mHealth Interventions for Self-Harm: Scoping Review

Abstract

Background Self-harm is a growing issue with increasing prevalence rates; however, individuals who self-harm do not often receive treatment. Mobile health (mHealth) interventions are a possible solution to some of the barriers that individuals face when seeking support, and they have also been found to be effective in improving mental health. Thus far, reviews of mHealth interventions for self-harm have been limited by study type. Therefore, we determined that a broader scoping review will provide a more exhaustive understanding of mHealth interventions for self-harm. Objective This scoping review aims to identify mHealth interventions for self-harm within the literature, understand the types and features of interventions that have been developed and evaluated, highlight research findings around mHealth interventions for self-harm, and determine what outcomes are typically used to assess the efficacy of interventions. Methods A search was conducted using Embase, PubMed, PsycINFO, PsycEXTRA, Web of Science, and the Cochrane Library. Studies were included if they described an mHealth intervention designed to have a direct (ie, if the intervention was designed for self-harm or for people who self-harm) or indirect (ie, if self-harm was measured as an outcome) treatment effect and if the paper was available in English. There were no exclusion criteria based on the study design. Results A total of 36 papers were included in the review, and most of them were randomized controlled trials published within the last 4 years. The interventions were mostly smartphone apps and calling or texting services, with 62% (21/34) having underlying therapeutic models to inform the intervention content. They were generally shown to be promising and appealing, but only 5 were widely available for use. Outcomes focused on a reduction of self-harm and suicidality, mood, and the users’ experiences of the intervention. Samples were typically nondiverse, and there was limited variety in the study designs and in the measurements of self-harm recovery. Conclusions Promising and appealing mHealth interventions have been developed but are not widely available. Research could benefit from greater diversity as well as a broader and more nuanced understanding of recovery from self-harm.

A systematic review of reviews on the advantages of mHealth utilization in mental health services: A viable option for large populations in low-resource settings

“…Accessibility and convenience are major advantages of utilization of mHealth within mental health services: mHealth has demonstrated to provide a feasible and practical model of healthcare service delivery for mental health patients (Ashfaq et al, 2020 ; Cliffe et al, 2021 ; Zhou et al, 2022 ).…”

Beating Adolescent Self-Harm (BASH): a randomised controlled trial comparing usual care versus usual care plus a smartphone self-harm prevention app (BlueIce) in young adolescents aged 12–17 who self-harm: study protocol

“…However, hardly any suicide or self-harm prevention apps have been developed with a recent systematic review identifying only four. 29 Similarly, systematic reviews evaluating the efficacy of technology and mhealth interventions in preventing suicide or self-harm in adolescents 30 and university students 31 have raised similar concerns. In addition, the availability of self-harm prevention apps is extremely limited with few being available for clinical use.…”

“…In addition, the availability of self-harm prevention apps is extremely limited with few being available for clinical use. 31 While these reviews all highlight the potential of self-help apps, further research is required to determine their efficacy in self-harm and suicide prevention with clinical populations.…”

Is a smartphone application (BlueIce) acceptable and safe for university students who self-harm: an open study

“…Given the difficulties students face in seeking professional support for self-harm, coupled with the perceived advantages of digital support, a smartphone application (app) seems like a valued option. Wider research has also suggested that digital interventions for self-harm can be helpful and produce positive outcomes 17. However, despite these potential benefits, no prior research has been conducted where university students have used and evaluated a smartphone app specifically developed to help manage self-harm 18…”