Table 1 Study characteristics for final inclusion in the articles

Anja Cuš ˇ 2021 Austria [20]

A purposive sampling approach at a Department of Child and Adolescent Psychiatry

N = 15/Female adolescents/Aged 12 to 18 years

Qualitative interview study

Smartphone apps

The semi-structured interviews/A reflexive thematic analysis approach by combining both con- structivist and experiential approaches

1) Explored the needs of young people in relation to their everyday experiences of managing NSSI and their preferences for smartphone interventions. 2) Young people's perceptions of how technology itself can improve or hinder participation in these interventions

Mental health condition, person and technology

The study findings would be strengthened by inclusion of male and/or gender diverse participants

Craig Mackie 2017 Canada [37]

Emergency department clinical staff at The Ottawa Hospital were asked to refer adult men to the research team who met the eligibility criteria

N = 6 men/Aged 19 to 41 years

Qualitative study

Smartphone app combined with face-to-face therapy

Semis-structured qualitative interviews/A thematic, grounded theory approach

To develop a treatment manual and to describe experience of receiving and delivering a novel blended therapy combining a customized smartphone application

Trust and connection

1) Small sample size. 2) The study use of a beta version of the app so bugs in the program have more prominence than would be expected in a final version

Olivia Simonsson 2021 Sweden [21]

Patients who had participated in the quantitative part of the pilot trial of online emotion regulation individual therapy for adolescents (ERITA) in Stockholm, Sweden

N = 9/6 females and 3 adolescents as nonbinary/Aged 14–17 years old

Qualitative study

Online emotion regulation individual therapy: a mobile app and online course

Semi-structured interviews/Thematic analysis

This study aims to explore the experiences of a novel online treatment for adolescents with NSSI and their caregivers

1) Theme support can come in different shapes. 2) Self-responsibility can be empowering as well as distressing. 3) Acquiring new skills and treatment effect

1) Sampling from a single pilot study limits the transferability of the results. 2) Some families were interviewed months after ending the treatment possibly introducing recall bias

Ozlem Eylem 2021 Netherlands [17]

Patients recruited from the general population using social media and newspaper advertisements

N = 12/9 women and 3 men/Aged 23 to 56 years

Mixed -methods study

Online self-help intervention and online guidance from the coaches

Telephone interviews which have an open question and a topic guide/Thematic analysis

The objectives of this study are twofold: 1) To investigate the feasibility of the adapted online intervention among Turkish migrants in the UK and in the Netherlands; 2) To investigate the likely effects of the culturally adapted online intervention in reducing suicide-related behaviors when compared with the treatment as usual

1) Theme 1: Therapeutic change Therapeutic alliance. 2) Theme 2: The gap between ‘reading it’ and ‘doing it’ in real life Feeling connect. 3) Theme 3: Recommendations for improvement More diversity

1) Lack of anonymity during the recruitment process. 2) Small sample size might be another important barrier

J. Kasckow

2014

United States [38]

Recruitment took place at the VA Pittsburgh Healthcare System Psychosis Service

N = 10 veterans/Not mentioned/mean of age 57.40 years

Qualitative study

Telehealth dialogues

Open-ended statements/Thematic analysis

1) To test an improved tele-health system for monitoring suicidal patients with schizophrenia. 2) To obtain patients' sense of experience and opinions

1) Certain topics elicited strong emotional responses. 2) There were concerns with confidentiality. 3) Some content was too vague. 4) There were problems with vocabulary and wording

Not mentioned

McManama O’Brien 2019

United States [39]

Patients be recruited from the inpatient psychiatric unit of an urban general hospital in the northeast United States

N = 8 Adolescents/Not mentioned/Aged 13 to 18 years

Qualitative interview study

Mobile health (mHealth) tools

Semi-structured interviews/Thematic analysis

The purpose of this study was to gather feedback to improve a brief alcohol intervention provided to suicidal adolescents during psychiatric hospitalization, and to develop a mHealth tool to extend care after discharge

