Pilot microrandomized trial of a brief digital intervention for suicidal thoughts

Area of Science:

• Psychiatry and Behavioral Health
• Digital Health Interventions
• Suicide Prevention Research

Background:

• Suicidal thoughts following psychiatric hospitalization pose a significant risk.
• Effective in-the-moment coping strategies are crucial for suicide prevention.
• Digital interventions offer a scalable approach to support individuals post-discharge.

Purpose of the Study:

• To pilot a microrandomized trial assessing a brief digital intervention.
• To evaluate the feasibility and acceptability of promoting coping strategy use.
• To examine the effectiveness of in-the-moment digital support for suicidal ideation.

Main Methods:

• A pilot microrandomized trial involving 71 adults recently hospitalized for suicide risk.
• Ecological momentary assessment (EMA) collected real-time data on suicidal thoughts for 28 days post-discharge.
• Participants reporting suicidal urges were randomized to receive personalized or general coping strategy messages via smartphone, or a no-message control.

Main Results:

• The digital intervention was found to be feasible and acceptable to participants.
• Personalized messages were preferred over general ones and showed stronger effects.
• Participants receiving intervention messages were significantly more likely to use coping strategies for suicidal thoughts, with no iatrogenic effects observed.

Conclusions:

• This pilot microrandomized trial demonstrates the feasibility and acceptability of a digital intervention for in-the-moment coping during suicidal thinking.
• Findings support the development of just-in-time adaptive interventions for suicide prevention.
• Results inform the design of larger microrandomized trials to optimize digital suicide prevention tools.