Developing a Safety Planning Smartphone App to Support Adolescents' Self-Management During Emotional Crises

Suicide is a leading cause of death among adolescents, highlighting the need for effective suicide prevention strategies. Safety planning is a best-practice intervention that has recently shifted toward smartphone-based formats. This study explored stakeholder perspectives (adolescents, parents, practitioners) and described the development of an age-tailored app. A qualitative study was conducted in Germany (2023-2024) with focus groups involving adolescents (n = 7), parents (n = 4), and practitioners (n = 4). Adolescents (14-21 years) were eligible if they had received inpatient treatment, experienced suicidal thoughts within the past 24 months, and had prior experience with safety planning. Parents and practitioners had experience or expertise with suicidality among adolescents. Data were analyzed using Kuckartz's qualitative content analysis. App development was based, among other things, on insights from focus groups and pertinent theories. Stakeholders expressed differing needs regarding app content, settings, and adjustability. The developed emira-app includes an interactive safety plan to support users in self-managing emotional crises, along with additional features (e.g., digital HopeBox and diary) to promote integration into users' daily routines. This multi-component safety planning app was specifically developed for adolescents, and its participatory development process allowed an intensive exploration of key stakeholders' perspectives.