Gamified mHealth program to reduce post-discharge suicide risk

The Tailored Evidence-based Enhancements in Mental Health-Gamified and Individualized Follow-Up Treatment for Suicide (TEEM-GIFTS) : Implementing a Gamified mHealth Intervention to Reduce Post-Discharge Suicide Risk in Patients With Mental Disorders Using Multiphase Optimization Strategy (MOST)

This project tests whether a gamified mobile app (TEEM) can help recently discharged adults with mental disorders in Shenzhen reduce suicidal thoughts and behaviors.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 640 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Shenzhen Kangning Hospital (Academic / other)
• Locations: 1 site (Shenzhen, Guangdong)
• Trial ID: NCT06358339 on ClinicalTrials.gov

What this trial studies

TEEM-GIFTS uses community-based participatory design to build a gamified mHealth app and then refines its components using the multiphase optimization strategy (MOST). The study has three phases: selection (co-designing gamification elements with stakeholders), optimization (a factorial randomized trial to test combinations of elements grouped as Routine Tracker, Mind Care, Social Connectivity, and Achievement & Rewards), and confirmation (a standard RCT evaluating the optimized package and implementation outcomes). Mixed methods will capture both patient outcomes and implementation measures from patients, lay supporters, and community providers. The trial is based at Shenzhen Kangning Hospital and enrolls discharged adult psychiatric inpatients who can use smartphone/WeChat apps.

Who should consider this trial

Good fit: Adults (18+) diagnosed with a mental disorder who were hospitalized for three or more days, live in Shenzhen with no plan to leave for 12 months after discharge, and can use smartphone/WeChat apps are ideal candidates.

Not a fit: Patients who cannot use smartphones/WeChat, plan to leave Shenzhen within 12 months, are unable to give informed consent due to cognitive problems, or have needs beyond app-based follow-up may not benefit from this intervention.

Why it matters

Potential benefit: If successful, the app could lower post-discharge suicide risk by increasing engagement with follow-up care and sustaining emotional and social support through gamified features.

How similar studies have performed: Prior mHealth and gamification studies have shown improved engagement and feasibility, but few randomized trials have definitively reduced post-discharge suicide risk and this specific multicomponent gamified approach in China remains largely untested.

Eligibility criteria

Inclusion Criteria:

For patients

* Being 18 years and above;
* Being diagnosed with mental disorders;
* Having received inpatient care for three days or more;
* Living in Shenzhen and having no plan to leave Shenzhen in the following 12 months after discharge;
* Being able to use apps or WeChat (WeChat mini program) on smart phones.

For lay health care supporters (LHSs)

* Being 18 years and above;
* Being without any diagnosis of mental disorder;
* Being the lay health care supporter in the family;
* Living in Shenzhen and having no plan to leave Shenzhen in the following 12 months after discharge;
* Being able to use apps or WeChat (WeChat mini program) on smart phones.

For the clinic and community mental health service providers

* Being 18 years and above;
* Having practiced in mental health service at least for 12 months.

Exclusion criteria For patients

* Refusing to provide written consent or be unable to provide written consent due to any cognitive problems.
* Being discharged by the patient's or LHSs' demand against medical advice.
* With no ID, no stable residence nor any source of income.

For For lay health care supporters (LHSs)

* Refusing to provide written consent.

For the clinic and community mental health service providers

* Refusing to provide written consent.

Where this trial is running

Shenzhen, Guangdong

• Shenzhen Kangning Hospital — Shenzhen, Guangdong, China (Recruiting)

Study contacts

• Principal investigator: Fengsu Hou, Ph.D. — Shenzhen Kangning Hospital
• Study coordinator: Fengsu Hou, Ph.D.

Conditions Suicide; Psychiatric patients; Post-discharge suicide; Gamification; Multiphase optimization strategy; Implementation science