A mobile phone app designed to deliver suicide-specific therapy reduced suicidal behavior among high-risk psychiatric inpatients, according to a new study by scientists at Yale School of Medicine and The Ohio State University Wexner Medical Center and College of Medicine.
The study, published Aug. 8 in JAMA Network Open, found that the app, OTX-202, reduced the recurrence of post-discharge suicide attempts by 58.3% among patients who had previously attempted suicide. This reduction is a critical achievement for a group that is particularly vulnerable to repeated suicidal behaviors, the researchers said.
Users of the app also experienced sustained reductions in suicidal thoughts for up to 24 weeks after psychiatric hospitalization, according to the study. In contrast, patients who used an active control app in addition to treatment as usual showed early improvement, but suicidal thoughts rebounded by week 24.
These findings suggest that OTX-202 may help preserve long-term gains in mental health during the high-risk period following hospital discharge, according to the study.
“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,” says study co-first author Craig Bryan, PsyD, professor in Ohio State’s Department of Psychiatry and Behavioral Health and director of its Suicide Prevention Program.
Suicide remains among the top 10 causes of death in the U.S.; it is the second leading cause of death among individuals aged 10–14 and 25–34, the third leading cause among those aged 15–24, and the fourth leading cause among those aged 35–44. Since 1999, suicide rates have risen by more than 33%.
Each year, more than 1 million adults engage in nonfatal suicidal behavior, and nearly 500,000 are hospitalized for suicide attempts. Suicide and suicide attempts also cost the U.S. health care system and broader economy an estimated $500 billion annually underscoring the urgent need for scalable, effective, and economically viable interventions. Suicide is the only top killer without any prescription products for the vast majority of patients at risk.
“It can take weeks to months to see an outpatient provider after discharge; however, the weeks and months after discharge from psychiatric hospitalization are among the highest risk periods for suicide mortality, underscoring the critical need for effective interventions like OTX-202,” says co-first author, Patricia Simon, assistant professor adjunct of psychiatry at Yale School of Medicine.
OTX-202, developed by Oui Therapeutics, offers a scalable and cost-effective approach during this critical gap.
Testing of OTX-202 by the Yale and Ohio State researchers involved a multi-site, double-blind randomized controlled trial with 339 psychiatric inpatients from six diverse hospitals across the United States.
The participants were randomly assigned to either the OTX-202 app or an active control app, both in addition to their usual treatment. The OTX-202 app delivered a suicide-specific therapy module while the control app included safety planning and psychoeducation.
Compared to the active control, patients using OTX-202 were significantly more likely to show clinical improvement, as measured by the Clinical Global Impression for Severity of Suicide-Change (CGI-SSC) scale. The CGI is widely used because it provides a standardized, clinician-rated measure of symptom severity and improvement over time, allowing for consistent assessment across diverse patient populations and treatment settings.
“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. The potential clinical and population health impact of this new option is extraordinary,” says senior author Seth Feuerstein, MD, JD, assistant clinical professor of psychiatry at Yale.
Yale authors include Patricia Simon, PhD; Samuel T. Wilkinson, MD; Lauren Astorino, MSN, APRN; Alecia D. Dager, PhD; and Seth Feuerstein, MD, JD. Ohio State authors include Craig Bryan, PsyD; Kristen M. Carpenter, PhD; Luke Misquitta, MD; Katherine Brownlowe, MD; Lauren R. Khazem, PhD; Jarred Hay; and Austin G. Starkey.
The research reported in this news article was supported by the National Institutes of Health (award R42MH123357) and Yale University. The content is solely the responsibility of the authors, and it does not necessarily represent the official views of the National Institutes of Health. Additional support was provided by Oui Therapeutics Inc.