Digital Health Tools for Suicide Prevention
Sandra Dawson
March 10 , 2017
HOpe Cen t re A t r ium
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Digital Health Tools for Suicide Prevention
No conflict of interest to declare
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Digital Health Tools for Suicide Prevention
Contents:
• Suicide and mental health care in Canada
• What is digital health?
– How is it applied to suicide prevention?
– How can it be used to manage mental health?
– Limitations
• Online advocacy
• Conclusion
Followed by Q&A Links shared on web page
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Digital Health Tools for Suicide Prevention
• 11.3 per 100,000 people died by suicide in Canada in 2014 (Statistics Canada)
• Rate is highest among middle-aged Canadians (40-59)
• High risk groups: men, First Nations, LGBTQ+, people with some mental illnesses
Source: Canadian Association for Equality, 2014
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Digital Health Tools for Suicide Prevention
• People with suicidal thoughts are advised to call 911 and go to the ER
• Hospitals like LGH can’t meet demand, with acute care bed shortages
• People certified under the BC Mental Health Act kept in the ER for days awaiting a psych ward bed, while others are told to seek community care
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Digital Health Tools for Suicide Prevention
• Community care has wait lists, barriers, silos
• Access to mental health professionals is the top
priority to 91% of Canadians with mental health issues
and caregivers (Mood Disorders Society of Canada
2015 Pan-Canadian Survey)
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Digital Health Tools for Suicide Prevention
• Phone helplines provide crisis support from trained
volunteers
• Greater Vancouver: 604-872-3311
• People avoid using phones:
– social anxiety
– phone phobia
– privacy
– not wanting helpline on cell phone bill
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Digital Health Tools for Suicide Prevention
What is digital health?
• Use of web, mobile, and other technologies for health
care
• Other names:
– ehealth
– mhealth (mobile apps)
– e-mental health
“...mental health services and information delivered or enhanced through the Internet and related technologies.” Christensen H, Griffiths KM, Evans K. (2002). e-Mental Health in Australia: Implications of the Internet and Related Technologies for Policy. ISC Discussion Paper No 3.
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Digital Health Tools for Suicide Prevention
Source: Mental Health Commission of Canada, "E-Mental Health: Transforming the System Using Technology - A Briefing Document," 2013
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Digital Health Tools for Suicide Prevention
How is digital health used for suicide prevention?
• Crisis chat and texting services
• Mobile apps
• Social media supports
• Advocacy and awareness
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Digital Health Tools for Suicide Prevention
• CrisisCentreChat.ca is an online chat service for adults
in BC and Yukon
• Open noon – 1:00am PT
• Chat interface is mobile compatible
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Digital Health Tools for Suicide Prevention
• YouthInBC.com is an online crisis chat for youth in the
Yukon and BC
• Open noon – 1:00am PT
• Mobile compatible chat
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Digital Health Tools for Suicide Prevention
• Youthspace.ca in Victoria, BC provides services to
Canadians under the age of 30
• Open 6:00 pm – midnight PT
• Online chat or texting (778-783-0177) with trained
volunteer counsellors
• Unique in offering ongoing email counselling with
licensed counsellors
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Digital Health Tools for Suicide Prevention
Online Suicide Help
• Global directory of e-mental health supports and tools
• Crisis chat, texting, email, social media, peer support
forums, videos, mobile apps, more
• Evidence-informed, many services certified by the
American Association of Suicidology, utilizing trained
volunteers
• Pages with specialized services for youth and
LGBTQ+ people
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Digital Health Tools for Suicide Prevention
TheLifelineCanada.ca
• Mobile app connects by voice to the nearest phone
helpline in Canada
• Links to online resources
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Digital Health Tools for Suicide Prevention
• Future help: a new Canadian service is to be launched
in late 2017
• Will provide a single access point to crisis support for
all of Canada, 24/7
• It will provide help by phone, web chat, and texting
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Digital Health Tools for Suicide Prevention
• The International Association for Suicide Prevention
(IASP) maintains a list of suicide prevention mobile
apps
• Includes reviews, links to scientific articles
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Digital Health Tools for Suicide Prevention
StayAlive mobile app
• Developed by UK suicide prevention organization so
contact info is UK based, but info and resources global
• Customizable safety plan, crisis contacts, coping tips
• Co-designed with people with lived experience for peer
perspective, which creates a richer and more usable
app
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Digital Health Tools for Suicide Prevention
@unsuicide on Twitter
– Signposting
– Online gatekeeping
– Informal peer support
– Inspiring recovery-oriented tweets
– Resources and information
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Digital Health Tools for Suicide Prevention
LiveThroughThis.org
• Awareness project by activist/photographer Dese'rae
Stage
• Web site featuring over 130 portraits with interviews of
suicide attempt survivors
• Peer support Facebook group
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Digital Health Tools for Suicide Prevention
How is digital health used to support mental health along
the continuum?
