Assessing suicidality and helping patients make a safety plan is one of the more challenging aspects of GPs’ work. Could an app help?
A prevention planning app, developed by Australian experts, reduces the risk of suicide in mentally ill patients and should be considered as part of a mental health treatment plan.
The free app, BeyondNow, has been designed for patients to help them monitor and manage their illness, and work through a suicide prevention plan in times of crisis. Among other features, the app helps patients who develop suicidal ideation by reminding them of reasons to keep living through their own written testimony and personal photographs.
Associate Professor Grant Blashki, GP and Lead Clinical Adviser of Beyondblue was discussing the app at the recent GPCE conference in Sydney and suggests GPs consider it as part of a patient’s therapy.
While originally launched in 2016 and already downloaded by more than 60,000 individuals, the effectiveness of the app could be enhanced if incorporated as part of a patient’s management plan – a form of digital contract, that if appropriate could be emailed between the patient, the doctor and family members.
“In my clinic, I use the app as part of my mental health assessment, particularly with patients who indicate they are having suicidal thoughts,” he said.
Once downloaded the app directs the user to record details about their condition, their current situation and their plans for management. Professor Blashki suggests this process could be started during the GP consult.
“They don’t have to fill it all in while they are in the consult. I say ‘look maybe play with this when you go home and add in your own personal material and when you come back let’s have a look at it together’,” Professor Blashki said.
Importantly, the patient is prompted to record any warning signs that they might be considering self-harm and have listed coping mechanisms and strategies which could help.
BeyondNow was co-created by Associate Professor Glenn Melvin, clinical psychologist from Deakin University who validated the app in a published study involving 36 patients at risk of suicide.
Over the eight week trial, Professor Melvin found use of the app was associated with a significant improvement in the patients’ capacity to cope with suicidal thoughts.
Professor Blashki said the app allowed for an ongoing digital mental health conversation, which was a powerful therapeutic tool.
“Anecdotally patients tell me it’s an anchor for them. We’re all wedded to our phones now. They have a whole suicide prevention plan in their pocket, easy to access if they are in crisis,” he said.
While the app won’t solve the problem of suicide risk altogether, it’s a very practical tool for GPs to recommend to help patients work through issues as they arise, Professor Blashki said.
“I write it in my notes to remind myself they are using the app and then I can use that in the future to ask them how they are going with it,” he said.
“As a GP, for my patients, I know that their suicidal impulses will often pass like a wave and I am keen to do everything I can to help them weather these crisis moments until they are safe again,” Dr Blashki said.
