The Acceptability and Feasibility of an ED-based, Peer-delivered, Suicide Safety Planning Intervention
Condition: Suicidal Ideation; Suicide, Attempted; Mental Health Issue
MeSH terms: Suicide; Suicidal Ideation; Suicide, Attempted
Study type: Interventional

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?
    

Intervention name(s): Peer Supporter Safety Planning
Intervention type(s): Other
Intervention description(s): The rationale for testing a peer-delivered intervention in the ED relies on the following evidence: a) a peer is an individual with lived experience who is now supporting other mental health patients in crisis; b) the experience of a mental health patient in the ED often shapes the perception of the health system, and may influence willingness to seek future care; c) peers may provide more empathetic care than providers without lived experience, which may positively impact patients; d) peer-based programs for patients with serious mental illness that do not involve safety planning are at least as good as non-peer based programs at preventing hospitalizations and promoting engagement in care, with the most promising interventions involving self-management or peer-navigator roles; and e) existing evidence from high-quality studies is scarce, but in moderate-low quality studies has indicated that peers are no less effective than mental health workers
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Suicide; Suicide Prevention; Safety Planning