Codesign of Digital Health Tools for Suicide Prevention: A Scoping Review
DOI:
https://doi.org/10.14738/bjhmr.105.15365Keywords:
digital health tools, suicide prevention, codesignAbstract
The importance of codesigning digital health tools for suicide prevention has gained popularity since 2012. Promoted as cost-effective and innovative, digital health tools are widely used but seldom described or evaluated from a codesign lens. This scoping review provides an overview of the research and gaps in the delivery of codesigned digital health tools for suicide prevention. This review is phase two within a three-phase study. Phase one involved a scoping review protocol which informed this scoping review and the results will contribute to a proof-of-concept project to develop a digital tool for suicide prevention (phase three). The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-SCR) and Population, Concept, Context (PCC) framework to ensure reporting standards were maintained and supplemented by Arksey and O’Malley and Levac et al. The search for literature occurred from November 2022 to March 2023. Five data bases were searched: Medline, Scopus, CINAHL, PsycInfo and Cochrane Database of Systematic Reviews. Grey literature searches included government, non-government health websites, Google and Google Scholar. 3260 records were identified from the initial search and 61 were included in the final review. All members of the research team screened the included records. Data from published and grey literature were extracted and a narrative approach identified the results and five themes: acceptability by users, future inclusion of experts-by-experience, inconsistent use of Patient and Public Involvement (PPI), digital tools to supplement face-to-face therapy and digital divide. We found that none of the data from the included studies used codesign methodology and experts-by-experience roles were minimised as members of focus groups, advisory groups, pilot studies or at the final stage of usability testing. Future research is required where codesign involves co-authorship with experts-by experience, end-to-end partnership from design, implementation and evaluation of digital health tools for suicide prevention.
References
World Health Organization. Suicide [Internet]. 2022 [cited 2023 March 31]. Available from https://www.who.int/news-room/fact- sheets/detail/suicide
Survivors of bereavement by suicide. Support after a suicide booklet. 2023 [cited 2023 March 31]. Available from https://uksobs.org/resources-for-survivors/support-after-a-suicide-booklet
Franco-Martin M, Munoz-Sanchez A, Sainz-de-Abajo J, Castillo-Sanchez L, Hamrioui B, Torre-Diez G. A Systematic Literature Review of Technologies for Suicidal Behaviour Prevention. Journal of Medical Systems. 2018; 42(4):1-7. Available from: https://doi.org/10.1007/s10916-018-0926-5
Witt K, Spittal MJ, Carter G, Pirkis J, Hetrick S, Currier D, et al. Effectiveness of online and mobile telephone applications (apps) for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. BMC Psychiatry. 2017; 17(297):1-18. Available from: https://doi.org/10.1186/s12888-017-1458-0
Arshad U, Farhat A, Gauntlett J, Husain N, Chaudhry N, Taylor PJ. A Systematic Review of the Evidence Supporting Mobile and Internet Based Pscyhcological Interventions for Self-Harm. Suicide & lifethreatening behaviour. 2020;50:151-179. Available from: https://doi.org/10.1111/sltb.12583
Robinson J, Georgina C, Bailey E, Hetrick S, Rodrigues M, Fisher S, et al. social media and suicide prevention: a systematic review. Early Intervention in Psychiatry. 2016; 10:103-12. Available from: https://doi.org/10.111/eip.12229
Torok M, Han J, Baker S, Werner-Seidler A, Wong I, Larsen ME, et al. Suicide prevention using self-guided digital interventions: a systematic review and meta-analysis of randomised controlled trials. Lancet Digital Health. 2020; 2(1):25–36. Available from: https://doi.org/10.1016/S2589-7500(19)30199-2
