The Safety Plan Intervention (SPI) has demonstrated to reduce suicide reattempts and to increase the ambulatory follow-up in american war veterans. This study evaluates the implementability and effectiveness in a significantly different population in a real world setting.
We will perform a Effectiveness-implementation Hybrid Design (Curran et al. 2012) to study firstly the feasibility of implementing the SPI in our clinical setting and secondly its effectiveness. The experimental arm will consist in a group of patients who visit the ED for a suicide-related concern in which the SPI is performed. This will be in the Emergency Department , unless for clinical reasons, the ED psychiatrist decide to postpone it to the first psychiatric appointment (which will be before one week of the ED visit as part of the treatment as usual). Right after the SPI is performed, both the patient and the clinician will complete questionnaire with satisfaction and acceptability measures. Subjects will be followed for 6 months. At this time medical records will be consulted to obtain suicide reattempts rates and follow-up adherence. At all times, the anonymity of the participants will be preserved and will require heading of informed consent, as well as other ethical aspects indicated by the Ethics Committee.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
58
The SPI has 6 key steps: (1) identify personalized warning signs for an impending suicide crisis; (2) determine internal coping strategies that distract from suicidal thoughts and urges; (3) identify family and friends who are able to distract from suicidal thoughts and urges and social places that provide the opportunity for interaction; (4) identify individuals who can help provide support during a suicidal crisis; (5) list mental health professionals and urgent care services to contact during a suicidal crisis; and (6) lethal means counseling for making the environment safer (Stanley \& Brown, 2012)
La Paz University Hospital
Madrid, Madrid, Spain
Feasibility of Safety Plan Implementation
Percentage of SPIs performed in ED from total number of suicide related ED visits.
Time frame: Baseline
Time required for the performance of the SPI
Minutes required for the performance of the SPI
Time frame: Baseline
Satisfaction of the patient with the Safety Plan
Likert-type scales with 5 levels of response will be measured through questions: "To what extent do the Safety Plan can help you to avoid a new situation of suicidal risk?"
Time frame: t0 (Safety Plan Performance )
Satisfaction of the Professional with the Safety Plan
Likert-type with 5 levels of response will be measured through questions: "To what extent do the Safety Plan can help you to avoid a new situation of suicidal risk?" Likert-type with 5 levels of response will be measured through questions: "To what extent the Safety Plan did you useful for the patient?". Open questions can be explained where contributions and obstacles encountered in its implementation will also be formulated.
Time frame: Baseline
Presence of suicide reattempt
Percentage of patients that commit suicide reattempt.
Time frame: Month 6
Time to suicide reattempt
Days from suicide attempt attended in the ED to the next suicide reattempt.
Time frame: Month 6
Adherence to psychiatric ambulatory follow-up
Percentage of patients that attend psychiatric ambulatory follow-up after ED discharge
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Time frame: Month 6