Introduction
As mental health practitioners, many of you may have worked with people who want to end their lives. You may have seen apps help save lives, also seen apps fail when people needed them most.
If you are building suicide watch telepsychiatry services, this guide might help you.
Test Your App at 3 AM
Before you build anything, think about this: It is 3 AM. Someone is alone and wants to die. They pick up their phone. Will your app help them or make things worse?
Let us consider a use case scenario: Jake tries to connect with the ABC suicide helpline services after he tried to kill himself. He tells them about the apps he used that night. “One app had seven steps to get help,” he said, and was not sure which one to use to seek help.
What you should do as a designer:
- Put the “Get Help Now” button on every screen
- Make buttons big and easy to see
- Use simple words, not medical words
- Remember: scared people cannot think clearly
Build Safety Features First
Every suicide watch telepsychiatry service needs these safety features (Shoib et al., 2024):
Crisis Help Button
- Always visible on every screen
- Connects to crisis hotlines (988 in US, Samaritans in UK)
- Works with one tap, not multiple steps
Location Sharing
- Ask users if they want to share location
- Only share if the user says yes
- Helps emergency services find them fast
Smart Alerts
- Send alerts when someone is in danger
- First alert goes to their doctor
- Then to family or friends
- Last alert goes to emergency services
Now, let us take the case of Maria. Her app noticed she was not sleeping and her writing was getting sad. Her doctor got an alert and called her. This stopped her from trying to hurt herself.
Think Long-Term, Not Just Crisis
Most people think suicide prevention is about stopping someone at the last minute. That is wrong. Real prevention happens weeks before (Stanley et al., 2018).
Good suicide watch telepsychiatry services watch for small changes:
- Person stops talking to family and friends
- Sleep patterns change
- Mood gets worse gradually
- Person misses appointments
Build These Features:
- Daily mood check (simple 1-10 scale or emoji)
- Sleep tracking
- Medicine reminders
- Simple check-ins (“How are you today?”)
- Charts that show changes over time
Use PERMA to Build Hope
PERMA stands for:
- Positive Emotion
- Engagement
- Relationships
- Meaning
- Accomplishment
Your app can help with all the above aspects from the PERMA framework (Al-Hendawi et al., 2024). Consider the following fictional anecdotes:
Positive Emotion: Tom is a car mechanic. He felt very sad. His app asked him to take photos of things he fixed each day. Seeing his “fixed things” collection made him feel better. He realized he could fix himself, too.
How to build this: Add simple photo features. Ask users to capture one good moment each day.
Engagement Lisa was an artist who stopped making art. Her app gave her simple drawing challenges. Five minutes of drawing each day helped her love art again.
How to build this: Add small activities users can do in 5-10 minutes. Make them optional, not required.
Relationships: Marcus felt alone. His app reminded him to text one friend each day. Not forced messages, just gentle reminders that friends care.
How to build this: Add contact reminders. Let users choose who to contact and when.
Meaning, Simple questions help people remember why life matters:
- “Who would miss your laugh?”
- “What would be lost if you were not here?”
- “What are you curious about?”
How to build this: Add reflection prompts. Keep them short and optional.
Accomplishment For sad people, getting out of bed is huge. Your app should celebrate small wins.
How to build this: Track tiny goals. Celebrate when users complete them, even small ones.
Consider integrating evidence-based wellbeing prompts, like gratitude exercises or daily reflections. Programs such as the Happiness Coach provide ready-made frameworks that can inspire these interventions
Journal Writing Saves Lives
Writing helps people feel better. Most apps do this wrong. Questions like “How do you feel?” can make sad people feel worse.
Better questions are:
- “What felt okay today?”
- “Where do you feel safe?”
- “What made you smile, even a little?”
- “Who cares about you?”
Rachel’s Story Rachel was a nurse with trauma. Instead of writing about bad memories, she wrote about safe places and people who cared. This helped her feel better.
How to build journal features:
- Use specific, helpful questions
- Keep writing private unless the user wants to share
- Look for warning signs in writing (words like “never,” “nothing,” “always”)
- Let users write as much or as little as they want
Make Your App Work with Doctors
The best suicide watch telepsychiatry services connect with real healthcare. If doctors cannot see the app data, it does not help much.
What you need:
- Connect with hospital computer systems
- Let different people see different information (doctor sees more than family) with consent and proper privacy features in place.
- Easy way to share important information
- Secure messaging between patient and care team
Carlos used an app that let his doctor, therapist, and sister all stay connected. This teamwork saved his life.
Simple Checklist for Designers
Must-Have Safety Features:
- ✓ Big “Get Help Now” button on every screen
- ✓ One-tap connection to crisis hotlines
- ✓ Location sharing (with permission)
- ✓ Smart alerts to doctors and family
Daily Support Features:
- ✓ Simple mood tracking (1-10 or emoji)
- ✓ Sleep and medicine reminders
- ✓ Charts showing changes over time
- ✓ Easy check-ins
Hope-Building Features:
- ✓ Photo sharing for positive moments
- ✓ Small activity challenges
- ✓ Reminders to contact friends
- ✓ Questions about meaning and purpose
- ✓ Celebration of small wins
Writing Features:
- ✓ Helpful journal questions
- ✓ Private writing space
- ✓ Option to share with care team
- ✓ Warning sign detection
Technical Features:
- ✓ Works with hospital systems
- ✓ Different access levels for different people
- ✓ Secure messaging
- ✓ Works on basic phones, not just new ones
Simple Language Tips
When writing app text:
- Use “sad” instead of “depressed”
- Use “worried” instead of “anxious”
- Use “doctor” instead of “clinician”
- Use “help” instead of “intervention”
- Ask “How can we help?” not “What are your symptoms?”
Your Responsibility
Every year, over 700,000 people die by suicide worldwide. Each person had family, friends, and dreams. Many deaths could be prevented with the right help at the right time.
When you build suicide watch telepsychiatry services, you are building hope. Someone might open your app when they want to die. Your design choices can save their life.
Make buttons easy to find. Use kind words. Build features that work when people are scared and cannot think clearly. Test everything many times.
You are not just making software. You are making a bridge between despair and hope (Witt et al., 2017).
Remember: Simple design saves lives. Complex design can kill.
References
- Al-Hendawi, M., Alodat, A., Al-Zoubi, S., Bulut, S., 2024. A PERMA model approach to well-being: a psychometric properties study. BMC Psychol. 12, 414. https://doi.org/10.1186/s40359-024-01909-0
- Shoib, S., Shaheen, N., Anwar, A., Saad, A.M., Mohamed Akr, L., I Saud, A., Kundu, M., Nahidi, M., Chandradasa, M., Swed, S., Saeed, F., 2024. The effectiveness of telehealth interventions in suicide prevention: A systematic review and meta-analysis. Int. J. Soc. Psychiatry 70, 415–423. https://doi.org/10.1177/00207640231206059
- Stanley, B., Brown, G.K., Brenner, L.A., Galfalvy, H.C., Currier, G.W., Knox, K.L., Chaudhury, S.R., Bush, A.L., Green, K.L., 2018. Comparison of the Safety Planning Intervention With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department. JAMA Psychiatry 75, 894. https://doi.org/10.1001/jamapsychiatry.2018.1776
- Witt, K., Spittal, M.J., Carter, G., Pirkis, J., Hetrick, S., Currier, D., Robinson, J., Milner, A., 2017. Effectiveness of online and mobile telephone applications (‘apps’) for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. BMC Psychiatry 17, 297. https://doi.org/10.1186/s12888-017-1458-0