Pauwels Kirsten, Aerts Saskia, Muijzers Ekke, De Jaegere Eva, van Heeringen Kees, Portzky Gwendolyn
Flemish Centre of Expertise in Suicide Prevention, Ghent, Flanders, Belgium.
Flemish Suicide Prevention Centre, Brussels, Brussels, Belgium.
PLoS One. 2017 Jun 21;12(6):e0178144. doi: 10.1371/journal.pone.0178144. eCollection 2017.
Suicide is a major public health issue and has large impact on the lives of many people. Innovative technologies such as smartphones could create new possibilities for suicide prevention, such as helping to overcome the barriers and stigma on help seeking in case of suicidal ideation. Due to their omnipresence, smartphone apps can offer suicide prevention tools very fast, they are easily-accessible, low-threshold and can help overcome some of the help-seeking barriers suicidal people experience. This article describes the development, testing and implementation of a mobile application for coping with suicidal crisis: BackUp.
Based on the analysis of literature and existing suicide prevention apps several tools were identified as relevant to include in a suicide prevention app. The selected tools (a safety planning tool, a hope box, a coping cards module, and a module to reach out) are evidence based in a face to face context, and could be easily transferred into a mobile app. The testing of existing apps and the literature also revealed important guidelines for the technical development of the application.
BackUp was developed and tested by an expert panel (n = 9) and a panel of end users (n = 21). Both groups rated BackUp as valuable for suicide prevention. Suicidal ideation of the end user group was measured using the Beck Scale for Suicidal Ideation before and after testing BackUp, and showed a small but non-significant decrease. The majority of the testers used BackUp several times. All tools were evaluated as rather or very useable in times of suicidal crisis.
BackUp was positively evaluated and indicates that self-help tools can have a positive impact on suicidal ideation. Apps in particular create opportunities in approaching people that are not reached by traditional interventions; on the other hand they can contribute to suicide prevention in addition to regular care. However, more research is needed on the impact and effect of suicide prevention apps.
自杀是一个重大的公共卫生问题，对许多人的生活产生重大影响。智能手机等创新技术可为自杀预防创造新的可能性，比如有助于克服自杀念头出现时寻求帮助的障碍和耻辱感。由于智能手机无处不在，其应用程序能够非常迅速地提供自杀预防工具，这些工具易于获取、门槛低，有助于克服有自杀倾向者在寻求帮助时遇到的一些障碍。本文介绍了一款应对自杀危机的移动应用程序BackUp的开发、测试和实施情况。
在分析文献和现有自杀预防应用程序的基础上，确定了几种与自杀预防应用程序相关的工具。所选工具（安全规划工具、希望盒、应对卡片模块和求助模块）在面对面情境中有循证依据，并且可以轻松转化为移动应用程序。对现有应用程序的测试和文献研究也揭示了该应用程序技术开发的重要指导原则。
BackUp由一个专家小组（n = 9）和一个最终用户小组（n = 21）进行开发和测试。两组均认为BackUp对自杀预防有价值。在对最终用户小组测试BackUp之前和之后，使用贝克自杀意念量表测量其自杀意念，结果显示有小幅但不显著的下降。大多数测试者多次使用BackUp。所有工具在自杀危机期间均被评估为相当有用或非常有用。
BackUp得到了积极评价，表明自助工具可对自杀意念产生积极影响。应用程序尤其为接触传统干预措施无法触及的人群创造了机会；另一方面，它们除了常规护理外，还可有助于自杀预防。然而，关于自杀预防应用程序的影响和效果还需要更多研究。
