The Acceptability and Feasibility of an ED-based, Peer-delivered, Suicide Safety Planning Intervention

Not Applicable

Completed

Brief Summary: Safety planning is a brief, ED-feasible intervention which has been demonstrated to save lives, and has been universally recommended by every recent expert consensus panel on suicide prevention strategies. In one popular version of the safety plan developed by Stanley et al, the patient is encouraged to write out the following items: identifying personal signs of a crisis; helpful internal coping strategies; social contacts or settings which may distract from a crisis; using family members or friends for help when in crisis; mental health professionals who can be contacted when in crisis; and restricting access to lethal means. In most emergency departments, safety-planning is done by clinical personnel such as psychologists or social workers, but these providers are often too busy to perform safety-planning well or have multiple other patient care responsibilities.

This study aims to find out if ED patients prefer to complete a safety plan with a peer supporter or clinical personnel. People who are visiting the emergency department for thoughts of self-harm will be asked to participate.

Detailed Description: This project aims to answer the following three research questions: (1) In general, do ED patients with suicidal ideation/attempt prefer to interact with/receive support from peers with life experiences of suicide or clinical professionals who might have such life experiences or not? (2) Will patients with suicidal ideation/attempt accept a peer-delivered safety planning intervention as opposed to one delivered by clinical personnel? (3) Are peer-delivered safety plans of equal quality as those delivered by clinical personnel?

Recruitment & Eligibility

Inclusion Criteria

Patients presenting for suicidal ideation (SI) or after a suicide attempt to the University of Arkansas for Medical Sciences (UAMS) Emergency Department (ED)
Willingness to engage in safety planning with trained non-clinical staff
English-speaking and English-writing (as translators will not be available for this study)

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Peer Supporter Safety Planning	Peer Supporter Safety Planning	Patients will complete a traditional written suicide safety plan with peer supporters.

Primary Outcome Measures

Name	Time	Method
Quality of Safety Plans	Up to 12 hours	Evaluate the quality of the completed safety plans. This will be done by retrospective review after the patient has left the ED. Safety plans will be graded individually, then resolved by consensus, for quality (0=blank, 1=boilerplate, 2=some evidence of personalization, 3=highly personalized; range=0-24) by the investigators using materials developed by Brown and Stanley for this purpose. Using a "safety checklist," responses for each of the 6 safety plan steps will be classified according to the personalization of the information in each step.
Number of Suicidal Ideology (SI) Participants Who Agree to Receive a Safety Plan	approach in the ED (typically <1 hour)	Evaluate the number of suicidal ideology (SI) patients approached in the ED who agree to receive a safety plan.
Proportion of Eligible Patients	Up to 12 hours	Evaluate the proportion of patients approached who meet all inclusion/exclusion criteria.
Satisfaction With Safety Planning	Up to 12 hours	Evaluate patient satisfaction with safety planning. This will be assessed by having the patient rate their experience with the safety planning process on a 7-point Likert scale (1 - strongly disagree; 2 - disagree; 3 - moderately disagree; 4 - neutral; 5 - moderately agree; 6 - agree; 7 - strongly agree). A Likert scale measures how much someone disagrees or agrees with a particular statement.