Comparing the Impacts of Crisis Response Plan and Self-Administered Safety Plan Use in Real Life on Key Clinical Outcomes.

Abstract

Background: Suicidal crises can occur when a clinician is not available to intervene. Safety planning-type interventions, such as the Crisis Response Plan (CRP) and the self-guided Safety Plan (SP), were developed to provide patients with skills to manage their suicide risk in daily life. These plans are similar in makeup, but differ in terms of how they are created. This study examined whether plan type moderated associations between frequency of plan use and suicide ideation and affect.

Method: Participants were 115 military personnel in a randomized clinical trial comparing the effectiveness of CRP versus a self-guided SP who completed an ecological momentary assessment battery. Generalized linear mixed-effects models examined whether plan type moderated the association between daily plan use frequency and clinical outcomes.

Results: Treatment group moderated the relationship between plan use frequency and the odds of suicidal ideation. When participants used plans more frequently than their average, they reported lower suicidal ideation and higher positive affect for CRP versus self-guided SP.

Conclusions: More frequent CRP use was linked with lower risk of suicidal ideation and greater positive affect. This may reflect better plan use due to clinician guidance. Results have critical implications for the implementation of safety planning-type interventions.