The Acceptability of a Smartphone App (BlueIce) for University Students Who Self-harm

Abstract

University students are twice as likely to self-harm than community controls but, unfortunately, help-seeking among this population is particularly low. Given the stigma around self-harm, the face-to-face nature of traditional support for self-harm can be a barrier to help-seeking. Smartphone applications (apps) are a possible alternative source of support, and research has shown that students are receptive to this option. This study sought to assess the acceptability of a smartphone app called BlueIce for university students who self-harm. Semi-structured interviews were conducted with 25 students with a history of self-harm. A qualitative content analysis was undertaken and five categories were identified: the content of BlueIce, the use of BlueIce with university students, the function of BlueIce, comparison with other support, and the implementation and uptake of BlueIce. Responses to BlueIce were very positive with students believing BlueIce to be a helpful resource that was perceived as more accessible than alternative support. Participants believed it could provide help in moments of distress as well as helping individuals learn longer-term coping skills. Others felt that BlueIce would not be adequate for some people and would be better used alongside other face-to-face support. Overall, it was clear that BlueIce was acceptable to the students in this study. Future research should seek to evaluate the feasibility and effectiveness of BlueIce within a university setting with students.

HIGHLIGHTS

• Students who self-harm found the BlueIce app to be an acceptable and appealing source of support for self-harm as well as other mental health difficulties.

• Participants felt that the app was more accessible than other forms of support, particularly for individuals who prefer not to discuss self-harm with a professional.

• Some felt that BlueIce could provide immediate support in moments of distress, while others believed it to be a longer-term solution that could help students learn more adaptive coping strategies.

Keywords:

• Digital intervention
• mental health
• mHealth
• self-harm
• university student

ACKNOWLEDGMENTS

The authors would like to thank the participants for their contribution to this research.

DISCLOSURE STATEMENT

Bethany Cliffe and Zoe Stokes declare that they have no conflicts of interest. Paul Stallard designed the BlueIce app but receives no financial gain from the app or from this research.

AUTHOR NOTES

Bethany Cliffe, Department for Health, University of Bath, Bath, UK. Zoe Stokes, Oxford Health NHS Foundation Trust, Oxford, UK. Paul Stallard, Department for Health, University of Bath, Bath, UK and Oxford Health NHS Foundation Trust, Oxford, UK.