Feedback on mHealth booster of in-person component, modalities, content and functionality, frequency and general thoughts

Limitations on sample size and representation

Tobias Schiffler 2022 Austria [40]

Using convenience sampling, patients from a transitional psychiatric ward at the hospital of Hietzing in Vienna, Austria

N = 13/12 women and 1 man/ Aged 18 to 23 years

Qualitative study

A mobile dialectical behavior therapy app

Individual semi-structured interviews/Thematic qualitative text analysis

The aim of the present study was to investigate whether using a mobile app with DBT content for 30 days influenced the perception of suicide-related behaviors and NSSI in TAY with BPD and how such an app could benefit this targets group

1) Experiences with DBT skills 2) Phenomenon of self-injury 3) Feelings connected with self-injury 4) Dealing with disorder-specific symptoms 5) Prevention of self-injury 6) Attitude toward skills apps

1) The small amount of time spent using the app had a substantial impact upon the data collected. 2) There was an imbalanced distribution of gender. 3) Limited time resources available

J. Kasckow 2015 United States [41]

Patients recruited from the VA Pittsburgh Healthcare System

N = 9 veterans/Not mentioned/Mean of age 57.0 years

Qualitative study

Telehealth dialogues

Open-ended statements/Thematic analysis

The purpose of this presentation is to describe the process we undertook. We also compared responses in these participants with a history of major depression to those given by a group of consumers with schizophrenia

(1) Certain topics elicited too strong of an emotional response; (2) There were concerns with confidentiality of responses; (3) There were problems with vagueness of questions

Not mentioned

Bethany Cliffe 2022 United Kingdom [24]

Participants were students from one UK University. Adverts around campus and on social media provide links to an online information sheet and form to register interest

N = 25 university Students/20 female, 4 male and 1 nonbinary/Aged 18 to 31 years

Qualitative study

Smartphone app

Semi-structured interviews/An inductive qualitative content analysis

This study sought to assess the acceptability of a smartphone app called Blue Ice for university students who self-injury

1) The content of Blue Ice. 2) The use of Blue Ice with university students. 3) The function of Blue Ice. 4) Comparison with other support. 5) The implementation and uptake of Blue Ice

Because COVID-19 lockdown, participants were unable to use the app which may have limited their understanding of it and influenced their feedback. This study may also be limited by a lack of diversity

Natasha Josifovski 2022 Australian [42]

Patients come from Australian emergency department in The Royal Prince Alfred Hospital, Sydney, and Toowoomba Hospital, Queensland

N = 6/Not mentioned/Aged 16–65

Mixed- methods study

A text message and online brief contact intervention

Semi-structured interviews/Thematic analysis

This study investigated the feasibility and acceptability of the RAFT brief contact intervention

1) Text messages served as a reminder for the participant to focus on their mental health and included useful tips to improve their mental state. 2) The text messages were often a comfort in knowing that someone was there and that someone cares

This was a pilot study with a small, almost all female sample and no control group, with difficulties identifying eligible participants in the clinical setting

Candice Biernesser 2021 United States [23]

Adolescent come from an intensive outpatient program at an academic medical center in Pennsylvania

N = 15/7 female, 5 male, 2 of whom reported other gender identities and 1 not described/Aged 13 to 17 years

Qualitative study

A tool about automated monitoring of digital media use

Focus groups with adolescent/thematic analysis approach

This study examines the current context of digital media monitoring for adolescents engaged in suicide-related behaviors seeking clinical care to inform the need for automated monitoring and the factors that influence the acceptance of automated monitoring of adolescents engaged in suicide-related behaviors’ DMU within clinical care

1) There should be a balance between the need for protection and free expression and privacy. 2) Perceptions on automated digital media monitoring: protection from harm; automated risk detection; Involvement of clinicians; Loss of digital privacy; Potential for false labeling; Tendency to alter behavior; Communication with parents about risk

