Safety Planning Intervention Telehealth Service Model in Emergency Departments

NCT05307432 | Enrolling By Invitation DMC

• 2 other identifiers: 8506361P50MH127511-01
• Study Type: interventional
• Target: 2,814
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to evaluate the effectiveness and implementation of a suicide prevention strategy delivered via telehealth in Emergency Departments. We will compare implementation of the Safety Planning Intervention plus follow-up calls (SPI+) delivered by Emergency Department (ED) staff to SPI+ delivered via ED referral to an off-site Suicide Prevention Consultation Center (SPCC).

Conditions

Suicide; Suicidal Ideation

Keywords

Safety Planning; Emergency Department; Risk Assessment; Follow-up Contact; Implementation Strategies; Telehealth

Outcome Measures

Primary Outcomes (7)

• Suicide Behavior Composite

  Number of patients who had a documented suicide attempt or death by suicide

  6 months after index ED visit

• Outpatient Treatment Engagement - Count

  Number of behavioral healthcare visits following discharge from index ED visit

  6 months after index ED visit

• Outpatient Treatment Engagement - Type

  Types of behavioral healthcare visits following discharge from index ED visit

  6 months after index ED visit

• Safety Planning Intervention Scoring Algorithm (SPISA)

  Fidelity of written safety plans post-discharge from index ED visit

  At index ED visit

• Fidelity of Follow-up Calls

  Number of patients who had 2 or more follow-up calls post-discharge from index ED visit

  1 month after index ED visit

• Reach/Penetration of Safety Plans

  Proportion of patients with a completed safety plan documented in the medical record out of all patients identified as at risk for suicide by the ED staff

  At index ED visit

• Reach/Penetration of Follow-up Calls

  Proportion of patients who receive 2 or more telephone follow-up attempts out of all patients who received a safety plan

  1 month after index ED visit

Secondary Outcomes (9)

• Suicide-related ED Visits and Psychiatric Hospitalizations

  6 months after index ED visit

• Suicide Attempts

  6 months after index ED visit

• Adoption

  At index ED visit

• Utilization of Screening of Suicide Risk Among ED Patients

  At index ED visit

• Index ED Visit Inpatient Admission Disposition

  At index ED visit

Study Arms (2)

Enhanced Usual Care

ACTIVE COMPARATOR

ED staff deliver SPI+ (Safety Planning Intervention plus 2 or more post-discharge telephone calls) to suicidal patients who are not admitted to an inpatient unit.

Behavioral: SPI+ Delivered by ED Staff

Suicide Prevention Consultation Center

EXPERIMENTAL

ED staff refer suicidal patients not admitted to an inpatient unit to the off-site Suicide Prevention Consultation Center (SPCC). SPCC clinicians will deliver SPI+ (Safety Planning Intervention plus 2 or more post-discharge telephone calls) to patients via telehealth.

Behavioral: SPI+ Delivered by SPCC Clinicians

Interventions

SPI+ Delivered by ED Staff BEHAVIORAL

ED staff will deliver SPI+ (Safety Planning Intervention plus follow-up phone calls) to patients at risk for suicide in the ED who are not admitted to an inpatient unit.

Enhanced Usual Care

SPI+ Delivered by SPCC Clinicians BEHAVIORAL

The Suicide Prevention Consultation Center (SPCC) will be located external to the Emergency Department (ED). ED staff will be able to refer patients at risk for suicide to the SPCC. Licensed and credentialed mental health clinicians will deliver SPI+ (Safety Planning Intervention plus follow-up phone calls) via telehealth to patients at risk for suicide in the ED who are not admitted to an inpatient unit.

Suicide Prevention Consultation Center

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• ED visit at one of our participating sites for a suicide-related event or determined to be at risk for suicide per the Electronic Health Record (EHR) and ED clinical staff
• years of age or older
• Not admitted to an inpatient hospital following the index ED visit as documented in the EHR

You may not qualify if:

• \- Inpatient admission following the index ED visit per the EHR
• Aim 2:
• ED clinician or leader at one of our participating sites, or ED patient who was referred to the SPCC
• years of age or older
• Able to communicate in English
• Willing to give informed consent
• Patients who are at imminent risk of suicide or acutely psychotic at the time of the interview, requiring emergency services and/or precluding ability to provide informed consent
• Patients without a phone for contact

Sponsors & Collaborators

• University of Pennsylvania: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

University of Pennsylvania Health System

Philadelphia, Pennsylvania, 19104, United States

Location

MeSH Terms

Conditions

Suicide; Suicidal Ideation; Emergencies

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Gregory K Brown, PhD

  University of Pennsylvania

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Stepped-wedge cluster-randomized controlled design

Study Record Dates

• First Submitted: March 2, 2022
• First Posted: April 1, 2022
• Study Start: May 1, 2022
• Primary Completion (Estimated): July 31, 2026
• Study Completion (Estimated): July 31, 2026
• Last Updated: July 16, 2025

Record last verified: 2025-07

Locations

US (1)