Can Your Smartphone Save A Life? A Systematic Review of Mobile-Based Interventions For Suicide Prevention

Abstract

Mobile health (mHealth) apps are handy tools for tackling stigmatized mental health issues, including suicide. Mobile-based interventions for suicide prevention are easily accessible, increase the likelihood of honest reporting on sensitive topics and reduce stigma as compared to face-to-face or traditional interventions. Many mHealth apps for suicide prevention exist. However, the persuasive strategies employed in these apps and their efficacy remains unknown. To address this gap, we reviewed 80 suicide prevention apps available on app stores and in academic journals. We identified different persuasive strategies implemented in these apps using the Persuasive System Design (PSD) model. We also identified current trends within these apps, most and least-dominant implementations of persuasive strategies, effectiveness of apps, evaluation methods, and app content. We found that Personalization (n = 32) and Self-monitoring (n = 29) were the most-dominant strategies and Social Comparison, Social Role were the least-dominant strategies in suicide prevention apps. Based on our findings we discuss three major concerns in developing suicide prevention apps and offer recommendations for mitigating them. Our results show that persuasive strategies are a promising tool that can be used for designing suicide prevention apps. Our conclusions and recommendations will guide future work in suicide prevention app development and enhance the usability, effectiveness, and user-experience of such apps.

Authors contributions

Smriti Jha conceived and designed the experiments, analysed the data, prepared figures, and tables, authored and reviewed drafts of the paper, approved the final draft. Seana Jewer authored and reviewed drafts of the paper, approved the final draft. Vincent IO Agyapong authored and reviewed drafts of the paper, approved the final draft. Rita Orji conceived and designed the experiments, prepared figures, and tables, authored and reviewed drafts of the paper, approved the final draft.

Acknowledgments

The authors would like to thank Gerry Chan for his support in reviewing the manuscript and providing valuable feedback.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This research was undertaken, in part, thanks to funding from the Canada Research Chairs Program. We acknowledge the support of the Natural Sciences and Engineering Research Council of Canada (NSERC) through the Discovery Grant [RGPIN-2018-05265]. The research was conducted as part of the Dalhousie University’s Persuasive Computing Lab.

Notes on contributors

Smriti Jha

Smriti Jha is a Master’s in Computer Science student, advised by Dr. Rita Orji at the Persuasive Computing Lab, Dalhousie University. She works on designing technologies to promote behavior change in domains like suicide prevention, digital health and wellbeing. Her interests are Human-Computer Interaction, Persuasive Technology, Digital Health and Wellbeing.

Seana Jewer

Seana Jewer is the Community Engagement Leader for Roots of Hope, Nova Scotia where she’s building community capacity to reduce suicide. She’s also the co-chair of Nova Scotia Health Southeastern Community Health Board and Nova Scotia Department of Health and Wellness’ Suicide Prevention Risk and Reduction Framework Community Working Group.

Vincent I. O. Agyapong

Vincent I. O. Agyapong is a Professor of Psychiatry and Global Mental Health and Head of the Department of Psychiatry at Dalhousie University. He’s also the Chief of Psychiatry for Central Zone at Nova Scotia Health Authority. His research interests include global mental health, disaster mental health, mental health systems and policy.

Rita Orji

Rita Orji is a Canada Research Chair in Persuasive Technology and a Computer Science Professor at Dalhousie University where she directs Persuasive Computing Lab. Her research is at the intersection of technology and human behavior, focusing on investigating user-centered approaches to designing technologies that improve lives and promote desirable behaviors.