Nusir M, Rekik M. Systematic review of co-design in digital health for COVID-19 research. Universal Access in the Information Society. 2022. Available from: https://doi.org/10.1007/s10209022-00964-x
McKercher KA. Beyond sticky notes: Codesign for real. Australia: Inscope Books; 2020. Available from: https://www.beyondstickynotes.com/tellmore
Care Quality Commission. Experts by Experience [Internet]. 2023 [cited 2023 March 31]. Available from: https://www.cqc.org.uk/about-us/jobs/experts-experience
Wepa D, Neal M, Abo-Gazala W, Cusworth S, Hargan J, Mistry M, et al. Codesign of a digital health tool for suicide prevention: protocol for a scoping review. BMJ Open. 2023. Available from: https://doi.org/10.1136/bmjopen-2-22-070329
Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005; 1:19-32. Available from:
Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Science. 2020; 20(5):69. Available from: https://doi.org/10.1080/1364557032000119616
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. Prisma Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine. 2018; 169(7):467-473. Available from: https://doi.org/10.7326/M18-0850
Peters M, Marnie C, Tricco A, Pollock D, Munn Z, Lyndsay A, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Synthesis. 2020; 18(10:2119-2126. Available from https://doi.org/10.11124/JBIES-20-00167
Veritas Health Innovation. Covidence Systematic Review Software [Internet]. 2022 [cited 2023 March 31]. Available from: https://www.covidence.org
De Jaegere E, van Landschoot R, van Heeringen K, van Spijker B, Kerkhof A, Mokkenstorm J, et al. The online treatment of suicidal ideation: A randomised controlled trial of an unguided web-based intervention. Behaviour Research and Therapy. 2019; 119:1-8. Available from https://doi.org/10.1016/j.brat.2019.05.003
Dimeff L, Jobes D, Koerner K, Kako N, Tropher J, Keey-Brimer A, et al. Using a table-based app to deliver evidence-based practices for suicidal patients in the emergency department: Pilot randomized control trial. JMIR Mental Health. 2021; 8(3):1-15. Available from https://doi.org/10.2196/23022
O’Toole M, Arendt M, Pedersen C. Testing an app-assisted treatment for suicide prevention in a randomized controlled trial: Effects on suicide risk and depression. Behavior Therapy. 2018; 50:421-429. Available from https://doi.org/10.1016/j.beth.2018.07.007
Rozek D, Andres W, Smith N, Leifker F, Arne K, Jennings G, et al. Using machine learning to predict suicide attempts in military personnel. Psychiatry Research. 2020; 294:1-5. Available from https://doi.org/10.1016/j.psychres.2020.112515
Chen M, Chan K. Effectiveness of digital health interventions on unintentional injury, violence and suicide: Meta-analysis. Trauma, violence & abuse. 2020: 23(2):605-619. Available from
Torous J, Nicholas J, Larsen M, Firth J, Christensen H. Clinical review of user engagement with mental health smartphone apps: evidence, theory and improvements. Evidence Based Mental Health. 2018; 21(3):116-119. Available from: https://doi.org/10.1136/be-2018-102891
Buscher R, Torok M, Terhorst Y, Sander L. Internet-based cognitive behavioral therapy to reducesuicidal ideation: A systematic review and meta-analysis. JAMA Network Open. 2020; 3(4):1-13. Available from https://doi.org/10.1001/jamanetworkopen.2020.3933
Goldberg S, Lam S, Simonsson O, Torous J, Sun S. Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials. PLOS Digital Health. 2022; 1(1):1-21. Available from https://doi.org/10.1371/journal.pdig.0000002
Baines R, Bradwell H, Edwards K, Stevens S, Prime S, Tredinnick-Rowe J, et al. Meaningful patient and public involvement in digital health innovation, implementation and evaluation: A systematic review. Health Expectations. 2022; 1-14. Available from https://doi.org/10.1111/hex.13506
Hobson G, Caffery L, Neuhaus M, Langbecker D. Mobile health for First Nations populations: Systematic Review. JMIR MHealth and UHealth. 2019; 7(10):1-16. Available from https://doi.org/10.2196/14877
