Suicide Prevention at Your Fingertips

Pauline Anderson

April 07, 2015

An easily accessible mobile app for suicide prevention is proving to be a real hit among practitioners across the country.

Just a little over a week after it was launched by the Substance Abuse and Mental Health Services Administration (SAMHSA) in early March, the new app, called Suicide Safe, had been downloaded 12,500 times.

This "very important tool" can be downloaded for free to Apple and Android mobile devices, said clinical psychologist Richard McKeon, PhD, chief, Suicide Prevention Branch at SAMHSA, an agency of the US Department of Health and Human Services.

"It walks the physician or other clinician through the steps needed to do a comprehensive suicide risk assessment," said Dr McKeon.

"The practitioner uses his or her judgement to determine what level of risk the person may be at; it could be an immediate emergency or it might not be an emergency but the person might require behavioral health treatment."

The handy app provides a link to an intervention that fits the level of risk assessed.

"For example, it allows physicians to link to SAMSHA's mental health services locator system (for local mental health services) as well as to the National Suicide Prevention Lifeline," said Dr McKeon.

The SAMHSA-sponsored Lifeline has answered more than seven million calls since its inception in 2005.

The app also contains case history material and opportunities for clinicians to practice performing assessments of suicide risk, said Dr McKeon.

Thumbs Up

Michael Myers, MD, professor of clinical psychiatry, State University of New York, in New York City, who has downloaded the app, said he was impressed by the case examples it includes.

One example is an African American suffering posttraumatic stress disorder. "Having a cross-cultural assessment is very helpful," he said.

He was also struck by the language used by the app.

"People who are generalists are trained in so many different things that it's hard for them to remember what are the standard suicide risk assessment questions," said Dr Myers. "Here they've really reduced it to one or two different ways of exploring suicidal thinking or suicidal attempts."

Dr Meyers said he was "absolutely delighted" with the app, which he called a "wonderful tool" and "a great service" not only for primary care physicians but for other mental health professionals, including emergency department physicians, psychologists, social workers, and nurse practitioners.

The app is also helping to "put suicide on the map," said Dr Myers. "It's saying, 'this is real, this is serious stuff,' and that you can learn to assess the risk easily and quickly."

To develop the app, researchers tapped into the expertise of certified suicide prevention professionals as well as primary care physicians and people who have had a suicidal crisis themselves. The app creators had to factor in the fact that physicians have busy practices, said Dr McKeon.

Seamless, Efficient

"We had it in mind that we needed to make it as seamless and as efficient as possible for primary care physicians to utilize, because if it was too lengthy or too unwieldy, there was the likelihood that it would simply not be used."

It is impossible to predict how many suicides the app might prevent, but according to Dr McKeon, almost half of individuals who commit suicide have visited a primary care provider in the month prior to their death, and 20% have had contact with mental health services.

"Sometimes clinicians are reluctant to ask about suicide if they're not sure what to do next," said Dr McKeon. "We want providers to feel that they know what to do next, and that's what this app tries to help them with."

When a patient shows evidence of depression, a substance use problem, or anxiety, primary care doctors should ask that patient whether he or she has had thoughts of suicide, said Dr McKeon.

Dr Myers foresees groups representing family doctors, emergency medicine specialists, and even teaching and community hospitals where assessments are carried out to find out how many members are using the app.

Suicide is the tenth leading cause of death in the United States and the second leading cause of death among people aged 15 to 34 years.

For more information, visit http://store.samhsa.gov/apps/suicidesafe/.

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