Users of e-Health tools for mental health and suicide primary prevention: description of their characteristics, usage, and satisfaction in the case of StopBlues.

BACKGROUND

Thousands of mental health (MH) applications are currently available. Suicidal behavior prevention could benefit from such tools, but few have been evaluated. StopBlues (SB) is an app- and web-based intervention for suicide primary prevention for the French general population. Our objectives were to better understand who users of e-health tools for suicide prevention are by describing SB users' characteristics and their use of the tool, engagement and satisfaction along with the factors associated with the latter two.

METHODS

Age, gender, socioeconomic status (SES), and MH were collected from users who registered to SB between March 2018 and February 2020. MH was self-assessed with validated questionnaires on global MH, depression, anxiety and suicide risk. Use of SB was assessed through functionalities users interacted with (questionnaires, moodtrackers and/or safety plan). Engagement was calculated between date of registration and last interaction with those functionalities. Satisfaction was assessed through a dedicated survey between May 2019 to June 2020. Regression models studied the factors associated with satisfaction and duration of engagement.

OUTCOMES: 10,792 people registered to SB during the study period. Two-thirds were women, mean age was was 38·5 years old (SD = 13·8), and 53·9 % lived in municipalities from the two highest SES quintiles. 47·8 % presented a risk of moderately severe or severe depression, and 27·2 % of severe anxiety. 23 % used the app for more than a day, with a mean duration engagement of 69 days (SD = 105). 96·4 % engaged at least once with either self-assessment questionnaires/moodtrackers or the safety plan, and 21·5 % interacted with both. 413 users completed the satisfaction survey and mean satisfaction was 61·6/100 (SD = 24·7).

INTERPRETATION: E-health tools for primary suicide prevention appear to be useful for users but close considerations to gender and age should be made when developing such tools.

FUNDING: French National Public Health Agency, Santé Publique France (grant 026/14).