage users to contact a crisis hotline, physician
or therapist, many apps are more likely to suggest people reach out
to peers for help, the study of 49 apps found.
Worse, two apps listed methods of committing suicide, which might be
intended as a prevention effort but could give dangerous ideas to
people in distress, the authors note in PLoS One.
“Technology that reaches people directly including apps, phone
conversational agents, and social media will play a huge role in
public health and prevention,” said Dr. Eleni Linos, a researcher
and epidemiologist at the University of California, San Francisco
who wasn’t involved in the study.
“But I think we have yet to see the potential of technology for
prevention,” Linos added by email.
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’s unclear whether the content in these apps can actually
help people in crisis, or even if some features might be harmful.
To assess the potential of apps for suicide prevention, Mark Larsen
of the Black Dog Institute at the University of New South Wales in
Sydney, Australia and colleagues downloaded 123 apps referring to
suicide and selected a subset with interactive features for their
analysis. Larsen didn’t respond to requests for comment.
The apps were made for Apple’s iPhone and devices running Google’s
Apps tended to focus on a single prevention strategy, although
safety-planning apps typically offered an average of about four
approaches for prevention, the study found.
Peer support was the most common recommendation, suggested in 27
In 14 apps, users were directed to follow safety plans to minimize
the risk of suicide with steps such as removing guns or weapons from
the home or adding speed dials within the app for people to contact
in a crisis.
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Other common features included referrals to crisis or suicide
support hotlines and prompts for users to self-screen for suicide
risk, which were included in 13 apps.
Three apps recommended physician screenings, while two proposed
One limitation of the study is that apps available in Australia may
not be the same as versions distributed in other countries, the
authors note. It’s also possible that the apps have been updated
since the study was done.
There’s also little evidence to suggest which features within apps
may be the most effective at preventing suicide.
Another issue with apps is that users have to install them and then
decide to use them in a crisis, which might not always happen when
people feel suicidal, noted Dr. Robert Steinbrook, a researcher at
Yale University School of Medicine who wasn’t involved in the study.
More research is also needed to determine what features in apps
encourage people to actually contact crisis hotlines or physicians,
Steinbrook added by email.
“It is important to not only study the characteristics of smartphone
applications but also to obtain information about how they are
used,” Steinbrook said.
SOURCE: http://bit.ly/1VAcWeS PLoS One, online April 13, 2016.
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