SAFETEL randomised controlled feasibility trial of a safety planning intervention with follow-up telephone contact to reduce suicidal behaviour: study protocol

Abstract

IntroductionThere are no evidence-based interventions that can be administered in hospital settings following a general hospital admission after a suicide attempt.AimTo determine whether a safety planning intervention (SPI) with follow-up telephone support (SAFETEL) is feasible and acceptable to patients admitted to UK hospitals following a suicide attempt.Methods and analysisThree-phase development and feasibility study with embedded process evaluation. Phase I comprises tailoring an SPI with telephone follow-up originally designed for veterans in the USA, for use in the UK. Phase II involves piloting the intervention with patients (n=30) who have been hospitalised following a suicide attempt. Phase III is a feasibility randomised controlled trial of 120 patients who have been hospitalised following a suicide attempt with a 6-month follow-up. Phase III participants will be recruited from across four National Health Service hospitals in Scotland and randomised to receive either the SPI with telephone follow-up and treatment as usual (n=80) or treatment as usual only (n=40). The primary outcomes are feasibility outcomes and include the acceptability of the intervention to participants and intervention staff, the feasibility of delivery in this setting, recruitment, retention and intervention adherence as well as the feasibility of collecting the self-harm re-admission to hospital outcome data. Statistical analyses will include description of recruitment rates, intervention adherence/use, response rates and estimates of the primary outcome event rates, and intervention effect size (Phase III). Thematic analyses will be conducted on interview and focus group data.Ethics and disseminationThe East of Scotland Research Ethics Service (EoSRES) approved this study in March 2017 (GN17MH101 Ref: 17/ES/0036). The study results will be disseminated via peer-reviewed publication and conference presentations. A participant summary paper will also be disseminated to patients, service providers and policy makers alongside the main publication.Trial registration numberISRCTN62181241.

Exploring the experiences of mental health professionals engaged in the adoption of mobile health technology in Irish mental health services

“…In a cohort comparison study, patients who received SPI with follow-up telephone contact were half as likely to display suicidal behaviour and more than twice as likely to engage with mental health services at 6 month follow-up compared with the control group who received Treatment As Usual [32]. A UK-based study comprising a randomised control trial of a face-to-face safety planning intervention with follow-up telephone contact is currently underway [33]. Recent advancements in mobile technology and increases in its adoption may further improve access to safety planning.…”

Understanding and managing suicide risk

“…During the followup contact, clinicians should be sensitive to the patient's successes, but also to their difficulties related to the crisis response and safety plan. A feasibility study of delivering a similar safety planning and telephone support intervention has recently been conducted in the UK (64).…”

Consumer and Carer Perspectives of a Zero Suicide Prevention Program: A Qualitative Study

“…Some consumers felt that their safety planning was not tailored to meet their individual psychosocial needs, and subsequently questioned the utility of the plan. Currently, there is limited systematic evaluation of suicide safety planning as an intervention [39][40][41][42]. Nevertheless, expert guidelines stress the importance of a tailored and collaborative discharge care plan that highlights relevant strategies for the consumer and provides them with autonomy over ongoing treatment [25].…”