JMIR Publications

ABSTRACT

Background:

Suicide is the second leading cause of death in adolescents, and self-harm is one of the strongest predictors of death by suicide. The rates of adolescents presenting to emergency departments (ED) for suicidal thoughts and behaviors (STB) have increased, but existing follow-up after ED discharge is inadequate, leaving a high-risk period for re-attempts and suicide. There is a need for innovative evaluation of imminent suicide risk factors in these patients, focusing on low assessment burden and reliance on patient disclosure of suicidal intent.

Objective:

This study examines prospective longitudinal associations between observed real-time mobile passive sensing, including communication and activity patterns, and clinical and self-report assessments of STB over six months.

Methods:

The study will include 90 adolescents recruited on their first outpatient clinic visit following their discharge from ED due to recent STB. Participants will complete brief weekly assessments and be monitored continuously for their mobile app usage, including mobility, activity, and communication patterns over six months using the iFeel research app. Participants will complete four in-person visits for clinical assessment at baseline, one- three- and six-month follow-up. Proximal associations between real-time observed communication, activity patterns, and STB will be examined.

Results:

We expect to find prospective proximal associations between mobile sensor communication and activity data and STB outcomes. We will test an algorithm predictive for suicidal behaviors among high-risk adolescents.

Conclusions:

Developing digital markers of STB in a real-world-setting sample of high-risk adolescents presenting to ED can inform different interventions and provide an objective means to assess the risk of suicidal behaviors. The results may lead to suicide risk measures that aid psychiatric follow-up, decision-making, and targeted treatments. This novel assessment could facilitate timely identification and intervention to save young people’s lives.