7 - (IOP 14) The Mobile Application to Prevent Suicide (MAPS): Feasibility, Acceptability, and Pilot Testing

Although evidence-based interventions for suicide exist, the suicide rate in the United States remains high, with nearly 50,000 deaths in 2022 alone (CDC, 2024). The suicide rate is particularly high following care transitions; for example, the rate of death by suicide is 200 times higher in the first month following psychiatric care compared to the general population (Chung et al., 2017). There are likely multiple reasons for these high rates, and two are particularly addressable. First, uptake of empirically supported interventions is limited, due to financial, logistical, attitudinal, symptomatic, clinical, or other barriers (Han et al., 2018). Second, the frequency and content of most interventions for suicide (e.g., weekly psychotherapy) may not match the dynamic, heterogeneous, and contextualized nature of suicide risk (Coppersmith et al., 2022).

Mobile health (mHealth) interventions, such as smartphone applications (apps), may mitigate some of these concerns. Unfortunately, existing smartphone apps for suicide have important limitations, including lack of evidence-based content for suicide prevention (Wilks et al., 2021), privacy and data security issues (Alhammad et al., 2024), and inaccurate crisis contact information (Martinengo et al., 2019). To bridge this gap, our team developed the Mobile Application to Prevent Suicide (MAPS), which is comprised of a patient-facing app and clinician dashboard for risk monitoring. MAPS is an ecological momentary intervention designed to identify suicide risk and intervene in the moment.

We recently published preliminary data from two open trials in which participants with past-month suicidal ideation and behavior used MAPS for 28 days following psychiatric inpatient discharge (N=10 adults) or during and after a partial hospitalization (N=10 young adults) (Schatten et al., 2024). These samples were diverse in terms of gender identity and sexual orientation (e.g., across studies, 10% of participants identified as transgender, 15% as nonbinary, and 5% as gender fluid; 40% identified as either gay, lesbian, bisexual, queer, or pansexual). Results suggested that MAPS was both acceptable and feasible to implement. Descriptive analyses suggested that during their use of MAPS, the majority of participants reported either decreases or no change in suicidal ideation severity, and there was an upward observable trend in outpatient treatment utilization. Following this phase of testing, we made changes to MAPS based on qualitative and quantitative participant feedback. Thus, in addition to the data from the first phase of open trials, we propose to present data from a second open trial with young adults in a partial hospitalization program (N=10), and we plan to have preliminary data to report from a pilot randomized trial of adult psychiatric inpatients (N=32). In sum, we propose to describe the development of MAPS and present data that provide initial support for the use of MAPS as an adjunctive intervention for suicidal ideation and behavior during transitions from a higher to lower level of care.