Recognizing the importance of digital communication, major suicide prevention helplines have started offering crisis intervention by chat. To date there is little evidence supporting the effectiveness of crisis chat services. To evaluate the reach and outcomes of the 113Online volunteer-operated crisis chat service, 526 crisis chat logs were studied, replicating the use of measures that were developed to study telephone crisis calls. Reaching a relatively young population of predominantly females with severe suicidality and (mental) health problems, chat outcomes for this group were found to be comparable to those found for crisis calls to U.S. Lifeline Centers in 2003-2004, with similar but not identical associations with specific helpers' styles and attitudes. Our findings support a positive effect of the 113Online chat service, to be enhanced by practice standards addressing an apparent lack of focus on the central issue of suicidality during chats, as well as by the development of best practices specific for online crisis intervention.

Evaluation of the 113Online suicide prevention crisis chat service: outcomes, helper behaviors and comparison to telephone hotlines

Background: The Internet is used increasingly for both suicide research and prevention. To optimize online assessment of suicidal patients, there is a need for short, good-quality tools to assess elevated risk of future suicidal behavior. Computer adaptive testing (CAT) can be used to reduce response burden and improve accuracy, and make the available pencil-and-paper tools more appropriate for online administration. Objective: The aim was to test whether an item response–based computer adaptive simulation can be used to reduce the length of the Beck Scale for Suicide Ideation (BSS). Methods: The data used for our simulation was obtained from a large multicenter trial from The Netherlands: the Professionals in Training to STOP suicide (PITSTOP suicide) study. We applied a principal components analysis (PCA), confirmatory factor analysis (CFA), a graded response model (GRM), and simulated a CAT. Results: The scores of 505 patients were analyzed. Psychometric analyses showed the questionnaire to be unidimensional with good internal consistency. The computer adaptive simulation showed that for the estimation of elevation of risk of future suicidal behavior 4 items (instead of the full 19) were sufficient, on average. Conclusions: This study demonstrated that CAT can be applied successfully to reduce the length of the Dutch version of the BSS. We argue that the use of CAT can improve the accuracy and the response burden when assessing the risk of future suicidal behavior online. Because CAT can be daunting for clinicians and applied scientists, we offer a concrete example of our computer adaptive simulation of the Dutch version of the BSS at the end of the paper. [J Med Internet Res 2014;16(9):e207]

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Applying computer adaptive testing to optimize online assessment of suicidal behavior: a simulation study.

Suicide is the second cause of death in young people. The use of technologies as tools facilitates the detection of individuals at risk of suicide thus allowing early intervention and efficacy. Suicide can be prevented in many cases. Technology can help people at risk of suicide and their families. It could prevent situations of risk of suicide with the technological evolution that is increasing. This work is a systematic review of research papers published in the last ten years on technology for suicide prevention. In September 2017, the consultation was carried out in the scientific databases PubMed, ScienceDirect, PsycINFO, The Cochrane Library and Google Scholar. A general search was conducted with the terms "prevention" AND "suicide" AND "technology. More specific searches included technologies such as "Web", "mobile", "social networks", and others terms related to technologies. The number of articles found following the methodology proposed was 90, but only 30 are focused on the objective of this work. Most of them were Web technologies (51.61%), mobile solutions (22.58%), social networks (12.90%), machine learning (3.23%) and other technologies (9.68%). According to the results obtained, although there are technological solutions that help the prevention of suicide, much remains to be done in this field. Collaboration among technologists, psychiatrists, patients, and family members is key to advancing the development of new technology-based solutions that can help save lives.

A Systematic Literature Review of Technologies for Suicidal Behavior Prevention

In this editorial, we discuss how mobile phone technology has the potential to move the field forward in terms of understanding suicide risk as well as laying foundations for the development of effective treatments/interventions. We have focused on mobile health technology given the rapid growth of mobile health approaches in suicide prevention (De Jaegere & Portzky, 2014; Mishara & Kerkhof, 2013) and psychological research more generally (Myin-Germeys et al., 2009; Nock, Prinstein, & Sterba, 2009; Palmier-Claus et al., 2011) and because mobile phone use is ubiquitous, with 75% of the world having access to a mobile phone (Kay, 2011). (aut. ref.)

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The Role of Mobile Phone Technology in Understanding and Preventing Suicidal Behavior

Mobile devices, and the apps (software applications) that operate on them, have potential to help manage and prevent suicidal behavior by assisting with assessment of risk, providing educational and support information, and facilitating access to safety plans, crisis support, and coping tools. This clinician-friendly review provides an overview of the principal features of currently available mobile health apps that are specially designed for suicide prevention. The use of patient contact interventions (i.e., text messaging and e-mail interventions) on mobile devices is also discussed. Recommendations for selecting and integrating these tools into patient care are provided, along with discussion of emerging capabilities and limitations including the lack of research regarding the clinical effectiveness of mobile health apps. The topics presented should be informative to individual practitioners as well as health care organizations that are considering adopting these technologies into their services.

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Mobile Health Technologies for Suicide Prevention: Feature Review and Recommendations for Use in Clinical Care

Throughout most of human history people with personal problems would need to seek out another person to obtain help or emotional support. The alternative was to deal with the problem oneself, pray for divine intervention or have some solace from religious beliefs. In more recent times, for those few with the ability and culture to do so, one could also seek information, guidance or support from printed books. The second half of the 20th century was a period when the use of face- to-face professional help expanded throughout the world. During this same period, books became a source of a “do-it-yourself” psychological treatment, with an exponential growth in self-help books for almost any human affliction. In the mid-20th century, a new technology, the telephone, expanded the options for help seeking. Telephone support for suicidal people expanded rapidly since the start of the Samaritan movement in the United Kingdom, founded by Reverend Chad Varah in 1953 (Mishara, 2012). Today, telephone helplines provide crisis inter- vention, emotional support and suicide prevention services throughout the world. For examples, Befrienders Worldwide has affiliate helplines in more than 40 countries that provide telephone help based upon the Samaritan approach.

Louis-Philippe Côté

Papers

Suicide Prevention and New Technologies: Towards Evidence Based Practice