Implementing Digital Suicide Risk Screening in Behavioral Health: a Mixed-methods Study of Organizational Adaptation.

Area of Science:

• Digital Health
• Behavioral Health
• Clinical Implementation Science

Background:

• Digital platforms enhance behavioral health care beyond traditional appointments.
• Implementation challenges hinder routine use of digital tools.
• Understanding asynchronous digital suicide screening implementation is limited.

Purpose of the Study:

• To examine the implementation experiences of nine organizations using digital suicide screening.
• To identify implementation patterns, adaptations, and provider attitudes.
• To offer considerations for future digital suicide screening integration.

Main Methods:

• Exploratory study using post-implementation surveys from nine organizations.
• Mixed-methods approach: Interpretative Phenomenological Analysis and VADER sentiment analysis.
• Analysis of operational, technical, clinical, and systemic challenges and provider sentiments.

Main Results:

• Implementation challenges span operational, technical, clinical, and systemic domains.
• Provider attitudes shift from initial anxiety to strong support in mature implementations (48% very supportive, 32% moderately supportive).
• Sentiment analysis revealed generally positive attitudes (mean score=0.24).

Conclusions:

• Two frameworks emerged: Service Delivery Ecosystem and Implementation Stage.
• Context-specific adaptations and progression from rollout to maturity are key.
• Findings inform organizations planning digital suicide screening integration.