Efficacy of a Smartphone Suicide Prevention App

Summary

It is an interventional research, single-blind, randomized, controlled, multicenter, which involves only minimal risks and constraints.

Patients who attend to the emergency department following a SA (Suicidal Attempt) represent a key group of patients with an extremely high risk of suicide in the short term.

A main problem in suicide prevention is that the increase of symptoms and suicidal risk occurs most often in the natural environment of patients, away from the system of care. Thus, the main goal in allowing real-time risk detection would facilitate immediate interventions, probably the best way to prevent a suicidal act. Additionally, the evolution of the suicidal crisis is very variable from one subject to another, in duration and symptoms, and often very brief. In contrast, the tools used to assess suicidal thoughts have so far been limited to intermittent assessments separated by weeks, months or years, which does not take into account the fact that suicidal thoughts can be highly variable over a few hours and that suicide attempts can occur in response to a rapid increase in thoughts over periods as short as the day. Mobile health (mHealth) interventions are the only that can respond to these fluctuations over time.

We have developed the first French app (emma) for EMA (Ecological Momentary Assessment) , customised EMI (Ecological Momentary Intervention) and prediction of SB (suicidal behaviour). It was designed by integrating evidence-based suicide prevention strategies and recommendations for the development of apps in the field of mental health. Emma helps to strengthen the patient's connection to his healthcare system and social network. This study led to the development and subsequent deployment of VigilanS. VigilanS is a multi-regional innovative care program for the prevention of suicide relapse, which has been implemented in several emergencies departments in France.

Our hypothesis is that emma offers an unprecedented opportunity to increase the efficiency of VigilanS, both for patients, by restoring their social connections, and for health professionals, in a simple, fast and efficient way. Thanks to emma, the patient will have daily support adapted to his condition (emotion management modules, safety plan, calls in case of emergency). Emma will fit easily into the daily practice of health professionals (little binding, little time consuming) and will complete the range of care organized by VigilanS.

The main objective is to evaluate over a 6-months follow-up the efficacy of a smartphone app (emma) in addition to the VigilanS program on the prevention of a suicidal event (suicide, SA, hospitalization or emergency department for suicidal ideation) compared to the VigilanS program only.

Conditions

• Suicide
• Suicide Attempt

Interventions

OTHER

emma application

1. Emma will allow the patient to spontaneously contact the VigilanS tele-clinician team via a simple and quick access (when the patient presses an ergonomic button with the VigilanS logo). He can also contact the National Service for Suicide Prevention (3114) or the French national emergency medical assistance service 24/7 (Samu). 2. Experts of the field have defined response thresholds for targeted questions on suicide risk and emotional tension. If the patient's answers to these questions reach these thresholds, emma will automatically send a message to the nearest VigilanS center. In this case, a message will appear indicating to the patient that the nearest center will contact him as soon as possible, encourage him to review his strategies and resources available on the app's Home and direct him to the breathing space. 3. Emma offers a Safety Plan module that will allow the patient to help him/her to put into practice what he/she will develop with the VigilanS team on a daily bas

Sponsors & Collaborators

• Fondation FondaMental

  collaborator OTHER

• University Hospital, Montpellier

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-09-30

Primary Completion

2028-03-31

Completion

2028-03-31

Countries

• France

Study Locations