Kreuze E, Jenkins C, Gregoski M, York J, Mueller M, Lamis D, et al. Technology-enhanced suicideprevention interventions: A systematic review. Journal of Telemedicine and Telecare. 2017; 23(6):605-617. Available from https://doi.org/10.1177/1357633X16657928
Martinengo L, Van Galen L, Lum E, Kowalski M, Subramaniam M, Car J. Suicide prevention and depression apps’ suicide risk assessment and management: a systematic assessment of adherence to clinical guidelines. BMC Medicine. 2019; 17(231):1-12. Available from https://doi.org/10.1186/s12916-019-1461-z
Pospos S, Young I, Downs N, Iglewicz A, Depp C, Chen J, et al. Web-based tools and mobile applications to mitigate burnout, depression and suicidality among healthcare students and professionals: A systematic review. Academic Psychiatry. 2018: 42:109-120. Available from https://doi.org/10.1007/s40596-017-0868-0
Bailey E, Muhlmann C, Rice S, Nedeljkovic M, Alvarez-Jimenez M, Sander L, et al. Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey. BMC Medical Ethics. 2020; 21(37):1-16. Available from https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-020-00479-1
Lai M, Maniam T, Chan L, Ravindran A. Caught in the web: A review of web-based suicide prevention. Journal of Medical Internet Research. 2014; 16(1):1-8. Available from https://doi.org/10.2196/jmir.2973
Milne-Ives M, Selby E, Inkster B, Lam C, Meinert E. Artificial intelligence and machine learning in mobile apps for mental health: A scoping review. PLOS Digital Health. 2022; 1(8):1-13. Available from https://doi.org/10.1371/journal.pdig.0000079
Rassy J, Bardon C, Dargis L, Cote LP, Corthesy-Blondin L, Morch CM, et al. Information and communication technology use in suicide prevention: Scoping review. Journal of Medical Internet Research. 2021; 23(5):1-20. Available from https://doi.org.10.2196/25288
Reen J, Friday A, Orji R. Saving life and keeping privacy: A study on mobile apps for suicide prevention and privacy policies. Persuasive. 2022; 190-207. Available from https://doi.org/10.1007/978-3-030-98438-0_15 URL: http://dx.doi.org/10.14738/bjhmr.105.15365. 27
Rice S, Robinson J, Bendall S, Hetrick S, Cox G, Bailey E, et al. Online and social media suicide prevention interventions for young people: A focus on implementation and moderation. Journal of the Canadian Academy of Child and Adolescent psychiatry. 2016; 25(2):80-86. Available from https://researchmgt.monash.edu/we/portalfiles/portal/303332545/303332247_0a.pdf
Balcombe L, Diego D. Human-computer interaction in digital mental health. Informatics. 2022; 9(14):1-18. Available from https://doi.org/10.3390/informatics9010014
Balcombe L, Diego D. The potential impact of adjunct digital tools and technology to help distressed and suicidal men: An integrative review. Frontiers in Psychology. 2022; 12:1-10. Available from https://doi.org/10.3389/fpsyg.2021.796371
Berrouiguet S, Gravey M, Le Galudec M, Alavi Z, Walter M. Post-acute crisis text messaging outreach for suicide prevention: A pilot study. Psychiatry Research. 2014; 217:154-157. Available from http://dx.doi.org/.1016/j.psychres.2014.02.034
Brown K, Toombs M, Nasir B, Kisely S, Ranmuthugala G, Brennan-Olsen S, et al. How can mobile applications support suicide prevention gatekeepers in Australian Indigenous communities? Social Science & Medicine. 2020; 258:1-10. Available from https://doi.org/10.1016/j.socsimed.2020.113015
Bruen A, Wall A, Haines-Delmont A, Perkins E. Exploring Suicidal Ideation Using an Innovative Mobile App-Strength Within Me: The Usability and Acceptability of Setting up a Trial Involving Mobile Technology and Mental Health Service Users. JMIR Mental Health. 2020;7(9):18407. Available from:
Buus N, Erlangsen A, River J, Andreasson K, Frandsen H, Larsen J, et al. Stakeholder perspectives on using and developing the MYPLAN suicide prevention mobile phone application: A focus group study. Archives of Suicide Research. 2018; 24(1):48-63. Available from https://doi.org/10.1080/13811118.2018.1489319
Dickter B, Bunge E, Brown L, Leykin Y, Soares E. van Voorhees B, et al. Impact of an onlinedepression prevention intervention on suicide risk factors for adolescents and young adults. mHealth. 2019; 5(11):1-10. Available from http://doi.org/10.21037/mhealth.2019.04.01
