Safety Planning on Crisis Lines: Feasibility, Acceptability, and Perceived Helpfulness of a Brief Intervention to Mitigate Future Suicide Risk

Abstract

Background The role of crisis hotlines traditionally was limited to de‐escalation and service linkage. However, hotlines are increasingly recruited to provide outreach and follow‐up to suicidal individuals. Hotlines have the opportunity to not just defuse current crises but also provide brief interventions to mitigate future risk. The Safety Planning Intervention (SPI) is a brief intervention designed to help manage suicidal crises, but its feasibility and effectiveness on hotlines are not established. Aims This study examined feasibility and perceived effectiveness of SPI, as reported by 271 crisis counselors at five centers in the National Suicide Prevention Lifeline network. Method Counselors were trained to use SPI. Self‐report surveys were completed immediately after training (time 1) and at the end of the study, approximately 9 months later (time 2). Results Counselors reported that SPI was feasible and helpful, and was used on both incoming and follow‐up calls. Utilization and perceived effectiveness at time 2 were predicted by self‐efficacy, feasibility, and helpfulness at time 1. Limitations Results are preliminary and limited to counselors’ perceptions. Future RCTs should establish efficacy of SPI for crisis callers. Conclusion The Safety Planning Intervention is a promising approach to reduce crisis callers’ future suicide risk that hotline counselors report is both feasible and helpful.

Emerging Adults’ Attitudes and Beliefs About Suicide and Technology/Social Media

“…In addition to the ASQ program, clinical pathways for suicide screening have been implemented in some settings, 48 , 50 , 51 and evidence-based standardized screening and care recommendations have been developed for use in various settings. 52 , 53…”

Considerations in the assessment of help‐seeking and mental health service use in suicide prevention research

“…Non‐traditional sources of care (e.g., crisis lines, peer support groups) are also important to consider when evaluating help‐seeking and mental health service utilization among individuals at elevated suicide risk. Suicide risk reduction often occurs in the context of crisis line calls (Labouliere et al, 20202019). Crisis line calls, too, have been shown to yield referrals to more traditional types of care (Britton et al, 2013), suggesting that they serve not only as a standalone mental health service but also as a conduit to other forms of services when indicated.…”

Evaluación y manejo inicial de las ideas e intentos de suicidio en atención primaria

“…Plan de seguridad: intervención que incluye una lista priorizada de estrategias de afrontamiento y fuentes de apoyo y consulta a las cuales acudir en caso de riesgo suicida. Individualizado según cada paciente y construido en conjunto entre médico, paciente y familiar (o tutor o responsable de la red de apoyo) 3,[26][27][28][29] . En conjunto proceder a: 1) enseñar a reconocer las señales de advertencia (emociones, estados de ánimo, pensamientos, imágenes, comportamientos) cuando comienza a pensar en el suicidio o siente impulso o se siente extremadamente angustiado; 2) revisar las estrategias de afrontamiento interno a las que el paciente recurrirá para no actuar según sus emociones, pensamientos o impulsos; 3) acordar y registrar entornos sociales seguros y enumerar varias personas (por si primera opción no esté disponible) que pueden distraerlo de la crisis por si ocurriera que con el propio afrontamiento no puede resolverla o reducir el riesgo de intentar suicidarse; 4) revisar a que familiares o amigos podría recurrir para que le ayude a resolver la crisis si con contactos sociales no fue posible, enumerar a quien solicitará ayuda en lista priorizada (varios por si primera opción no esté disponible) e identificar posibles obstáculos y la forma como superarlos; 5) educar y registrar contacto de profesionales de salud y unidades de urgencia (nombres, ubicación, lugar, vía de acceso, teléfono) donde recurrir si la crisis no se resuelve o reduce el riesgo de intento de suicidio y 6) indagar sobre potenciales medios letales y acordar colaborativamente el modo de restringir el acceso.…”