Safety Planning Intervention in Swedish Healthcare: A Multisite Study for Suicide Prevention
ConditionSuicide Attempt
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorRegion Skane
About this trial
Suicide is one of the leading causes of premature death and a prioritized public health concern.
Safety Planning Intervention (SPI) is a method with strong international research support for reducing suicidal behaviour by enhancing individuals' strategies for crisis management and improving access to support. SPI is a single-session intervention lasting approximately 45 minutes, which any healthcare provider can deliver after a brief training. Despite promising results, the implementation of SPI in Swedish healthcare remains limited. This project examines how SPI can be integrated into various healthcare settings and evaluates its impact on suicide-related emergency visits, psychiatric hospitalizations, and healthcare utilization. Data and Methods Stepped-Wedge implementation study in specialist psychiatry, where SPI is gradually introduced in psychiatric units. This study design allows for a robust evaluation of effects while ensuring all units eventually receive the intervention. As part of this study, a survey among healthcare professionals will be conducted to assess their experiences with feasibility, usability, and implementation barriers.
Data will be collected from QlikView healthcare utilization data. Poisson regression models with mixed effects will be used to analyze the impact of SPI on emergency visits and psychiatric hospitalizations. A health economic analysis will be conducted to evaluate the cost-effectiveness of SPI. Societal Relevance and Impact
The project contributes to Sweden's national suicide prevention strategy by:
1. Scientifically evaluating the feasibility and effects of SPI in Swedish healthcare. 2. Developing training programs for healthcare professionals in suicide prevention. 3. Informing policy decisions and national guidelines. 4. Analyzing the cost-effectiveness of SPI from a societal perspective. Implementation The research team includes experts in suicide prevention, psychiatry, epidemiology, patient safety, and health economics, creating a strong multidisciplinary foundation. The Stepped-Wedge design ensures an ethically and methodologically sound evaluation of SPI.
Gradual implementation allows for time-based comparisons, minimizes selection bias, and ensures all patients receive the intervention. The project is conducted in close collaboration with healthcare providers and policymakers to ensure that research findings can be integrated into clinical practice and strengthen suicide prevention efforts in Sweden.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
None
Trial design
Design model
Sequential
Treatments tested in this trial
Safety Planning Intervention (SPI)
BehavioralSafety Planning Intervention (SPI), developed by Stanley \& Brown (12), is a brief, structured suicide preventive intervention designed to help individuals identify warning signs, develop coping strategies, and establish emergency contact pathways. SPI is a single-session intervention that typically lasts approximately 45 minutes and is delivered in clinical or emergency care settings. It is designed to help individuals identify warning signs, develop coping strategies, and establish a concrete plan for seeking support during a suicidal crisis. Unlike traditional risk assessments that focus on predicting suicide risk, SPI actively engages individuals in managing crises before they escalate. The intervention consists of six core steps.
Treatment groups
8,000 Participants
are divided into 1 treatment groupGroup A: Safety Planning Intervention for suicide preventionExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Monthly rate of emergency visits for suicide attempts
Monthly number of emergency department visits for suicide attempts identified using ICD-10 codes X60-X84 and events of undetermined intent (Y10-Y34), obtained from aggregated healthcare utilization data from psychiatric clinics in Region Skåne.
Time frame
Monthly measurements throughout the 45-month study periodSecondary outcomes
1
Monthly rate of psychiatric inpatient admissions for suicide attempts
Monthly number of psychiatric inpatient admissions with ICD-10 diagnoses indicating suicide attempts (X60-X84) or events of undetermined intent (Y10-Y34), obtained from aggregated healthcare utilization data.
Time frame
Monthly measurements throughout the 45-month study period2
Emergency department revisits following suicide attempts
Monthly number of emergency department revisits due to suicide attempts or events of undetermined intent within 30 days, 6 months, or 12 months after a previous visit.
Time frame
Monthly measurements throughout the 45-month study period3
Psychiatric inpatient readmissions following suicide attempts
Monthly number of psychiatric inpatient readmissions due to suicide attempts or events of undetermined intent within 30 days, 6 months, or 12 months after a previous admission.
Time frame
Monthly measurements throughout the 45-month study period4
Incremental cost-effectiveness of SPI implementation
Incremental cost-effectiveness ratio comparing the Safety Planning Intervention (SPI) with usual care based on healthcare utilization costs and suicide-related healthcare events.
Time frame
Assessed over the 45-month implementation periodSponsors and contacts
Click on the lead sponsor to view all of their trials.
Region Skane
Lead sponsor
Forte
Collaborator
Source ClinicalTrials.gov