Comprehensive Online Self-Monitoring to Support Clinicians Manage Risk                 of Suicide in Youth Depression

Hetrick, Sarah; Goodall, Joanne; Yuen, Hok Pan; Davey, Christopher G.; Parker, Alexandra G.; Robinson, Jo; Rickwood, Debra; McRoberts, Alison; Sanci, Lena; Gunn, Jane; Rice, Simon; Simmons, Magenta

doi:10.1027/0227-5910/a000422

Cited by 30 publications

(29 citation statements)

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“…As Perry et al (2016) noted in their SR, other areas of suicide prevention, such as screening young people for risk of suicide, are beginning to use web-based platforms to deliver services 64. The use of ‘real time’ monitoring and intervention provided via handheld devices to support young people ‘in the moment’ has been flagged as important for overcoming difficulties mental health services have with responding to fluctuating SI and episodes of SH and SA 65. Despite the trial by Tighe and colleagues not being eligible for inclusion in this review, the Ibobbly intervention is worthy of further exploration in an adolescent and youth population (under 25 years) given its accessibility 35…”

Section: Discussionmentioning

confidence: 99%

Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where?

Cox

Hetrick

2017

Evid Based Mental Health

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We reviewed the evidence for the effectiveness of indicated individual psychosocial interventions for the treatment of self-harm, suicidal ideation and suicide attempts in children and young people, with a particular emphasis on the emerging use of electronic methods to deliver psychological interventions. In total, 16 randomised controlled trials (RCTs) were identified, none of which included children under the age of 12 years. Cognitive-behavioural therapy is the most commonly implemented approach in RCTs until now, although problem-solving therapy, interpersonal psychotherapy, social support and distal support methods by provision of a green card and regular receipt of postcards have also been investigated. Young people have been recruited into RCTs within schools, outpatient clinics, emergency departments and inpatient facilities. Face-to-face delivery of therapy has dominated the intervention trials thus far; however, the use of the internet, social media and mobile devices to deliver interventions to young people and other family members allows for a more novel approach to suicide prevention in youth going forward.

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Section: Discussionmentioning

confidence: 99%

Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where?

Cox

Hetrick

2017

Evid Based Mental Health

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“…Young people with depression commonly experience suicidal ideation and engage in self-harm ( 23 ) and require support to monitor symptoms outside of face-to-face treatment ( 24 ). During a scoping/generative phase (Figure 2 ), SH and colleagues engaged young people with lived experience of self-harm individually to understand their needs.…”

Section: Introductionmentioning

confidence: 99%

Co-design of eHealth Interventions With Children and Young People

et al. 2018

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Co-design, defined as collective creativity across the entire design process, can lead to the development of interventions that are more engaging, satisfying, and useful to potential users. However, using this methodology within the research arena requires a shift from traditional practice. Co-design of eHealth interventions with children and young people has additional challenges. This review summarizes the applied core principles of co-design and recommends techniques for undertaking co-design with children and young people. Three examples of co-design during the development of eHealth interventions (Starship Rescue, a computer game for treating anxiety in children with long-term physical conditions, a self-monitoring app for use during treatment of depression in young people, and HABITS, the development of an emotional health and substance use app, and eHealth platform for young people) are provided to illustrate the value and challenges of this contemporary process.

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“…Moreover, clinicians are specifically instructed to monitor the emergence of suicidal ideation once a week for 4 weeks, and biweekly thereafter, upon commencing antidepressant medication, due to the known risks of this adverse outcome for young people taking antidepressants [ 6 , 8 ]. The accurate reporting of symptoms facilitates therapeutic monitoring [ 9 ] in terms of enhancing clinicians’ knowledge about the clients’ symptoms and risk, which can have a positive impact on treatment planning [ 10 , 11 ]. Young people have been shown to have faster symptom improvement when their clinicians receive feedback about treatment progress [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…The use of technology in clinical practice has been shown to be acceptable to users and health professionals [ 35 , 36 ]. There is emerging evidence that young people may, in some circumstances, be more comfortable with technology over face-to-face intervention with therapists [ 37 ], and studies have shown that rates of disclosure of mental health difficulties and suicidal ideation are higher when paper and pencil or Web-based approaches are used relative to face-to-face assessment [ 9 , 10 , 38 - 42 ]. Similarly, young people are particularly enthusiastic users of smartphones and various mobile phone apps [ 43 , 44 ], and consider smartphones an acceptable form of support [ 45 - 47 ].…”

Section: Introductionmentioning

confidence: 99%

Youth Codesign of a Mobile Phone App to Facilitate Self-Monitoring and Management of Mood Symptoms in Young People With Major Depression, Suicidal Ideation, and Self-Harm

Hetrick¹,

Robinson²,

Burge³

et al. 2018

JMIR Ment Health

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127

141

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BackgroundEffective treatment of depression in young people is critical, given its prevalence, impacts, and link to suicide. Clinical practice guidelines point to the need for regular monitoring of depression symptom severity and the emergence of suicidal ideation to track treatment progress and guide intervention delivery. Yet, this is seldom integrated in clinical practice.ObjectiveThe objective of this study was to address the gap between guidelines about monitoring and real-world practice by codesigning an app with young people that allows for self-monitoring of mood and communication of this monitoring with a clinician.MethodsWe engaged young people aged 18 to 25 years who had experienced depression, suicidal ideation including those who self-harm, as well as clinicians in a codesign process. We used a human-centered codesign design studio methodology where young people designed the features of the app first individually and then as a group. This resulted in a minimal viable product design, represented through low-fidelity hand-drawn wireframes. Clinicians were engaged throughout the process via focus groups.ResultsThe app incorporated a mood monitoring feature with innovative design aspects that allowed customization, and was named a “well-being tracker” in response to the need for a positive approach to this function. Brief personalized interventions designed to support young people in the intervals between face-to-face appointments were embedded in the app and were immediately available via pop-ups generated by a back-end algorithm within the well-being tracker. Issues regarding the safe incorporation of alerts generated by the app into face-to-face clinical services were raised by clinicians (ie, responding in a timely manner) and will need to be addressed during the full implementation of the app into clinical services.ConclusionsThe potential to improve outcomes for young people via technology-based enhancement to interventions is enormous. Enhancing communication between young people and their clinicians about symptoms and treatment progress and increasing access to timely and evidence-based interventions are desirable outcomes. To achieve positive outcomes for young people using technology- (app) based interventions, it is critical to understand and incorporate, in a meaningful way, the expectations and motivations of both young people and clinicians.

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Comprehensive Online Self-Monitoring to Support Clinicians Manage Risk of Suicide in Youth Depression

Cited by 30 publications

References 50 publications

Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where?

Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where?

Co-design of eHealth Interventions With Children and Young People

Youth Codesign of a Mobile Phone App to Facilitate Self-Monitoring and Management of Mood Symptoms in Young People With Major Depression, Suicidal Ideation, and Self-Harm

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