JMIR Publications

ABSTRACT

Background:

Long wait times for mental health services could lead to delays in early detection and management of suicidal ideation and behaviors, which are crucial for effective mental health care and suicide prevention. The use of digital technology is a potential solution for efficiently identifying youth with high suicidality.

Objective:

To evaluate the use of a digital suicidality notification system designed to detect and respond to suicidal needs in youth mental health services; to examine characteristics of young people displaying high levels of suicidal ideation and behaviors.

Methods:

Young people aged 16-25 years presenting to participating mental health services between November 2018 and October 2023 completed a multidimensional online assessment collecting demographic, clinical, social, and functional data. The initial assessment was mandatory however, reassessment was encouraged to monitor their symptoms throughout care. When their suicidality score exceeded a predetermined threshold informed by clinical expertise and established service policies, the online platform immediately generated a notification, alerting treating clinicians. Subsequent clinical actions and their response times were analyzed.

Results:

A total of 2021 individuals participated and 11% (N=226) expressed high suicidality. Of the 292 notifications generated, over 75% (222/292) were resolved, with a median response time of 1.9 days (range: 0-50.8 days). Clinical actions taken to address suicidality were conducting safety plans (60%), safety checks (18%), psychological therapy (8%), transfer to another service (3%), and scheduling of new appointments (2%). Young people with high suicidality were more likely to present with multidimensional indicators of complexity, including disengagement from work or education, heterogenous psychopathology, substance misuse, and recurrent illness.

Conclusions:

The digital suicidality notification system effectively elicited clinical actions when triggered for high suicidal ideation and behaviors. The multidimensional assessment revealed complex symptom presentations of youth that generated a notification. Therefore, this study demonstrates that the digital system can efficiently stratify care for young people with varying levels of suicidality. By expediting the delivery of care to those displaying elevated suicidality, the system can play a pivotal role in preventing its detrimental impacts on mental health.