Abstract
BackgroundOnline and mobile telephone applications (‘apps’) have the potential to improve the scalability of effective interventions for suicidal ideation and self-harm. The aim of this review was therefore to investigate the effectiveness of digital interventions for the self-management of suicidal ideation or self-harm.MethodsSeven databases (Applied Science & Technology; CENTRAL; CRESP; Embase; Global Health; PsycARTICLES; PsycINFO; Medline) were searched to 31 March, 2017. Studies that examined the effectiveness of digital interventions for suicidal ideation and/or self-harm, or which reported outcome data for suicidal ideation and/or self-harm, within a randomised controlled trial (RCT), pseudo-RCT, or observational pre-test/post-test design were included in the review.ResultsFourteen non-overlapping studies were included, reporting data from a total of 3,356 participants. Overall, digital interventions were associated with reductions for suicidal ideation scores at post-intervention. There was no evidence of a treatment effect for self-harm or attempted suicide.ConclusionsMost studies were biased in relation to at least one aspect of study design, and particularly the domains of participant, clinical personnel, and outcome assessor blinding. Performance and detection bias therefore cannot be ruled out. Digital interventions for suicidal ideation and self-harm may be more effective than waitlist control. It is unclear whether these reductions would be clinically meaningful at present. Further evidence, particularly with regards to the potential mechanisms of action of these interventions, as well as safety, is required before these interventions could recommended.
Highlights
Online and mobile telephone applications (‘apps’) have the potential to improve the scalability of effective interventions for suicidal ideation and self-harm
Search strategy and selection criteria We searched for literature indexed in seven electronic databases covering a wide range of disciplines, including: computing and information technology (Applied Science & Technology) clinical trials (Cochrane Central Register of Controlled Trials [CENTRAL]), medicine (Embase; Medline), psychology (PsycARTICLES; PsycINFO), and public health (Global Health) as well as a database that indexes literature on interventions for the prevention of suicide (Centre for Research Excellence in Suicide Prevention [CRESP])
The findings of the present review significantly extend this by suggesting that digital interventions which incorporate the principles of standard cognitive behavioural therapy (CBT) may have promising effects in reducing suicidal ideation in non-clinical populations, at least in the short-term
Summary
Online and mobile telephone applications (‘apps’) have the potential to improve the scalability of effective interventions for suicidal ideation and self-harm. Effective face-to-face treatments for self-harm and suicidal ideation are available [9,10,11]. For example, been found between per capita availability of mental health services and suicide rates in a number of countries [12,13,14]. Even in countries where access to psychotherapy for suicidal ideation and self-harm are available, less than one-half of those who self-harm receive treatment [15]. There are a number of barriers to treatment for those who experience self-harm or suicidal ideation, including: beliefs that treatment is not warranted and/or is likely to be ineffective, stigma, shame, negative prior experiences with mental health care providers, and financial difficulties [15]. Young people in particular cite a preference for self-management as a major obstacle to help-seeking for self-harm from clinical services [16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
