Design and Feasibility of an SMS-based Safety Planning Intervention

NCT07365579 | Not Yet Recruiting

• 2 other identifiers: STU00217191K08MH128640
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study is testing whether it is feasible to run a larger randomized controlled trial and whether an automated text messaging program is acceptable to young adults who have suicidal thoughts. The program is designed to help participants create and use a safety plan, which is a personalized list of warning signs, coping strategies, supportive people, professional resources, ways to make their environment safer, and reasons for living. After joining and completing an initial survey, participants are randomly assigned by a computer to one of two groups. One group starts right away with the interactive safety planning text program. The other group first receives simple text messages with 24/7 crisis resources and then, after four weeks, also receives the interactive safety planning program. Participants use the text program for about four weeks and complete online surveys at the start and again over a total period of 24 weeks.

Conditions

Suicidal Ideation and Behavior

Keywords

Text message; safety plan; suicide prevention

Outcome Measures

Primary Outcomes (3)

• Frequency of suicidal thoughts

  The number of times an individual has experienced suicidal thoughts

  enrollment to 4 weeks

• Frequency of suicidal behaviors

  Frequency of suicidal behaviors

  enrollment to 4 weeks

• Severity of suicidal thoughts

  Severity of suicidal thoughts

  enrollment to 4 weeks

Secondary Outcomes (5)

• Unbearable Psychache Scale (UP3)

  enrollment to 4 weeks

• Beck Hopelessness Scale-Short Form (BHS-SF)

  Enrollment to 4 weeks

• PROMIS Social Isolation - CAT

  Enrollment to 4 weeks

• Suicide Capacity Scale (SC3)

  enrollment to 4 weeks

• After-Scenario Questionnaire (ASQ)

  enrollment to 4 weeks

Other Outcomes (1)

• Suicide Related Coping Scale

  Enrollment to 4 weeks

Study Arms (2)

SMS based safety planning intervention (SMS-SPI)

EXPERIMENTAL

The SMS-SPI consists of a 4-week automated text messaging intervention. It is designed to guide users through the steps of the safety planning process for management of suicide related thoughts and behaviors. The intervention delivers structured, interactive messages daily addressing coping strategies, crisis resources, environmental safety, family and friends for support, distraction techniques, and recognition of warning signs. The number of messages sent each day varies based on users' interactions with the program; users who respond more frequently may receive more messages. In addition to text messaging, the program includes a web-based interface that enabled users to conveniently review and update their safety plan. The SMS-SPI uses message stems that establish a particular topic (e.g., identification of crisis warning signs) and message probes that follow-up on users' responses, which is individualized through branching logic.

Behavioral: Text Messaging based Safety Planning Intervention

Enhanced waitlist control (eWLC)

ACTIVE COMPARATOR

Text messages that are non-interactive and contain referral to crisis services (e.g., the National Suicide Prevention Lifeline, the Crisis Text Line, and (c) the Trevor Project Lifeline). Facilitated referral is a first-line prevention strategy for suicide and is a best-practice commonly integrated into internet-based screenings and informational tools.

Behavioral: Text Messaging based Safety Planning Intervention; Behavioral: Facilitated Referral to Crisis Resources

Interventions

Facilitated Referral to Crisis Resources BEHAVIORAL

Text messages that are non-interactive and contain referral to crisis services (e.g., the National Suicide Prevention Lifeline, the Crisis Text Line, and (c) the Trevor Project Lifeline).

Enhanced waitlist control (eWLC)

Text Messaging based Safety Planning Intervention BEHAVIORAL

A 4-week automated text messaging intervention designed to guide users through the steps of the safety planning process. The intervention delivers structured, interactive messages daily addressing coping strategies, crisis resources, environmental safety, family and friends for support, distraction techniques, and recognition of warning signs.

Enhanced waitlist control (eWLC); SMS based safety planning intervention (SMS-SPI)

Eligibility Criteria

• Age: 18 Years - 24 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Ages 18 to 24 \*The age to provide consent in Nebraska is 19. Individuals recruited from the state of Nebraska must be 19 or older.
• endorsement of past 2-week suicidal ideation
• Resident of the United States
• Owns a smartphone

You may not qualify if:

• Serious mental illness for which intervention would be contraindicated (i.e., active psychosis or mania)
• Imminent suicidality (i.e., experiencing active suicidal ideation with a plan and intent to act)
• Written English language skills that are insufficient to engage in the consent, design, evaluation, or intervention procedures.

Sponsors & Collaborators

• Northwestern University: lead

MeSH Terms

Conditions

Suicidal Ideation; Behavior; Suicide Prevention

Condition Hierarchy (Ancestors)

Suicide; Self-Injurious Behavior; Behavioral Symptoms

Study Officials

• Jonah Meyerhoff, PhD

  Northwestern University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jonah Meyerhoff, PhD

CONTACT

312-503-1232; jonah.meyerhoff@northwestern.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Assistant Professor

Model Details: enhanced waitlist control design

Study Record Dates

• First Submitted: January 22, 2026
• First Posted: January 26, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): January 1, 2027
• Last Updated: January 27, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share