(PS11-22) Comparing the Quality of In-person and Online Suicide Safety Plans

Background: With one suicide death occurring every 11 minutes (CDC, 2022), focus on implementation of brief suicide interventions has increased. Suicide safety planning is a collaborative, evidence-based suicide prevention tool that may be used during a suicidal crisis (Stanley & Brown, 2013). The safety plan consists of six steps: Warning signs, internal coping strategies, social distractions, people you can ask for help, professionals you can contact, and methods of making your environment safer. Recent systematic review indicated that safety planning interventions delivered in-person or through internet-based applications were feasible and reduce suicidal ideation, depression, and hopelessness (Ferguson et al, 2021). Research also indicates an association between safety plan quality and subsequent psychiatric hospitalization (Gamarra et al., 2015). However, studies have not yet evaluated differences in the quality of safety plans conducted in person and online.

Aims: The primary aims of this study is to examine the quality of safety plan completed through three different modalities: (1) traditional, in-person with a trained graduate-level research assistant, (2) independently through mysafetyplan.org (Vibrant Emotional Health, 2021), and (3) independently through Qualtrics using the Safety Plan Assistant, which provides instructional videos to guide participants through the process (Hill et al., 2020). We hypothesize that traditional safety plans and guided online safety plans will be of greater quality than unguided online safety plans. A secondary aim will be to assess the relationship between safety plan quality and perceived helpfulness; here we hypothesize that higher quality safety plans, regardless of delivery modality, will be perceived as higher quality at follow-up.

Methods: A total of 150 participants (college students, at least 18 years of age, with recent suicidal ideation) will be recruited and randomly assigned to one of three conditions. Participants will attend an in-person appointment where they will complete a series of self-report measures and are randomized to one of the three safety plan modalities. Self-report measures will then be completed at 2-week follow-up. Safety plan quality will be assessed in accordance with the quality assessment developed by Gamarra and colleagues (2015). Recruitment will continue through March 2024, with analysis occurring in Summer 2024.

Data Analyses: The primary outcome will be safety plan quality, as determined by the degree to which individuals created a completed and personalized their safety plan (Gamarra, et al., 2015), as rated by trained research assistants. To compare the effects of treatment on safety plan quality and completeness, a series of analyses of variance (ANOVAs) will be conducted. Additionally, for participants that indicate use of their safety plan during their 2-week follow-up, descriptive statistics and frequencies of each safety plan steps will be compared to evaluate perceived helpfulness, as rated through the Safety Plan Utilization questionnaire.