JMIR Publications

ABSTRACT

Background:

Suicide is the fourth leading cause of death among young people aged 15-29 worldwide and suicide rates are increasing. Suicide prevention strategies can be effective but young people face barriers accessing them. Providing support digitally can facilitate access, but this can also pose risks if there is inappropriate or harmful content. Collaborative approaches are key for developing digital suicide prevention tools to ensure support is appropriate and helpful for young people. Tellmi (previously known as MeeToo) is a pre-moderated UK-based peer-support app where young people aged 11-25 can talk to others of a similar age anonymously about issues ranging from worries to life challenges. It has procedures to support high risk users, nevertheless, Tellmi is interested in improving the support they provide to users with more acute mental health needs, such as young people struggling with suicide and self-harm ideation. Further research into the best ways of providing such support for this population is necessary.

Objective:

Explore the key considerations for developing and delivering digital suicide prevention tools for young people aged 18-25 from a multi-disciplinary perspective, including the views of young people, practitioners and academics.

Methods:

A full day, in-person workshop was conducted with mental health academics (n=3) and mental health practitioners (n=2) with expertise in suicide prevention, young people with lived experience of suicidal ideation (n=4), a computer scientist (n=1) and technical staff from the Tellmi app (n=6). Tellmi technical staff presented 14 possible evidence-based adaptations for the app as a basis for the discussions. A range of methods were used to evaluate them, including questionnaires to rate the ideas, annotating print outs of the ideas with post-it notes, and group discussions. A reflexive thematic analysis was performed on the qualitative data to explore key considerations for designing digital suicide prevention tools in the context of peer support.

Results:

Participants discussed the needs of both those receiving and providing support, and they noted several key considerations for how best to develop and deliver digital support for high-risk young people. Four themes were developed: 1) the aims of the app must be clear and consistent, 2) there are unique considerations for supporting high-risk users; sub-theme) customization helps tailor support to high-risk users, 3) ‘progress’ is a broad and multifaceted concept, and 4) considering the roles of those providing support: sub-theme) expertise required to support app users; sub-theme) mitigating the impact of the role on supporters.

Conclusions:

This study outlined several suggestions that may be beneficial for developing digital suicide prevention tools for young people. Suggestions included apps being customizable, transparent, accessible, visually appealing, and working with users to develop content and language. Future research should further explore this with a diverse group of young people and clinicians.