Is a smartphone application (BlueIce) acceptable and safe for university students who self-harm: an open study

Bethany Cliffe, Emma Moore, Kathryn Whittle, Paul Stallard

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Background Many university students self-harm but few receive support. Smartphone apps have been identified as acceptable sources of support for students who self-harm, but the use of supportive self-harm apps is yet to be explored in this population. Objective This study sought to explore the acceptability and safety of a specific app (BlueIce) for university students who self-harm. Methods This was an exploratory, mixed methods study with 15 university students attending university well-being services with self-harming thoughts and/or behaviours. BlueIce was offered alongside the face-to- face support provided by the well-being service. Self-harming thoughts and behaviours, coping self-efficacy, and symptoms of anxiety and depression were measured before and after using BlueIce for 6 weeks. Follow-up interviews were also undertaken to explore how students perceived BlueIce in more depth. Results Following app use, there were statistically significant reductions in symptoms of anxiety (baseline M 12.47, SD 4.42; follow-up M 10, SD 4.16) t(14)=2.26, p=0.040, d=0.58 and depression (baseline M 16.5, SD 5.17, follow-up M 12.27, SD 3.66) t(13)=5.50, p<0.001, d=1.47. Qualitative findings showed participants found BlueIce to be acceptable, safe and helpful, and reported that they were more able to cope with difficult feelings and better understand their self-harm triggers following use of the app. Conclusion BlueIce was an acceptable, safe and helpful source of support for university students struggling with self-harm thoughts and/or behaviours. This builds on previous findings with adolescents and suggests that BlueIce could be a particularly acceptable and helpful resource for university students.

Original languageEnglish
Article numbere069862
JournalBMJ Open
Issue number4
Early online date24 Apr 2024
Publication statusPublished - 30 Apr 2024

Data Availability Statement

No data are available. Consent was not received from participants to make data publicly available.


The authors would like to thank the participants for their contribution to this research.

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