Real-world feasibility and acceptability of real-time suicide risk monitoring via smartphones: A 6-month follow-up cohort

Active and passive Ecological Momentary Assessment of suicide risk is crucial for suicide prevention. We aimed to assess the feasibility and acceptability of active and passive smartphone-based EMA in real-world conditions in patients at high risk for suicide. We followed 393 patients at high risk for suicide for six months using two mobile health applications: the MEmind (active) and the eB2 (passive). Retention with active EMA was 79.3% after 1 month and 22.6% after 6 months. Retention with passive EMA was 87.8% after 1 month and 46.6% after 6 months. Satisfaction with the MEmind app, uninstalling the eB2 app and diagnosis of eating disorders were independently associated with stopping active EMA. Satisfaction with the eB2 app and uninstalling the MEmind app were independently associated with stopping passive EMA. Smartphone-based active and passive EMA are feasible and may increase accessibility to mental healthcare.

Automated summary

This study aimed to assess the feasibility and acceptability of active and passive smartphone-based Ecological Momentary Assessment (EMA) in real-world conditions among patients at high risk for suicide. Results showed that retention rate with active EMA was lower after 6 months, while retention rate with passive EMA was relatively higher. Satisfaction, app uninstallation, and diagnosis of eating disorders were associated with stopping active EMA, while satisfaction and app uninstallation were associated with stopping passive EMA. Smartphone-based active and passive EMA have the potential to increase accessibility to mental healthcare.