Safety Planning Intervention in Swedish Healthcare: A Multisite Study for Suicide Prevention
1 other identifier
interventional
8,000
1 country
4
Brief 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.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Oct 2025
Longer than P75 for not_applicable
4 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
October 1, 2025
CompletedFirst Submitted
Initial submission to the registry
February 16, 2026
CompletedFirst Posted
Study publicly available on registry
March 13, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
October 1, 2028
ExpectedStudy Completion
Last participant's last visit for all outcomes
July 1, 2029
March 13, 2026
February 1, 2026
3 years
February 16, 2026
March 9, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Monthly rate of emergency visits for suicide attempts
Monthly number of emergency department visits for suicide attempts identified using ICD-10 codes X60-X84 and events of undetermined intent (Y10-Y34), obtained from aggregated healthcare utilization data from psychiatric clinics in Region Skåne.
Monthly measurements throughout the 45-month study period
Secondary Outcomes (4)
Monthly rate of psychiatric inpatient admissions for suicide attempts
Monthly measurements throughout the 45-month study period
Emergency department revisits following suicide attempts
Monthly measurements throughout the 45-month study period
Psychiatric inpatient readmissions following suicide attempts
Monthly measurements throughout the 45-month study period
Incremental cost-effectiveness of SPI implementation
Assessed over the 45-month implementation period
Study Arms (1)
Safety Planning Intervention for suicide prevention
EXPERIMENTALStepped wedge design with four areas being added to the study on at a time
Interventions
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.
Eligibility Criteria
You may qualify if:
- Patients presenting to psychiatric services with suicidal ideation, suicidal planning, or a suicide attempt
- Patients receiving care in participating adult psychiatric emergency or inpatient units
You may not qualify if:
- Age under 18 years
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Region Skanelead
- Fortecollaborator
Study Sites (4)
Region Skåne, psychiatric services
Helsingborg, Skåne County, Sweden
Region Skåne, psychiatric services
Kristianstad, Sweden
Region Skåne, psychiatric services
Lund, Sweden
Region Skåne, psychiatric services
Malmo, 22736, Sweden
Related Publications (1)
Nuij C, van Ballegooijen W, de Beurs D, Juniar D, Erlangsen A, Portzky G, et al. Safety planning-type interventions for suicide prevention: meta-analysis. The British journal of psychiatry : the journal of mental science. 2021;219(2):419-26
BACKGROUND
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NA
- Masking
- NONE
- Purpose
- PREVENTION
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
February 16, 2026
First Posted
March 13, 2026
Study Start
October 1, 2025
Primary Completion (Estimated)
October 1, 2028
Study Completion (Estimated)
July 1, 2029
Last Updated
March 13, 2026
Record last verified: 2026-02
Data Sharing
- IPD Sharing
- Will not share