Studies show that self-guided apps can prevent suicides
India accounts for 25% of the world’s suicides. Self-guided apps could potentially overcome some of the hurdles people face in accessing mental health care.
The minutes before someone commits suicide are crucial. Research shows that people can be talked out of causing self-harm if they get the right kind of support at the right time.
But what is the right kind of support? And how many people have access to it?
Michelle Torok, a researcher at the Black Dog Institute, a non-profit organisation in Australia, wrote in a recent article that there may be a way to put a suicide prevention guide in the hands of anyone with a smartphone - through suicide prevention apps.
In a meta-analysis published in The Lancet on 28 November, Torok argued that self-guided digital interventions can be effective for people who, for some reason, cannot or will not go to a psychologist.
The interventions in the studies Torok looked at delivered cognitive behavioural therapy or dialectical behavioural therapy - the two treatment methods that are generally given to suicide patients.
While cognitive behavioural therapy teaches people about the effects of their feelings and thoughts on their mindset and actions, dialectical behavioural therapy focusses on enabling them with ways to cope with psychological and mental disorders.
India accounts for 25% of the world’s suicides (globally, around 817,000 people kill themselves each year). The reason: social stigma around mental health issues and lack of access to good health care services. Self-guided apps could potentially overcome some of these hurdles to accessing mental health care.
More than depression
The research team at the Black Dog Institute included studies on two types of digital suicide interventions: direct - for people who were thinking about suicide or had displayed suicidal tendencies, and indirect - for people who were depressed. In all, they studied 16 unique papers with a combined strength of 4,398 participants aged 15 to 42.5 years. More than half of the participants were women.
Here’s what the team found: direct interventions were much more effective than indirect ones. In fact, they were found to be as effective as one-on-one therapy with a health practitioner.
True, depression is implicated in about 92% of suicide cases. But when it comes to suicide prevention, it makes a lot more sense to reach out to people who have suicidal thoughts directly.
Another thing stood out in the meta-analysis: most direct interventions were based on dialectical behavioural therapy, while the indirect ones were based on cognitive behavioural therapy.
The findings showed that there is a need to shift the focus to more alternative approaches than the traditional cognitive behavioural therapy to reduce the overall suicide rate. Dialectical behavioural therapy could be one, along with therapeutic evaluative conditioning. The latter is a Pavlovian technique that focuses on changing a person’s negative perception towards a thing by combining it with a neutralising thought.
In some studies, scientists have found that evaluative conditioning is effective in preventing non-suicidal self-injury - a behaviour that often precedes suicide attempts.
Concluding her study, Torok wrote that there is a significant target area between non-suicidal self-injury and actual suicide attempts. If targetted properly, it is warranted to give results.
Over two lakh people commit suicide in India each year. While many of these are indebted farmers, there are also several students and young professionals in this mix. The self-guided apps could potentially reach both sets, provided India can make them available in multiple languages.
For more information, please read our article on Suicidal Tendency: Signs and Prevention.
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