– Wellness and relaxation
– Monitoring and self-management
– Treatment interventions
– Peer support
– Web tools, mobile apps, wearables, robots
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Digital Health Tools for Suicide Prevention
JoyForAll companion robot cat
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Digital Health Tools for Suicide Prevention
BounceBackOnline
• From the Canadian Mental Health Association (CMHA)
BC Division
• Internet Cognitive Behavioural Therapy (CBT) program
• Evidence-based as effective for mild to moderate anxiety
and depression
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Digital Health Tools for Suicide Prevention
• CREST.BD’s Bipolar Quality of Life Tool
• Bipolar Wellness Centre resources
• Evidence-based, developed with peer researchers,
clinicians, academics
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Digital Health Tools for Suicide Prevention
• #CopingChat is a monthly Twitter-based knowledge
exchange event
• People share lived experience of effective coping skills
with peers
• Two people win hope bracelets in a random draw
giveaway
• Next #CopingChat is March 16 (all day)
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Digital Health Tools for Suicide Prevention
Peer support online:
• Mood Disorders Society of Canada discussion forum (moderated)
• iPrevail - non-crisis web site with mental health quizzes, trained peer support chat, and clinically-proven online therapy programs based on CBT
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Digital Health Tools for Suicide Prevention
Breathe2Relax
• Breathing exercise mobile app
• Part of the T2 National Center for Telehealth &
Technology suite of apps, evidence-based
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Digital Health Tools for Suicide Prevention
American Psychiatric Association (APA)
App Evaluation Model
• Framework to assess apps, instead of a guide to
individual apps in a market that changes fast
• Evidence can include user ratings
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Digital Health Tools for Suicide Prevention
How to access BC’s mental health care system
• Several points of digital entry
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Digital Health Tools for Suicide Prevention
BC government web portal announced in new budget
• 8-1-1 HealthLinkBC health services and information
directory
• Mental Health and Substance Use Supports in B.C.
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Digital Health Tools for Suicide Prevention
MindhealthBC.ca
• BC mental health web portal
• Offers scientific questionnaires to screen for depression, anxiety, and several other mental illnesses
• Referral to information, resources, and contact information to get help in local communities
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Digital Health Tools for Suicide Prevention
EQVirtual.com
• Web site or mobile app
• Convenient clinic providing video access to GPs and specialists (including psychiatrists)
• Free with provincial health card number
• 7 days a week, extended hours
• Provide medical advice, order tests, send prescriptions electronically to a pharmacy of your choice, then send a report to your GP
• Anxiety is one of the most common conditions EQVirtual treats
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Digital Health Tools for Suicide Prevention
What digital health can’t do:
• Limitations of new technology
• Digital divide
• Apps and lack of research evidence
• Dropout rates
• User skepticism
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Digital Health Tools for Suicide Prevention
• Stigma prevents some people from seeking care
• Ehealth offers a way around stigma with confidentiality
and anonymity online, eg. transgender peer support
• Ehealth reaches some people that no form of traditional
care would
• Also used for antistigma education, eg.
SuicideInTheMedia Twitter bot
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Digital Health Tools for Suicide Prevention
Online advocacy
– Social media (eg. #BellLetsTalk)
– Crowdfunding
– People organize, combat stigma, and raise
awareness
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Digital Health Tools for Suicide Prevention
• The Peyton Heart Project - antistigma suicide prevention
campaign that shares hearts tagged with inspiring
quotes, around the world
• People find hearts and share photos on social media
with hashtag #PeytonHeartProject
• Hearts shared today were made by HOpe Centre
volunteers. Thanks volunteers, and Bita Ardakani for
organizing.
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Digital Health Tools for Suicide Prevention
• Amanda Todd was a teenage girl who was sexually
exploited and cyberbullied by a man now facing criminal
charges
• Died by suicide
• The Amanda Todd Legacy is run by her mother Carol
Todd, doing suicide prevention advocacy online and in
schools
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Framework for Successful Messaging
• Media ethics apply to social media
• Communicate about suicide online safely to prevent
contagion, encourage help-seeking and hope
• Learn more and take the pledge from the National
Action Alliance for Suicide Prevention
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Digital Health Tools for Suicide Prevention
Conclusion:
• Access is a top priority
• Being able to self-refer to digital health addresses
system gaps
• E-mental health empowers users to manage, treat,
and support mental health and ultimately prevent
suicide
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Digital Health Tools for Suicide Prevention
• Find links from today’s talk at unsuicide.wikispaces.com/HOpeCentreLinks
• email [email protected]
Thank you