Adaptation of a French E-health Tool for Suicide Prevention in Young Populations

"Context: France's suicide rate is among the highest in Europe, with the young among the more at risk. Several European projects have demonstrated the effectiveness of using e-tools in suicide prevention particularly for hard-to-reach populations.

Lessons from StopBlues, an e-health tool (application/website) for suicide prevention in the general population developed in 2018 which was promoted by municipalities and general practitioners, show the necessity to adapt its content for young people.

Research objectives:

Phase I: Development of the e-health tool The objective of this part is to set up a consultation to co-construct, on the one hand, an e-mental health tool including a smartphone application and its website with and for young people adapted to their age group and, on the other hand, the promotionnal plan.

Methodology: The detailed content of the e-health tool and the promotional tools will be determinated with a literature review and consultations of youth and experts. Then, the investigators will rely on different networks to invite young people to an online consultation according to their age group to participate from the start to this intervention. Several means will be mobilised to involve them. the investigators will discuss with them: their feelings about the existing StopBlues adult tool (www.stopblues.fr), their perception of the specific topics that need to be addressed regarding the causes of psychological suffering, the possible solutions, the identification of speakers who act out situations that young people can identify with, their opinion on the graphic charter and design, and finally the means of dissemination that we could use to promote this tool.

The investigators will use the data saturation method to stop recruiting. The data collection necessary for the co-construction will be realised on digital platforms through surveys including questionnaires with either open questions or multiple-choice questions. The data will then be analysed using qualitative and quantitative methods.

The investigators will also use the digital platforms mobilised for this consultation to present the results and validate with participating youth the final version of the content, structure and ergonomics of the tool to be developed.

Expected results: This consultation will allow the project team to co-construct with young people an e-health intervention involving a mobile application, a website and their promotion.

The investigators also expect it to provide more precise information on:

• youth feelings about the adult version of the tool (StopBlues): its content, its ergonomics and the means of communication used (videos of professionals and testimonies);
• youth perception of the specific topics that need to be addressed regarding the causes of psychological suffering and possible solutions;
• youth opinions concerning the graphic charter, the name and logo of the tool; - and identification of some witnesses or witnesses' relatives to interview.

Phase II: Implementation of the intervention

The main objective is to assess the effectiveness in reducing suicidal acts of a suicide prevention program for young adults in the general population, combining an e-health tool and its promotion by local authorities. The secondary objectives are to assess the effect of the programme on youth in terms of :

• efficiency of the programme and its total and sectoral budgetary impact.
• quality of life
• mental health status (anxiety and depressive symptoms, addictions, eating disorders, suicide risk)
• use of formal and informal help
• depression detected by a relative
• user satisfaction
• effectiveness of the promotion on the intensity of use of the e-health tool
• completion of the safety plan
• school or employment integration
• effectiveness of the tool according to the social status of users
• spillover effect of the programme on the youth suicide prevention policy: measures put in place secondarily by the communities involved
• the process of implementation of the promotion by the communities
• barriers and levers for studying transferability. Methodology: The trial will last 18 months from the moment the e-tool will be online. Data will be collected both from health data bases and at the individual user level.

Expected results: The intervention, which includes the development of an e-health tool for young people and its implementation with a promotion, will make it possible to confirm the applicability of the intervention model used for adults for suicide prevention in the general population (StopBlues), on a more restricted population (the E-psyjeunes tool), that of 11-25 year olds. This project will make it possible to address the question, mentioned many times when StopBlues was set up, of psychological suffering of young people. The malaise of adolescents and young adults is unique and requires specific development. Through this project, a response can be provided to the many actors (young people, associations, health professionals, local authorities, etc.) looking for help and solutions.

The investigators believe that this intervention will lead to a reduction in suicidal acts (suicides and attempted suicides) of young people. With the use of these tool, users should develop a better knowledge of mental health and suicide in general, but also of their own mental health status. They should also become more aware of the formal and informal ways of seeking help and their use of help should increase, as well as their actions increasing well-being/coping strategies implementation. A decrease in the stigma of mental disorders is also expected among young people."