Suicide remains one of the leading causes of death in the U.S., and while therapy and medication are still the primary tools used in suicide prevention, researchers are increasingly looking to digital technology as a potential new safeguard.
A recent study by a multi-university team of researchers that included Ohio State explored whether a mobile phone app, developed by Oui Therapeutics, can help reduce suicidal behavior among high-risk patients.
The results, published in JAMA Network Open, offer some intriguing insights and possibly new hope.
Dr. Seth Feuerstein is the study’s senior author and a clinical professor of psychiatry at Yale University. He talked with WOSU's Matthew Rand about the app and the study.
Anyone experiencing thoughts of suicide can seek help by calling or texting the National Suicide Crisis Hotline, 988.
Matthew Rand: Tell us about this app. How does it work, what features does it offer and what questions did you hope to answer with the study?
Seth Feuerstein, MD, JD: The app was designed to try to take the best validated therapy which patients generally don't get access to (because of how difficult it is to learn and deliver) and put core components into this digital application.
We partnered with several of the nation’s—and really the world's—leading researchers and clinicians to develop the app. We developed the app over several years, got funding from the government to study it and did a few studies that showed certain elements were quite effective and very safe.
We really wanted to roll it out as a tool that patients and the providers that care for them could use to expand access to therapy, as well as make sure it was tightly controlled and validated to what we knew worked and could work.
Matthew Rand: If I understand these findings correctly, you found the app made no significant difference in time for psychiatric inpatients to make their first suicide attempt, but it did lead to a sustained reduction in suicidal ideation. Is that right?
Seth Feuerstein, MD, JD: There's a subtlety in there. So, in some diseases, we look at how long do you delay a single recurrence of the disease? We do that a lot in areas like cancer, for instance, where usually patients would only have one recurrence.
Suicide is a little bit different. We care about both how long to you delay something if it may happen, but also how many of the events happen. So, suicide is one of those conditions where suicide attempts can happen multiple times, and each time comes with the risk of death, as well as significant cost.
So, in our study—which was in some ways, I think some of our partners and researchers would have said in some ways it's the most ambitious study done in the field—we looked at a few different things. One of them was the delay in time. The other one was the total number of attempts. And we saw a very large difference in the total number of attempts, but we did not see a significant difference in the time to the first event.
Matthew Rand: What do those findings tell you, and were there any surprises in the results—either challenges or unexpected benefits?
Seth Feuerstein, MD, JD: Great question. In the time delay piece of it, it's possible that it does work and that we just didn't have enough people in the study to see the difference.
On the reduction in attempts, we saw a 58% reduction in the number of attempts per patient per year, who were at the very highest risk, and that's a very large reduction and signals a potentially extremely large breakthrough for that patient type.
The other thing that the study found was a significant extension in the reduction in suicidal thinking. Suicidal ideation, as we refer to it in the field, can be thought of as kind of like pain. It's very uncomfortable for patients to be thinking about suicide. And, while not directly linked always to an attempt, is also important for patients and providers.
So, we saw very large reductions in the number of attempts in those at highest risk, and then a significant extension in the reduction in suicidal thinking. And those are really important because of the scalability of this intervention potentially.
In terms of where people can now get access to something that would theoretically help them in ways they would not have had access to otherwise.
