JMIR Publications

ABSTRACT

Background:

Clinical trials have shown follow-up contact with post-discharge self-harm young adults results in a significant reduction in self-harm. Our aim was to determine whether community-based caring contact via a mobile app with or without volunteer support, in addition to treatment as usual (TAU), is effective in reducing suicide risk among such patients and to generate empirical evidence on the use of these interventions.

Objective:

Our aim was to determine whether community-based caring contact via a mobile app with or without volunteer support, in addition to treatment as usual (TAU), is effective in reducing suicide risk among such patients and to generate empirical evidence on the use of these interventions.

Methods:

We conducted a pragmatic RCT on discharged patients aged 18–45 with self-harm episodes/suicide attempts from the emergency departments of four hospitals in Hong Kong. Participants were randomly assigned to one of three groups, 1) mobile app+TAU(App+TAU), 2) mobile app+volunteer support + TAU(App+Vol+TAU), or 3) TAU-only as the control group(TAU), for a three-month observation with four measurement time points.

Results:

A total of 40 participants were recruited. Blending volunteer care with a pre-programmed mobile app was found effective in improving service compliance. Drawing upon the interpersonal-psychological theory of suicide (IPTS), our findings could ascertain a reduction in thwarted belongingness (TB) through community-based caring contact is linked to improvement in hopelessness, albeit a transient one, and suicide risk in a growth model.

Conclusions:

A combination of volunteer care with a mobile app as a strategy for strengthening the continuity of care can be cautiously implemented for discharged self-harm patients during the transition from hospital to a community setting. Clinical Trial: The trial was registered with the U.S. National Institutes of Health Clinical Trials Registry (Identifier: NCT03081078).