Health citizenship and digital technology for suicide prevention

9th April 2024

Authors: Dr Md Shafiqur Rahman Jabin, Assistant Professor, University of Bradford, UK, and Associate Professor Dianne Wepa, Charles Darwin University, Australia

Jabin Rahman Jabin photo  Dianne Wepa photo

Suicide is one of the leading causes of death worldwide, and annually, it affects 700,000 people – the person’s family, friends and community.

In the midst of this disastrous challenge, digital health technologies have emerged as one of the solutions for suicide prevention. Among many, some of the digital solutions for suicide prevention are digital speech analysis, facial emotion analysis, wearable sensors, mobile apps, automated cognitive behaviour therapy, and cloud-based technology. Despite many benefits, such as monitoring individuals at risk of suicide on the web, offering help on suicidal thoughts and behaviour and web-based assessment, these technologies have been reported to have a number of limitations.

The challenges may include restrictions in obtaining ethics approval (as ethics jurisdictions differ from country to country), difficulty translating findings in clinical practice, lack of strategy integration, and lack of opportunity for emotional connection.

The major drawback of these digital health solutions has been the absence of the concept of health citizenship before deploying the technologies to the market. Therefore, important attention is required for the incorporation of technological evolution for suicide prevention with the health citizens who have lived experience of using mental health/social care services or caring for someone who used such services.

Now, the questions arise – what approach should be followed in incorporating technology development and engaging patients and the public, i.e., refining the interface between humans and technology? How can we ensure patient satisfaction, acceptability, and socio-cultural inclusion and improve efficiency, effectiveness, feasibility, rigour, and readiness of these digital health tools? The most suitable approach is a co-creation approach, which involves collaboration among academics, researchers, mental health/social care service users, and end users from the onset.

There have always been questions on patient satisfaction and acceptability of suicide prevention and self-injury apps. In order to overcome such challenges, co-creation or user-centred design through a collaboration of multiple academics and research experts has been the emphasis.

The approach comprises the importance of user involvement, focus groups, advisory groups, and consultation with people with lived experience, including strategies for developing a safety plan and lived experience video footage. The user involvement should not be limited to the evaluation of those technologies; rather, the user should be engaged as co-creators of new online materials and approaches.

Most evidence show that the health citizens were engaged passively either during the final stages of the usability testing, middle of the study as user-informed participants, or part of the partnership process to support the analysis.

What we suggest is that the co-creation strategy must have authentic involvement along with the health citizens and other relevant experts in all the phases, such as planning, designing, implementation, and evaluation of digital health tools for suicide prevention.

A regular monitoring of such suicide prevention intervention by health professionals need to be in place once trials are completed, and the product is in the market for use to confirm if engagement with the tools continued and had an impact.


D Wepa, M Neale, W Abo-Gasala, S Cusworth, J Hargan, J Vaughan, S Giles, M Khan (2023) Codesign of Digital Health Tools for Suicide Prevention: A Scoping Review, British Journal of Healthcare and Medical Research, 10(5), 1-30

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