Safety Planning Intervention in Swedish Healthcare: A Multisite Study for Suicide Prevention

Summary

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.

Conditions

• Suicide Attempt

Interventions

BEHAVIORAL

Safety Planning Intervention (SPI)

Safety 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.

Sponsors & Collaborators

• Forte

  collaborator INDUSTRY

• Region Skane

  lead OTHER

Study Design

Allocation

NA

Purpose

PREVENTION

Masking

NONE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-10-01

Primary Completion

2028-10-01

Completion

2029-07-01

Countries

• Sweden

Study Locations