Efficacy of BrighterSide, a Self-Guided App for Suicidal Ideation: Randomized Controlled Trial

Background: Self-guided digital interventions can reduce the severity of suicidal ideation, although there remain relatively few, rigorously evaluated, smartphone apps targeting suicidality. Objective: This trial evaluated whether the BrighterSide® smartphone app intervention was superior to a waitlist control group at reducing the severity of suicidal ideation. Methods: 550 adults aged 18-65 with recent suicidal ideation were recruited from the Australian community. In this randomized controlled trial, participants were randomly assigned to receive either the BrighterSide® intervention app, or to a waitlist control group which involved treatment as usual. The app was self-guided, and participants could use the app at their own pace for the duration of the study period. Self-report measures were collected at baseline, 6-weeks, and 12-weeks. The primary outcome was severity and frequency of suicidal ideation, and secondary outcomes included psychological distress and functioning and recovery. Additional data were collected on app engagement and participant feedback. Results: Suicidal ideation reduced over time for all participants, but there was no significant interaction between group and time. Similar improvements were observed for self-harm, functioning and recovery, days out of role, and coping. Psychological distress was significantly lower in the intervention group at the 6-week follow-up, but this was not maintained at 12 weeks. Conclusions: The BrighterSide® app did not lead to a significant improvement in suicidal ideation, relative to a waitlist control group. Possible reasons for this null finding are discussed. Clinical Trial: Australian New Zealand Clinical Trials Registry (ACTRN12621000712808).