is vice president of mission engagement for the AFSP and a licensed psychologist.

Doreen Marshall, PhD

The American Foundation for Suicide Prevention (AFSP) has contributed expertise and content on suicide to Most Days, a daily routine app that helps people track their mental health and well-being through different routines and provide support through the app’s community network. To discuss the upcoming collaboration, 

 sat down with Doreen Marshall, PhD, vice president of mission engagement for the AFSP and a licensed psychologist.

Psychiatric Times (PT): Most Days is the AFSP’s first collaboration in the mental health digital app space. What makes this app special?

 While there are many apps in the mental health space, it is important that app developers work with mental health experts and clinical providers to ensure that the content being provided actually does support mental health. Most Days approached AFSP with a desire to improve their app’s content in terms of suicide prevention and suicide grief. They also clearly communicated that the app is not a replacement for professional treatment and are eager to share resources that would help those in crisis get the help they need. After many discussions, we felt that a collaboration would help bring needed resources as well as support to individuals who may not be aware that these resources exist.

PT: You drafted the 4 routines related to suicide prevention for Most Days: (1) Thoughts of Self-harm or Suicide, (2) Healing After Surviving a Suicide Attempt, (3) Supporting Others Who May Have Thoughts of Self-harm or Suicide, and (4) Grieving Loss of a Friend or Family Member from Suicide. Could you tell us more about the routines and their accompanying resources? How did you pick these 4 routines?

 We know that when people are struggling with their mental health, it can be difficult to adhere to a daily routine that helps them. We also know that small actions matter. Most Days has a number of expert-developed routines that support mental health for those struggling with depression, anxiety, sleep problems, and grief. We thought that if we could build additional habits into the routines to help people based on what we have learned, it would help support suicide prevention and suicide grief work.

The habits we added will guide individuals toward actions that can support their other efforts to help themselves or others. For example, reminders to take medication as prescribed, review one’s safety plan, take steps to stay connected, can all have a positive impact on one’s mental health and may even save a life. Again, while using the app is not a substitute for working with a mental health professional, using an app to track habits and to connect to a supportive peer community can encourage people to proactively take daily steps to help their mental health.

We also thought there might be similar routines that could help support those who are caring for others or grieving a suicide loss. AFSP engages in several program efforts to educate the public about supporting those who may be struggling or grieving a suicide loss. Incorporating similar information into an app seemed to be an important way to extend these efforts to reach more people.

Finally, part of this collaboration was to include resources that can help someone who approaches the app and needs immediate support, so we incorporated the National Suicide Prevention Lifeline, a phone line that provides access to crisis counseling, to appear when someone engaged one of the suicide prevention related routines.

PT: How do routines help maintain an individual’s mental health?

 There is good research to support that maintaining a daily routine can support one’s mental health. When we are not experiencing optimal mental health, it can be more difficult to do the very things we know help us. Yet, we know that our daily actions matter, and things like remembering to take prescribed medication, getting some daily exercise, and reaching out to others can all have a positive impact on our mental health. Routines and prescribed daily habits can also help anchor us and provide some sense of control when we feel overwhelmed or unable to think about the next thing we can do to help.

PT: Part of the Most Days app’s appeal is the community aspect. Could you elaborate on the importance of communal support in building self-care routines?

 I think we all do better knowing there is support whenever we are trying to make a positive change. Most Days has a community of people who are actively trying to make positive changes to support their mental health, and for someone trying to do the same, it can help to know that others are working through similar challenges and that you are not alone.

PT: How can apps like Most Days build upon the clinical treatment patients receive?

 This is an important caveat for the use of apps related to mental health—they are not to be used instead of clinical treatment, but rather as an adjunct to treatment when treatment is needed. We know, though, that clinical treatment is usually limited—you may see an outpatient mental health professional for an hour a week, but you have lots of other hours outside of treatment to navigate your daily life and put into practice what you are learning in treatment. Apps that help track daily habits can help clients with reminders to engage in those helpful actions, as well as help them track their own behavior outside of treatment to be able to report accurately what they are experiencing to their clinical provider. And it always helps treatment when patients can accurately describe what is happening in between treatment sessions, which can be especially hard for patients to do when feeling depressed or struggling with their mental health.

PT: Finally, what is the most important thing about Most Days that you think mental health clinicians should know about?

 Apps cannot and should not replace clinical treatment when that is what is needed. But I think clinicians can consider how these existing mental health apps may support treatment efforts. They can work with patients to identify apps that are evidence-informed and contain expert content and resources. We should also remember that our patients are not the only ones that can benefit from apps to support our mental health—they can be helpful to us as clinicians in managing our mental health, too.

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The American Foundation for Suicide Prevention collaborates with Most Days, a mental health app, to provide suicide prevention expertise and content. Learn more about the partnership here. 

Doreen Marshall, PhD

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Mental Health App Collaborates With the American Foundation for Suicide Prevention