Crisis Care: A Smartphone Application Intervention for Suicidal Adolescents

Background and Purpose: Interconnectedness through technology is a fact of life for today’s adolescents. The new digital metropolis presents both challenges and opportunities for social worker engagement and intervention with adolescents with mental health problems. Many social workers interact with suicidal adolescents and their families in their daily practice. There is a critical need to reach suicidal adolescents at their time of highest acuity and vulnerability, and to do so using the mechanisms of communication with which they are most familiar. A recent and continuing increase in smartphone ownership by adolescents across race, ethnicity, and income (Lenhart, 2012) suggests the potential for smartphone applications as intervention approaches with suicidal adolescents.

Methods: Crisis Care (O’Brien, Wharff, & Kahn, 2013) is a smartphone application intervention developed specifically for suicidal adolescents and their caregivers. There is an adolescent mode and a caregiver mode designed to be used in tandem when the adolescent is experiencing a suicidal crisis. The primary function of Crisis Care is to give adolescents and caregivers an immediate connection to help. Additionally, the adolescent can access a set of personalized skills and the caregiver can access tips on effective listening and skill coaching. A web-based prototype of Crisis Care was developed and pilot tested with 10 participants (n=5 adolescents, n=5 caregivers). The System Usability Scale (SUS), a 23 item questionnaire, was used to assess usability and acceptability.

Results: All 10 participants answered “Agree” or “Strongly Agree” to the statement “I thought the app was easy to use,” and 9 of 10 answered “Agree” or “Strongly Agree” to the following statements: “I think most people could learn to use the app quickly,” “I think I would use the app,” and “I think most people would be able to use the app in a crisis situation.” Specific to usability, 9 of 10 participants were able to find and access what was asked of them by the interviewer in two or fewer clicks.

Conclusions and Implications: Crisis Care is a promising technological intervention for suicidal adolescents and their caregivers in the context of a suicidal crisis. The limited use of smartphone applications in mental health care represents a missed opportunity, as they have the potential to extend and supplement traditional therapies (Erhardt & Dorian, 2013). Social workers may be skeptical about integrating technological innovations into mental health care because of the fear of taking away from the client-centeredness of the profession and diminishing face to face practice interaction. However, smartphone application interventions have the ability to personalize content (Erhardt & Dorian, 2013) and make care more accessible, efficient, and interactive (Luxton et al., 2011). They have the potential to engage adolescents in their individual, familial, and social worlds, and to do so in a way that is uniquely personalizable. By establishing a custom-made connection to a support system, smartphone applications have the opportunity to enhance safety planning procedures, interventions, and treatment with suicidal adolescents.