Clinical trial NCT04068142: The Acceptability and Feasibility of an ED-based, Peer-delivered, Suicide Safety Planning Intervention
Official title: The Acceptability and Feasibility of an ED-based, Peer-delivered, Suicide Safety Planning Intervention
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Suicidal Ideation
Suicide, Attempted
Mental Health Issue
Keywords: Suicide
Suicide Prevention
Safety Planning
Lead sponsor: University of Arkansas
Sponsor class: OTHER
First posted: 2019-08-28
Enrollment: 37
Sex: ALL
Minimum age (years): 18
Maximum age (years): 89
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

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?

Eligibility criteria: 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:

* \<18 or \>89 years of age
* Patients appearing critically-ill
* Incarcerated or in police custody
* Currently intoxicated with alcohol or other substance
* ED staff objection to patient enrollment in study
* Unwilling or unable to complete the safety plan with a peer supporter
* Unwilling or unable to show the safety plan to clinical staff

Primary outcomes:
measure: Number of Suicidal Ideology (SI) Participants Who Agree to Receive a Safety Plan
timeFrame: approach in the ED (typically <1 hour)
measure: Proportion of Eligible Patients
timeFrame: Up to 12 hours
measure: Quality of Safety Plans
timeFrame: Up to 12 hours
measure: Satisfaction With Safety Planning
timeFrame: Up to 12 hours
Secondary outcomes:
Other outcomes:
Locations:
city: Little Rock
country: United States
facility: University of Arkansas for Medical Sciences
state: Arkansas
Study officials:
affiliation: University of Arkansas
name: Michael P Wilson, M.D., Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Wilson MP, Waliski A, Thompson RG Jr. Feasibility of Peer-Delivered Suicide Safety Planning in the Emergency Department: Results From a Pilot Trial. Psychiatr Serv. 2022 Oct 1;73(10):1087-1093. doi: 10.1176/appi.ps.202100561. Epub 2022 May 3.