(PS9-B40) A Systematic Review of the Virtual Hope Box Mobile Application

The Virtual Hope Box (VHB) smartphone application was developed as a mobile version of the conventional hope box (Bush et al., 2015). The application provides easy access to cognitive-behavioral-based therapeutic approaches including relaxation exercises, coping tools, activity planners, and reminders of reasons for living. Several studies have assessed the effectiveness and utility of the application and demonstrated its use in suicide prevention. This review is the first to explore the existing evidence of the VHB. The authors performed a review of the literature using the phrase “Virtual Hope Box.” Searches were conducted in February of 2023 using PsychINFO, EBSCOhost, and PubMed. Additional articles were identified via Google Scholar, and one was identified by an author familiar with the subject matter. Studies were included if they were available in English, peer-reviewed, and were primary research articles that included at least one outcome related to the Virtual Hope Box. A total of 143 citations were identified; 137 were identified from the database searches, 4 were identified via Google Scholar, and one was identified by an author familiar with the subject matter. Twenty citations were removed for being duplicates across and/or within databases, resulting in a total of 122 unique citations. Articles were removed for being irrelevant to the current review (n = 5; i.e. no mention of the VHB or mental health applications), not being available in English (n = 1), only citing VHB studies and not adding any meaningful contribution to the VHB literature (n = 67), not being peer reviewed (n = 2), or for not including an outcome measure related to the VHB (n = 34; i.e. reviews of mobile health apps or recommendations for use of mental health apps). The remaining 14 articles were included in the final review. The articles underwent qualitative review, and three broad themes were identified: (1) efficacy and effectiveness, (2) acceptance, adoption, and feasibility in high-risk populations, and (3) implementation approaches in high-risk populations. Since so few mental health apps have any evidence to support their use, the VHB stands out as an important exception. The VHB has evidence to support its feasibility, acceptability, potential implementation strategies, and its effectiveness in supporting individuals with suicidal thoughts and behaviors. However, future research is needed to explore the effectiveness and utility of the VHB in a wider range of suicide-related outcomes and populations (i.e., civilian populations, individuals with other mental health diagnoses), investigating how individuals interact with and use the application, and exploring ways clinicians can incorporate the VHB into treatment.