“You feel like you’re not alone ”: Exploring a sociotechnical assembly in suicide prevention

Abstract

Suicidal ideation is highly dynamic and can rapidly escalate to suicide attempts. Traditional clinical assessment tools rely on retrospective, one-off evaluations, limiting their effectiveness in timely intervention and individual prevention. Digital technologies offer promising alternatives by enabling real-time, context-sensitive assessments and interventions. In response to this potential, a multidisciplinary French team developed EMMA—a smartphone application designed to assess and help prevent suicide directly from an individual’s pocket, as part of a clinical trial. Drawing on new materialist and sociomaterial perspectives, this study aims to explore how the use of EMMA reconfigures relationships and practices within the emerging paradigm of digital suicide prevention. Semi-structured interviews were conducted with individuals experiencing severe suicidal ideation, all of whom participated in the clinical trial and used EMMA over a 6-month period. The goal was to capture their subjective experiences and engagement with the digital tool. Participants initially engaged with EMMA as a source of support during a vulnerable post-hospitalization period, perceiving it as an extension of care. Use was most intense in the early weeks, then declined as their condition improved. While EMMA enabled self-reflection and awareness of emotional patterns, it also elicited ambivalent responses—some found it comforting, others intrusive or overwhelming. The app reshaped connections not only to the self but also to relatives and the healthcare system, acting as a relational interface within a broader network of care. Overall, the findings suggest that using EMMA involved forms of digital intimacy within a sociotechnical assemblage, engaging in a complex feedback loop involving the tool, themselves, their relatives, and the healthcare system. This study highlights that innovation in suicide prevention does not reside solely in technological design, but emerges through socio-material practices and the ways digital tools become entangled with lived experience and care relationships.