Hetrick S, Robinson J, Burge E, Blandon R, Mobilio B, Rice S, et al. Youth Codesign of a mobile phone app to facilitate self-monitoring and management of mood symptoms in young people with major depression, suicidal ideation and self-harm. JMIR Mental Health. 2018; 5(1):1-14. Available from https://doi.org/10.2196/mental.9041
Josifovski N, Shand F, Morley K, Chia J, Henshaw R, Petrie K, et al. A pilot study of a text message and online brief contact intervention following self-harm or a suicide attempt: A mixed methods evaluation. General Hospital Psychiatry. 2022; 76:1-2. Available from https://doi.org/10.1016/j.genhosppsych.2022.03.002
Kennard B, Goldstein T, Foxwell A, McMakin D, Wolfe K, Biernesser C, et al. As safe as possible (ASAP): A brief app-supported inpatient intervention to prevent post discharge suicidal behaviour in hospitalized, suicidal adolescents. Am J Psychiatry. 2018; 175:864-872. Available from https://doi.org/10.1176/appi.ajp.2018.17101151
Kennedy A, Brumby S, Versace V, Brumby-Rendell T. The ripple effect: a digital intervention to reduce suicide stigma among farming men. BMC Public Health. 2020; 20:1-12. Available from
Kimberly H, O’Brien M, LeCloux M, Ross A, Gironda C, Wharff E. A pilot study of the acceptability and usability of a smartphone application intervention for suicidal adolescents and their parents. Archives of Suicide Research. 2017; 21:254-264. Available from https://doi.org/10.1080/13811118.2016.1182094
Kiosses D, Monkovic J, Stern A, Czaja S, Alexopoulos G, Arslanoglou E, Ebo T, et al. An emotion regulation tablet app for middle-aged and older adults at high suicide risk: Feasibility, acceptability and two case studies. American Journal of Geriatric Psychiatry. 2022; 30(5):575-584. Available from https://doi.org/10.1016/j.jagp.2021.08.015
Martinez-Miranda J, Martinez A, Ramos R, Aguilar H, Jimenez L, Arias Hodwar et al. Assessment of users’ acceptability of a mobile-based embodied conversational agent for the prevention and detection of suicidal behaviour. Journal of Medical Systems. 2019; 43(246):1-18. Available from
Morgieve M, Genty C, Aze J, Dubois J, Leboyer M, Vaiva Guillaume et al. A digital companion, the Emma App, for ecological momentary assessment and prevention of suicide: Quantitative case series study. JMIR MHealth and UHealth. 2020; 8(10):1-16. Available from https://doi.org/10.2196/15741
Biddle L, Derges J, Goldsmith C, Donovan JL, Gunnell D. Online help for people with suicidal thoughts provided by charities and healthcare organisations: a qualitative study of users’ perceptions. Social Psychiatry and Psychiatric Epidemiology. 2020; 55:1157–1166. Available from:
Castillo-Sanchez G, Camargo-Henriquez I, Munoz-Sanchez J, Franco-Martin M, Torre-Diez I. Suicide prevention mobile apps: Descriptive analysis of apps from the most popular virtual stores. JMIR MHealth and UHealth. 2019; 7(8):1-9. Available from https://doi.org/10.2196/13885
Gibson K, Wilson J, Le Grice J, Seymour F. Resisting the silence: The impact of digital communication on young people’s talk about suicide. Youth & Society. 2019; 51(8):1011-1030.Available from https://doi.org/10.1177/0044118X17720986
Gould M, Chowdhury S, Lake A, Galfalvy H, Kleinman M, Kuchuk M, et al. National Suicide Prevention Lifeline crisis chat interventions: Evaluation of chatters’ perceptions of effectiveness. Suicide and Life-Threatening Behavior. 2021; 51:1126-1137. Available from https://doi.org/10.1111/sltb.12795
O’Grady C, Melia R, Bogue J, O’Sullivan M, Young K, Duggan J. A mobile health approach for improving outcomes in suicide prevention (SafePlan). Journal of Medical Internet Research. 2020; 22(7):1-14. Available from https://doi.org/10.2196/17481
Primack J, Bozzay M, Barredo J, Armey M, Miller I, Fisher J, et al. Feasibility and acceptability of the mobile application for the prevention of suicide (MAPS). Military Psychology. 2021; 34()3):315-325. Available from https://doi.org/10.1080/08995605.2021.1962187
