Suicide Prevention Apps: A Review

Suicide can often be a spontaneous decision, so a good suicide prevention device would be one that people always have with them. There is now a device that most of us carry with us at all times – our phones. The mental health consequences of this fact are unclear, but at least it provides the potential for an effective suicide prevention device. So what are the best suicide prevention apps that are currently available?

This post is a critical review of some of the most downloaded suicide prevention apps, with an eye towards whether these suicide prevention apps provide effective interventions, in light of the research that is available on this new and significant topic.

This post covers several leading suicide prevention apps. That apps must: (i) focus primarily on suicide prevention, (ii) be available on both iOS and Android, (iii) receive multiple reviews on both the App Store and the Google Play store. (The last requirement is intended to establish some baseline level of popularity, since precise download statistics are not publicly available.)

Among the apps that satisfy those minimal criteria, the following six apps stand out:

1. Better Stop Suicide

Created by: The Better App Company

Available for: iOS, Android

Better Stop Suicide is the most reviewed app on the Apple Store, and the reviews are almost uniformly strong. It is easy to see the appeal of the app: it is elegantly designed:

A screenshot from Better Stop Suicide

It is also prescriptive, walking the user through a sequence of steps they can use to cope with suicidal thinking: listing contacts, making a gratitude list, and even listening to audio recordings provided by the app.

Creating a contact list

Once the user has gone through this sequence, they can use the app in the future to revisit the resources they have assembled.

The Better Stop Suicide app is an impressive contribution to mental health: it combines gorgeous digital design with best practices for dealing with suicidal thinking. It is built by a new UK-based organization – The Better App Company – which reports several other mental health apps in development.

2. MY3 – Support Network

Created by: Mental Health Association of New York City

Available for: iOS, Android

The MY3 app was created by the same people who operate the National Suicide Prevention Lifeline, and it is focused on having individuals reach out to their support network. The app’s main purpose is to have three people readily accessible contacts displayed for a person to contact in a crisis, as well as the number for the National Suicide Prevention Lifeline and for emergency services:

The home screen for MY3

MY3 has a pleasingly simple design, though it does not quite have the professional polish of the Better Stop Suicide app. In addition, the app requires that the user provide access to their contacts in order for the app to function properly. Since many suicidal individuals are protective of their privacy, it would probably be better if this were not a mandatory feature of the app.

The setup screen

The app also allows the user to store a safety plan, and provides a thorough listing of mental health services and resources. Overall, this is a simple and well-intentioned app that focuses on the importance of a user’s support network.

3. Stay Alive

Created by: Grassroots Suicide Prevention

Available for: iOS, Android

This UK-based app has an extremely simple text-based interface:

The home screen

On the other hand, it has a wealth of nice resources buried under that interface. For example, there is a place for the user to store photos of loved ones as a reminder, as well as an elegantly designed breathing device that could be an app in its own right:

Breathe in

This app is not the most immediately appealing, but it is surprisingly useful for anyone who is willing to overlook its initially drab presentation.

4. Suicide Safety Plan

Created by: MoodTools

Available for: iOS, Android

This is a text-based app that focuses on a user’s safety plan: their strategy for staying safe when they are experiencing suicidal thoughts.

Safety planning

It offers a simple interface for constructing and saving a plan, as well as a list of additional resources.

The app is advertised by an elegant webpage, and appears to be designed by a company (or organization?) called MoodTools, that also makes an app for diagnosing and treating depression.

5. A Friend Asks

Created by: The Jason Foundation

Available for: iOS, Android

A Friend Asks is focused on helping a “third-party” user: it gives tips on what do to if a friend or a loved one is suicidal.

The main menu

The app is elegantly designed, though there is very little actual content in the app. It’s primary resources are a list of warning signs:

as well as a helpful list of what not to say to a suicidal individual. It also includes links to The Jason Foundation and other resources. The app is certainly handy to have, though it adds only a modest amount of value to the third-party resources that are already available.

6. Suicide Safe

Created by: Substance Abuse and Mental Health Services Association

Available for: iOS, Android

The Suicide Safe app, created by SAMHSA, is a format that should at this point be pretty familiar:

Home screen

The app provides a list of text-based resources, as well as methods of contacting suicide hotlines and other resources for assistance. The most distinctive aspect of the app is its inclusion of case studies:

Case studies

As these case studies suggest, the primary purpose of this app is to train clinicians to treat suicidal patients, rather than for patients themselves or their friends and families. Arguably an app is not the best tool for that particular job – one would want for proper clinical training to involve much more information than an app is typically meant to provide. Nonetheless, more education is better than less so this app, like A Friend Asks, does provide some value.

Summary

Given the ubiquity of phones, a suicide prevention app would be a useful thing to have. And these six apps are valuable additions to the mental health app space.

Nonetheless, the results of this survey show significant room for improvement. For one thing, none of these apps (with the possible exception of “Better Stop Suicide”) have an especially sophisticated UI/UX, despite the fact that some of them are backed by large government or non-profit agencies. Good design is not in itself a treatment, but it is crucial to usability for a kind of app that could be much more widely used.

A note on use. Most of these apps have more than 10,000 installs in the Google Play store, but none of them has more than 50,000. (The Play store only reports thresholds, not precisely install numbers, and the Apple store does not report installs publicly at all). That sounds like a lot. But really, it’s not very much at all.

As a point of comparison, a somewhat random search through the Play Store reveals dozens of apps for the popular “Keto diet.” The most popular of these have over 1 million installs, while the 20th or 30th in popularity have more than 10,000 installs – which is to say as many as any of the apps above. The point of this comparison the apps above occupy a really tiny portion of the larger app marketplace, even when compared to one tiny corner of health apps.

At the same time, suicidal ideation is widespread – the CDC reports that, in 2017, 4.3% of adults over 18 had thoughts about suicide. In absolute terms (using figures from the 2010 census), that is roughly ten million individuals. In comparison, the cumulative global install numbers for these apps are, at best, several hundred thousand. Which is to say that a very small percentage of individuals experiencing suicidal ideation install any one of these apps.

This is a potentially useful area of intervention for agencies wishing to make a real impact on suicide prevention. App development costs vary widely, but one cost calculator suggests that a beautiful but simple app costs approximately $50,000 to build. By comparison, the Veteran’s Association alone has an annual suicide prevention budget of $47.5 million, with $20 million of that earmarked for outreach. Which is to say that 0.25% of just the VA’s outreach budget (that is, one-quarter of one percent) could suffice to build a pretty good suicide prevention app; someone willing to invest a bit more than that, along with real know-how in product design, could build a great one.

Note: The contents of this post are for informational purposes only. This is not professional medical advice and it is not intended to be a substitute for professional medical advice. Always consult with a physician with any questions that you have about a medical condition, including a mental health condition. If you think you are in a medical emergency, call 911 or your local emergency services number immediately.