Objectives:
Rates of youth suicide in Australian Indigenous communities are four times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help-seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities.The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress, and impulsivity among Indigenous youth in remote Australia.
Setting:
Remote and very remote communities in the Kimberley region of north Western Australia
Participants:
Indigenous Australians aged 18-35 years.
Interventions:
61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks.
Primary and secondary outcome measures:
The primary outcome was the Depressive Symptom Inventory – Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), the Kessler Psychological Distress Scale (K10), and the Barratt Impulsivity Scale (BIS-11).
Results:
Although pre- post-intervention change on the (DSI-SS) was significant in the ibobbly arm (t=2•40; df=58•1; p=0•0195), this difference was not significant compared to the waitlist arm (t=1•05; df=57•8; p=0•2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared to waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use.
Conclusions:
Apps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps.
Trial Registration:
Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000104752.
↧