New Digital Intervention for Patients With Increased Suicide Risk

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A new mobile app has been shown to reduce suicidal behavior among high-risk psychiatric inpatients. The app, OTX-202, reduced the recurrence of inpatient psychiatric post-discharge suicide attempts by 58.3% for patients with a prior suicide attempt.¹ However, there was no significant difference in time to first suicide attempt between those who used the app and those who did not.

The recent multi-site, double-blind study enrolled 339 adult inpatients with a psychiatric disorder, who received either the OTX-202 app or an active control app, in addition to their usual treatment (including suicide risk assessment, supportive listening, crisis resources, clinician assessment, safety planning, and referral to outpatient treatment). Exclusion criteria included “acutely impaired mental status inhibiting capacity to provide informed consent (eg, uncontrolled psychosis or mania, or under the influence of alcohol or other substances)” and “cognitive impairments or medical conditions that could adversely affect the integrity of the data.”¹ The intervention app was designed to deliver suicide-specific cognitive-behavioral therapy (CBT) modules, while the control app provided general psychoeducation and safety planning. Suicidal ideation was measured throughout the study by the Clinical Global Impression for Severity of Suicide Change scale. For both groups, the first app session was completed prior to hospital discharge and the remaining sessions could be completed after discharge.

Most notably, there was a significant sustained reduction in suicidal ideation among participants who used OTX-202; the reduction persisted for up to 24 weeks after discharge. In contrast, the control group's suicidal ideation levels, which initially decreased, rebounded by the 24-week follow-up. The odds of clinical improvement were also higher for the treatment group, with 97.9% vs 87.5% for treatment vs control and odds ratio, 7.59; 95% CI, 1.14-153.62; P = .04. The authors hypothesized that the digital intervention may be able to maintain therapeutic progress from inpatient treatment outside of the structured clinical setting.

The app focuses on ensuring access to specialized, suicide-focused therapy, which is particularly important during the high-risk post-hospitalization period. Therapeutic modules found on the app are delivered in brief 10 to 15 minute sessions and are designed to reinforce key CBT principles for managing suicidal thoughts and developing coping strategies. Senior author Seth Feuerstein, MD, JD, a lecturer in psychiatry at Yale School of Medicine, underscored this critical need, stating in a press release, “Patients and those who care for them do not have access to reliable and effective tools and resources to reduce future suicide risk. This population faces arguably the biggest gap in access to effective interventions of any leading killer.”²

The weeks and months following discharge from psychiatric hospitalization are among the highest-risk periods for suicide attempts and death; this new digital intervention targets the vulnerable group of individuals who are at higher risk for multiple suicidal behaviors or attempts. According to study author Craig Bryan, PsyD, a professor at Ohio State University’s Department of Psychiatry and Behavioral Health, the app offers a novel solution to the challenge of connecting patients with specialized, life-saving therapy after they leave the hospital. “Although suicide-specific therapy is highly effective for reducing suicidal thoughts and urges, finding therapists who know how to do this life-saving therapy after leaving the hospital can be challenging. OTX-202 provides a possible solution to that problem,” he noted.²

References

1. Bryan CJ, Simon P, Wilkinson ST, et al. A digital therapeutic intervention for inpatients with elevated suicide risk: a randomized clinical trial. JAMA Netw Open. 2025;8(8):e2525809

2. Gardner C. Yale study: mobile phone app reduced suicidal behavior among high-risk patients. Yale School of Medicine. August 8, 2025. Accessed August 19, 2025. https://medicine.yale.edu/news-article/yale-ohio-state-study-mobile-phone-app-reduced-suicidal-behavior-among-high-risk-patients/