Key Decision Points for Personalization and Customization in Self-Guided Digital Suicide Prevention: Qualitative Interview Study

Background

Young adults in the United States experience high rates of suicidal thoughts and behaviors (STB) but low engagement with traditional care, highlighting the need for accessible and scalable digital interventions. Self-guided digital safety planning interventions (SPIs) can expand access to support but introduce important decisions about what content to deliver, when systems should intervene, and how users retain control over system actions. Personalization, defined as system-initiated adaptation, and customization, defined as user-initiated control, may offer complementary approaches to these decisions. However, how they should be coordinated to preserve autonomy and reduce burden during periods of distress remains unclear.