A suicide prevention app developed by experts in the field — including one affiliated with the Yale School of Medicine — is expanding to some college campuses.
The app, known as OTX-202 or Aviva, is a supplement to therapy. It helps users recognize personal warning signs, identify sources of social support and practice strategies like relaxation, mindfulness and distraction using modules drawn from cognitive behavioral therapy.
A recent study showed promising results, according to Craig J. Bryan, professor of psychiatry at the University of Vermont and director of the Suicide Care Clinic at University of Vermont Medical Center.
“We did some work with college-age youths who were receiving mental health treatment and found that the app was well-received and used frequently,” said Bryan, one of the authors of a study on the app published recently in the peer-reviewed Journal of Medical Internet Research.
The study showed a large reduction in suicidal ideation among the participants, a group of 59 people ages 18-25 who had recent attempts or thoughts of self-harm. Participants also received mental health care outside an inpatient hospital setting.
The researchers found that reductions in suicidal ideation were similar to reductions seen in some of the most effective therapies for suicide risk.
“An unexpected finding from that research was that therapy sessions were more efficient when youths were using the app,” Bryan said. “At scale, this could greatly improve access to specialty care for suicide risk.”
Suicide is a leading cause of death among youth and adolescents in the country, according to the Centers for Disease Control and Prevention.
A recent study found suicidal ideation among college students has continued to rise in the last 15 years.
And yet there's a shortage of clinicians trained in suicide prevention. That’s where the app — when scaled up — could fill in the access gaps, said Dr. Seth Feuerstein, assistant clinical professor of psychiatry at the Yale School of Medicine, and one of the developers of the app.
“If there's 100 subspecialists in the country, if each of them can see five times as many people, it's like having 500 specialists,” he said.
A 2025 study published in JAMA Network Open found that the app reduced the recurrence of post-discharge suicide attempts by 58.3% among patients who had previously attempted suicide compared to a control group.
The outcome has caught the attention of college administrators.
“We've got a few academic medical centers where we're expecting to roll it out in the coming months in places where there are suicide experts who want to oversee the rollout more broadly at their centers,” Feuerstein said. “We've had some requests from health insurance plans, because there are no prescription drugs for the typical suicide at-risk individual that have been shown to reduce suicide risk.”
Feuerstein said a study is ongoing in the U.S. Department of Defense under the watch of M. David Rudd, a suicide prevention expert at the University of Memphis.
“For DoD participants, Aviva doubled overall engagement rates compared to other available digital therapeutics, coupled with significant impact in comparison to usual face-to-face treatment" alone, he said.
Early data also points to significant reductions in suicidal ideation and related measures of emotional upset and distress, Feuerstein said.
If you or someone you know needs help, visit 988lifeline.org or call or text 988 for the Suicide & Crisis Lifeline.
