September is Suicide Prevention Awareness Month, which aims to encourage more open conversations about suicide and challenge the stigma that still surrounds it. According to the World Health Organization, more than 720,000 people die by suicide worldwide each year, and suicide is the third leading cause of death among people aged 15–29 (World Health Organization, 2025).
For those working in digital mental health, it can also be a moment to consider what prevention looks like outside direct clinical contact. Digital services have created many more opportunities to remain connected with people between appointments and after they have interacted with a service. This can take the form of text messages, app-based follow-ups, remote monitoring or more sophisticated systems designed to identify changes in risk. Within all of this technology, however, there is evidence behind something relatively straightforward: maintaining contact.
What the evidence shows
A recent systematic review and meta-analysis by Homan et al. (2026) examined 36 randomised controlled trials involving 9,552 adults who had previously attempted suicide. Brief interventions and contacts were associated with significantly lower odds of another suicide attempt compared with control conditions (OR = 0.72). This means that participants who received these interventions had approximately 28% lower odds of making another suicide attempt than participants in the control groups. A smaller reduction in suicidal ideation was also found, although the certainty of evidence for this outcome was lower.
The interventions included in the review were varied, ranging from telephone calls and letters to psychoeducation and structured psychosocial interventions. The findings showed that continued contact can form a useful part of post-attempt care, particularly when it is embedded within a wider system of support (Homan et al., 2026).
What engagement data can and cannot tell us
This has particular relevance for digital mental health because digital services generate a great deal of information about engagement. A platform can record when someone logs in, completes an assessment, responds to a prompt or stops using the service altogether. What these data cannot necessarily explain is what has changed in that person's life.
Disengagement is particularly difficult to interpret. Someone may stop using a service because they are doing better, because it was not useful to them, because they have moved to another form of support or because engaging has become more difficult during a period of deteriorating mental health.
Detecting a change is not the same as responding to it
Researchers are exploring whether digital technologies can provide a more detailed picture of these changes. A 2026 scoping review of digital approaches to suicide prevention identified work involving web-based screening, ecological momentary assessment, mobile sensing and machine-learning models. Many have not yet been tested widely outside research settings, and it is not always clear how a detected change should inform clinical care; privacy, engagement and data governance also remain important considerations. For now, these tools are best understood as additions to clinical support.
The distinction between detecting a change and knowing how to respond to it is also relevant. A mental health app may be able to identify that somebody has stopped engaging, but responding appropriately requires more than an automated notification. The purpose of the contact matters, along with consent, timing, wording and what support is available if the person needs more help.
It is also important not to assume that delivering an intervention digitally automatically makes it effective. Burr et al. (2025) reviewed randomised controlled trials of digital suicide-prevention interventions and found a small overall effect on suicidal ideation. Effects were significant among adults but not adolescents, and outcomes differed according to the type of control group used. The authors therefore point to a more specific research agenda: identifying which interventions work, for whom, in comparison with what alternative, and under which conditions.
This evidence is relevant during Suicide Prevention Awareness Month because awareness is only one part of prevention. Effective prevention may depend not only on initial contact, but also on how that contact is maintained over time.
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