Stanley B, et al. - Researchers ascertained if the Safety Planning Intervention (SPI), administered in Emergency Departments (EDs) with follow-up contact for suicidal patients, was correlated with decreased suicidal behavior and improved outpatient treatment engagement in the 6 months following discharge, an established high-risk period. They found that SPI+ was correlated with a decline in suicidal behavior and increased treatment engagement among suicidal patients following ED discharge. The findings suggested that it could be a valuable clinical tool in healthcare settings.

Methods

• This investigation was a cohort comparison design with 6-month follow-up at 9 EDs (5 intervention sites and 4 control sites) in Veterans Health Administration hospital EDs.
• Eligibility criteria for patients included if they were 18 years or older, had an ED visit for a suicide-related concern, had inpatient hospitalization not clinically indicated, and were able to read English.
• Data were gathered between 2010 and 2015.
• Data were analyzed between 2016 and 2018.
• The intervention combines SPI and telephone follow-up.
• The SPI was charaterized as a brief clinical intervention that combined evidence-based strategies to lessen suicidal behavior through a prioritized list of coping skills and strategies.
• Patients were contacted at least 2 times to monitor suicide risk, review and revise the SPI, and support treatment engagement in telephone follow-up.
• Following ED discharge, suicidal behavior and behavioral health outpatient services extracted from medical records for 6 months.

Results

• According to the findings obtained, out of 1640 total subjects, 1186 were in the intervention group and 454 were in the comparison group.
• It was observed that patients in the intervention group had a mean (SD) age of 47.15 (14.89) years and 88.5% were men (n = 1050).
• In addition, patients in the comparison group had a mean (SD) age of 49.38 (14.47) years and 88.1% were men (n = 400).
• Findings suggested that patients in the SPI+ condition were less likely to engage in suicidal behavior (n = 36 of 1186; 3.03%) than those receiving usual care (n = 24 of 454; 5.29%) during the 6-month follow-up period.
• Data reported that the SPI+ was correlated with 45% fewer suicidal behaviors, approximately halving the odds of suicidal behavior over 6 months (odds ratio, 0.56; 95% CI, 0.33-0.95, P=.03).
• Researchers found that intervention patients had more than double the odds of attending at least 1 outpatient mental health visit (odds ratio, 2.06; 95% CI, 1.57-2.71; P < .001).