Remarks y Stand-alone digital interventions hold promise for increased scalability and sustainability for the selfmanagement of suicidal thoughts (and of self-harm once evidence of effectiveness was available), which could be especially valuable for LMICs. y The applicability and health outcomes may be affected by individuals’ preferences for human or digital contact. y Non-specialized health workers can encourage people to use evidence-based digital interventions. y In situations where no treatment is available at all, the benefits of technology-based suicide preventive interventions may outweigh the risks. One risk may be the loss of resources that could instead be used to implement other, more effective interventions. y There are concerns regarding potentially sensitive content and data privacy while using digital health interventions. Measures should be taken to ensure that digital interventions are provided under conditions of safety/security, confidentiality, informed consent and privacy of data. This can include the establishment of standard operating procedures that describe protocols for ensuring consent, data protection and storage, and verifying provider licensing and credentials. Further guidance can be found in the 2019 WHO guideline: recommendations on digital interventions for health system strengthening (31).

Implementation considerations y Costs pertain largely to the technical development phase of setting up and sustaining digital interventions online. Once available on a digital platform, cost of delivery is likely to be low (or lower than interventions delivered by health workers) and there is a high potential to reach a large portion of the population. y There may be different preferences by users for human versus digital contact, and geographical variability in access to digital platforms. In delivering digital interventions, there is a need to consider the potential digital divide across population groups with some having unequal access to and skills to use digital technologies. Access might be particularly difficult for certain population groups with poor access to network services, mobile devices or electricity, and/or with low literacy and digital literacy skills. Measures should be taken to address inequities in access to mobile devices so that further inequity is not perpetuated in accessing health information and services, including mechanisms to ensure individuals who do not have access to mobile devices can still receive appropriate services. y Country adaptation and translation of digital interventions tools with subsequent evaluation is essential.