Psychological Impact of COVID-19 Recovery: Suicide Risk Stratification Using the SAFL Digital Tool

Introduction: The psychological aftermath of COVID-19 has emerged as a significant public health concern, with increasing reports of mood disturbances, distress, and suicidality in recovered individuals. Digital tools may aid in timely screening and intervention which is crucial in these population. The study aims to assess suicide risk and effectiveness of the SAFL (Self-Assessment for Life) digital application among these individuals attending a tertiary care hospital, Mysore.
Methodology: This cross-sectional study included 400 adult post-COVID patients who were not critically ill. Sociodemographic and clinical details were recorded. Suicide risk was assessed using the Columbia Suicide Severity Rating Scale (C-SSR) and the SAFL app.  Assessments included mood, sleep, and distress using the Numerical Rating Scale (NRS). Pearson correlation was used to validate the SAFL app against C-SSR.
Results: The majority of patients were aged 30–44 years (36%), female (51.5%), and urban residents (68%). Most were educated and above the poverty line. Based on C-SSR, 77.5% were low risk, 12% moderate, and 10.5% high risk for suicide. The SAFL app classified 59.8% as low, 28.8% as moderate, and 11.2% as high risk. A significant positive correlation (r = 0.78, p < 0.05) was found between both tools. The SAFL app showed excellent performance for high-risk identification (sensitivity 82.2%, specificity 98.6%, accuracy 96.7%) but lower sensitivity (37.7%) in moderate-risk detection.
Conclusion: The SAFL app is a valid and effective digital screening tool for high-risk identification. However, clinical oversight is essential, especially for moderate-risk patients, to ensure comprehensive mental health care.