First, the use of a convenience sample, the small sample size, and the exploratory nature of this study limit our ability to generalize our results to a larger population. 2) There was a lag in data collection

E. Baileyy 2021 Australia [22]

Participants were current clients of a youth mental health clinic in Melbourne, Australia

N = 15/9 female, 5 male, and 1 as transgender/Aged 17 to years

Qualitative study

A closed website incorporating 3 key components: therapeutic content delivered via comics, peer-to-peer social networking, and moderation by peers and clinicians

Semi-structured interviews/Inductive thematic analysis and consensual qualitative research method

The aim of this study is to report qualitative data collected from study participants regarding their experience of the web-based social network and the consequent safety features

1) A safe and supportive environment. 2) The importance of mutual experiences. 3) Difficulty engaging and connecting. 4) The pros and cons of banning discussions about suicide-related behaviors

1) Small sample size. 2) Qualitative methods bring a degree of researcher subjectivity. 3) They did not analyze relationships between the themes. 4) Participants were not asked to review the transcripts or the study findings

Rebecca Grist 2018 United Kingdom [43]

Patients are recruited by all clinical teams at Oxford Health NHS Trust

N = 33/ Participants were predominantly girls/ Aged 12 to 17 years

Qualitative study

A mobile phone app

Semi-structured interviews/Thematic analysis

The aim of this study was to explore the acceptability, use, and safety of, a mobile phone app for young people who self-injury and who are attending child and adolescent mental health services

1) Appraisal of the app. 2) Usability of the app. 3) Safety. 4) Benefits of the app. 5) Agency and control. 6) The app less helpful

1) The sample is mainly young people who are actively participated and may be more likely to present a positive attitude. 2) Missing explanation for interrupted visits to personnel. 3) Some of the questions in the post use interview maybe subject to recall bias. 4) The study design may be possible synergic effects

Ana Radovic 2021 United States [44]

Participants were recruited through primary care clinics and flyers posted in clinical settings at Pennsylvania

N = 11 adolescents/5 female and 6 male/ Aged 15 to 17 years

Qualitative study

A decision support tool: screening wizard

Interviews and focus groups/Codebooks were inductively developed based on the content and Completed coding was used to produce thematic analyses

This study aims to describe multi-stakeholder perspectives of adolescents, parents, and providers to understand the potential barriers to the implementation of a technology-based decision support tool

Theme 1: Adolescents believe that depression screening should occur in pediatric primary care; Theme 2: There is concern that accurate self-disclosure does not always occur during depression screening; Theme 3: SW is viewed as a tool that could facilitate depression screening and that might encourage more honesty in screening responses. Theme 4: Adolescents do not want SW to replace mental health discussions with providers. Theme 5: Providers want to maintain autonomy in treatment decisions

1) Limitation is that the study did not collect information about gender or sexual minority status. 2) Small sample size and diversity

Joseph Tighe 2020 Australia [25]

Participants were purposefully selected due to their close proximity to the research team in Broome, Western Australia

N = 13/10 identified as female and 3male/Aged 19 to 29 years

Mixed methods study

A suicide prevention app

Semi-structured interviews/Thematic analysis

This paper explores the pilot use and acceptability data for the iBobbly suicide prevention app

1) Acceptability — being private and acceptable 2) Cultural appropriateness and future help-seeking 3) Helping with feelings and creating distractions

With a small sample and usage data included from just the intervention group, the analyses lacked power and precision

Mareka Frost 2016 Australia [45]

Participants were recruited to complete an Internet survey via a variety of online and offline sources in Australia

N = 457/Not mentioned/Mean age of 18 years

Mixed methods study

Provide online help for information

Open question/Thematic analysis and an inductive approach

To investigate the perspectives of young people who self-injure regarding online services, with the aim of informing online service delivery

1) Information 2) Guidance 3) Reduced isolation 4) Online culture 5) Facilitation of help-seeking 6) Access 7) Privacy

Recruiting was not randomized which may have led to a sample that is not representative. There was a high percentage of female participants