Digital health tools_for_suicide_prevention_sandra_dawson

Digital Health Tools for Suicide Prevention

Sandra Dawson

March 10 , 2017

HOpe Cen t re A t r ium

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No conflict of interest to declare

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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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• 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

http://www.statcan.gc.ca/eng/help/bb/info/suicide

http://equalitycanada.com/the-facts-about-suicide-and-men-in-canada-an-infographic/

http://equalitycanada.com/the-facts-about-suicide-and-men-in-canada-an-infographic/

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• 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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• 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)

https://mdsc.ca/research/2015-mental-health-care-system-survey-results/





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• 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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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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Source: Mental Health Commission of Canada, "E-Mental Health: Transforming the System Using Technology - A Briefing Document," 2013

http://www.mentalhealthcommission.ca/English/document/27081/e-mental-health-canada-transforming-mental-health-system-using-technology






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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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• CrisisCentreChat.ca is an online chat service for adults

in BC and Yukon

• Open noon – 1:00am PT

• Chat interface is mobile compatible

https://crisiscentrechat.ca/

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• YouthInBC.com is an online crisis chat for youth in the

Yukon and BC

• Open noon – 1:00am PT

• Mobile compatible chat

http://youthinbc.com/

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• 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

http://youthspace.ca/

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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

http://unsuicide.wikispaces.com/

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TheLifelineCanada.ca

• Mobile app connects by voice to the nearest phone

helpline in Canada

• Links to online resources

http://thelifelinecanada.ca/

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• 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

http://news.gc.ca/web/article-en.do?nid=1159919&tp=1

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• The International Association for Suicide Prevention

(IASP) maintains a list of suicide prevention mobile

apps

• Includes reviews, links to scientific articles

http://www.iasp.info/resources/Suicide_Prevention_and_New_Technologies/Suicide_Prevention_Smartphone_Apps/

http://www.iasp.info/resources/Suicide_Prevention_and_New_Technologies/Suicide_Prevention_Smartphone_Apps/

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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

http://www.prevent-suicide.org.uk/stay_alive_suicide_prevention_mobile_phone_application.html



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@unsuicide on Twitter

– Signposting

– Online gatekeeping

– Informal peer support

– Inspiring recovery-oriented tweets

– Resources and information

https://twitter.com/unsuicide

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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

http://livethroughthis.org/



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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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JoyForAll companion robot cat

http://joyforall.hasbro.com/



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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

http://www.bouncebackonline.ca/

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• CREST.BD’s Bipolar Quality of Life Tool

• Bipolar Wellness Centre resources

• Evidence-based, developed with peer researchers,

clinicians, academics

http://bdqol.com/

http://bdqol.com/

http://bdqol.com/

http://bdwellness.com/



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• #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)

https://twitter.com/search?f=tweets&vertical=default&q=%23CopingChat&src=typd

https://twitter.com/search?f=tweets&vertical=default&q=%23CopingChat&src=typd

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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

https://mdsc.ca/discussion-forum/

https://mdsc.ca/discussion-forum/

https://www.iprevail.com/

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Breathe2Relax

• Breathing exercise mobile app

• Part of the T2 National Center for Telehealth &

Technology suite of apps, evidence-based

http://t2health.dcoe.mil/apps/breathe2relax

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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

https://www.psychiatry.org/psychiatrists/practice/mental-health-apps/app-evaluation-model



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How to access BC’s mental health care system

• Several points of digital entry

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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.

http://www2.gov.bc.ca/gov/content/mental-health-support-in-bc



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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

http://www.mindhealthbc.ca/

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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

https://eqvirtual.com/british-columbia/en/

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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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• 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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Online advocacy

– Social media (eg. #BellLetsTalk)

– Crowdfunding

– People organize, combat stigma, and raise

awareness

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• 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.

http://thepeytonheartproject.org/

http://thepeytonheartproject.org/

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• 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

https://www.facebook.com/AmandaToddLegacyStayingStrong/timeline

https://www.facebook.com/AmandaToddLegacyStayingStrong/timeline

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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

http://suicidepreventionmessaging.actionallianceforsuicideprevention.org/

http://suicidepreventionmessaging.actionallianceforsuicideprevention.org/

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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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• Find links from today’s talk at unsuicide.wikispaces.com/HOpeCentreLinks

• email [email protected]

Thank you

http://unsuicide.wikispaces.com/HOpeCentreLinks

mailto:[email protected]

Digital health tools_for_suicide_prevention_sandra_dawson

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