Povey J, Mills P, Dingwall K, Lowell A, Singer J, Rotumah D, et al. Acceptability of mental health apps for Aboriginal and Torres Strait Islander Australians: A qualitative study. Journal of Medical Internet Research. 2016; 18(3):1-12. Available from https://doi.org/10.2196/jmir.5314
Cohen R, Rifkin-Zybutz R, Moran P, Biddle L. Web-based support services to help prevent suicide in young people and students: A mixed-methods, user-informed review of characteristics and effective elements. Health and Social Care in the Community. 2022; 30:2404-2413. Available from https://doi.org/10.1111/hsc.13819
Dreier M, Baumgardt J, Bock T, Harter M, the 8 Lives Team, Liebherz S. Development of an online suicide prevention program involving people with lived experience: ideas and challenges. Research Involvement and Engagement. 2021; 7(60):1-14. Available from https://doi.org/10.1186/s40900-021-00307-9
Bush N, Dobscha S, Crumpton R, Denneson L, Hoffman J, Crain A, et al. A virtual hope box smartphone app as an accessory to therapy: Proof-of-concepts in a clinical sample of veterans. Suicide and Life-Threatening Behaviour. 2015; 45(1):1-9. Available from https://doi.org.10.1111/sltb.12103 29
Meier L, Gurtner C, Nuessli S, Miletic M, Burkle T, Durrer M. SERO – A new mobile app for suicide prevention. In: Healthcare of the Future. Studies in Health Technology and Informatics. 2022; 292:3-8. Available from https://doi.org/10.3233/SHTI220310
Papyrus. Thinking of suicide? [Internet]. 2023 [cited 2023 April 3]. Available from https://www.papyrusuk.org
Varzgani F, Tulu B, Djamasbi S, Frost E, Wang Z, Pietro J, et al. Suicide prevention through smartphone applications: A systematic review of literature. AMCIS Proceedings. 2021. Available from https://doi.org/10.2196/jmir.5314
Tighe J, Shand F, McKay K, McAllister T, Mackinnon A, Christensen H. Usage and acceptability of the iBobbly App: Pilot trial for suicide prevention in Aboriginal and Torres Strait Islander Youth. JMIR Mental Health. 2020; 7(12):e14296. Available from https://doi.org/10.2196/14296
Samaritans. Staying safe [Internet]. 2023 [cited 2023 April 3]. Available from https://giveusashout.org
Facebook. Facebook rolls out AI to detect suicidal posts before they’re reported [Internet]. 2017. [cited 2023 April 3]. Available from https://techcrunch.com/2017/11/27/facebook-ai-suicide-prevention/
Save.org. Suicide can be prevented and SAVE is here to help [Internet]. 2023. [cited 2023 April 3]. Available from https://save.org
National Suicide Prevention. Preventing suicide together [Internet]. 2023. [cited 2023 April 3]. Available from https://nspa.org.uk
Lifeline. Lifeline is always here to help [Internet]. 2023. [cited 2023 April 3]. Available from https://www.lifelinehelpline.info
Forefront. Reconstructing resilience: Mental Health Literacy [Internet]. 2023. [cited 2023 April 3]. Available from https://intheforefront.org
Mental Health and Wellbeing Commission. Transforming the mental health and wellbeing system [Internet]. 2023. [cited 2023 April 3]. Available from https://www.mhwc.govt.nz
Beyond Blue. We’re here for you [Internet]. 2023. [cited 2023 April 3]. Available from https://www.beyondblue.org.au
UK Standards for Public Involvement. Definitions [Internet]. 2023. [cited 2023 April 10]. Available from https://www.nihr.ac.uk/pi-standards/definitions
Digital Divide Council. What is the Digital Divide? [Internet]. 2023. [cited 2023 April 10]. Available from https://www.digitaldividecouncil.com/what-is-the-digital-divide/
Which.co.uk. The UK 3G network switch off: what you need to know [Internet]. 2023. [cited 2023 April 10]. Available from https://www.which.co.uk/review/mobile-phone-providers/article/the-uk-3g-networkswitch-off-
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Dianne Wepa, Martin Neal, Waseen Abo-Gazala, Sally Cusworth, Jae Hargan, Manoj Mistryh, Jimmy Vaughan, Stephen Giles, Mehnaz Khan

This work is licensed under a Creative Commons Attribution 4.0 International License.