Only 10% of suicide prevention apps cover recommended strategies

According to new research, most mobile apps for suicide prevention and depression management do not provide recommended strategies as per international clinical guidelines.

A new study, led by Nanyang Technological University, Singapore (NTU Singapore), has found that 93 per cent of mobile apps for suicide prevention and depression management do not provide all the six suicide prevention strategies that are commonly recommended in international clinical guidelines.

International guidelines from the UK, US and the World Health Organisation recommend six evidence-based strategies for preventing suicide, the researchers noted: “the tracking of mood and suicidal thoughts, development of a safety plan, recommendation of activities to deter suicidal thoughts, information and educational articles on signs of suicidality, access to support networks, and emergency counselling”.

Most apps included at least three suicide prevention approaches, they said, most commonly emergency contact information (94 per cent of apps tested), direct access to a crisis helpline (67 per cent) and suicide-related education (51 per cent).

But incorrect emergency telephone numbers were found in several apps available worldwide. Among the apps providing incorrect information were two that had been downloaded more than 1 million times each.

“Some patients may feel more at ease discussing their mental condition online than in person,” said NTU Singapore Associate Professor Josip Car.

“They also consider the internet accessible, affordable and convenient. With the high rates of smartphone use around the world, health apps can be a crucial addition in the way users manage their health and wellbeing on a global scale.”

“However, for this to become a reality, health app development and release should follow a transparent, evidence-based model.”

Wong Lai Chun, senior assistant director at Samaritans of Singapore, a non-profit organisation focused on crisis intervention and suicide prevention, advised against over-reliance on mobile apps.

“As suicide is a complex and multifaceted issue, intervention should not be replaced by mobile applications, but rather act as a complement to the existing pool of resources,” Ms Wong said.

“The findings in the study raised the worrying issue of inaccurate information and the lack of quality assurance for apps that are accessible to the general public. It is vital that mobile application developers ensure the information in their apps is kept up to date.”

The study, published online in the journal BMC Medicine, highlights the need for responsible design and creation of guidelines for apps that could have great impact on people’s lives.

In the study, the NTU-led team looked at 69 apps sourced through a systematic search on the Apple App Store and Google Play: 20 were depression management apps and 46 suicide prevention apps. Of the 69, three apps covered both conditions. The apps were identified based on keywords used to describe them and selected through a set of criteria, including the stated target users and provision of advice to prevent suicide attempts.

The researchers then assessed the apps against the clinical strategies stated in the international guidelines, using a series of 50 criteria-based questions.