Abstract

Objective We aimed to examine the characteristics, features, and content of suicide prevention mobile apps available in app stores in Canada and the United Kingdom.

Design Suicide prevention apps were identified from Apple and Android app stores between March-April 2023. Apps were screened against predefined inclusion criteria, and duplicate apps were removed. Data were then extracted based on descriptive (e.g., genre, app developer), security (e.g., password protection), and design features (e.g., personalization options). Content of apps were assessed using the Essential Features Framework. Extracted data were analyzed using a content analysis approach including narrative frequencies and descriptive statistics.

Results Fifty-two (n=52) suicide prevention apps were included within the review. Most were tailored for the general population and were in English language only. One app had the option to increase app accessibility by offering content presented using sign language. Many apps allowed some form of personalization by adding text content, however most did not facilitate further customization such as the ability to upload photo and audio content. All identified apps included content from at least one of the domains of the Essential Features Framework. The most commonly included domains were sources of suicide prevention support, and information about suicide. The domain least frequently included was screening tools followed by wellness content. No identified apps had the ability to be linked to patient medical records.

Conclusions The findings of this research present implications for the development of future suicide prevention apps. Development of a co-produced suicide prevention app which is accessible, allows for personalization, and can be integrated into clinical care may present an opportunity to enhance suicide prevention support for individuals experiencing suicidal thoughts and behaviours.

Strengths and limitations of this study

This app review used an established method for systematically identifying and examining suicide prevention apps, which has been successfully used previously.

There is potential for overlap between different domains of the Essential Features Framework, which could lead to changes in reporting of percentages relating to app review findings.

Only apps available in the UK and Canada in the English language were assessed. Current provision and content of suicide prevention apps may differ across countries, including those available in lower- and middle-income countries.

Strengths and limitations of this studyDue to resource and time constraints, the quality of apps were not assessed.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This research received support from the Centre for Addiction and Mental Health (CAMH) and Oxford Health NHS Foundation Trust (OHFT).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

Two appendices are available as supplementary files which include the data extraction template used for the app store review, a list of included apps, apps excluded at full review stage, and reasons for exclusion. Additional data is available upon request to the corresponding author.

AbbreviationsLGBTQIA+lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other identitiesUKUnited KingdomPRISMApreferred reporting items for systematic reviews and meta-analysesPHQ-9patient health questionnaireK10Kessler Psychological Distress ScaleC-SSRSColumbia-suicide severity rating scale