Research indicates that a considerable proportion of suicide decisions are made impulsively within minutes. The Safety Plan Intervention (SPI) is a method designed to counteract this impulsivity, encouraging individuals to follow coping strategies instead of acting on suicidal urges. Although SPI is advised for those with suicidal tendencies, about 40% of individuals don’t utilize their safety plans.
A key challenge is that people often struggle to apply skills from therapy in real life due to motivational or self-control issues, which are particularly notable in substance use disorders. Motivational Interviewing (MI) has been employed to boost the sustained use of SPI but traditionally requires face-to-face sessions. Some evidence suggests that sending supportive text messages can enhance the use of safety plans. While MI interventions can be technology-driven, combining them with SPI without in-person sessions remains unexplored.
This study will conduct preliminary work to support a future just-in-time adaptive intervention (JITAI) to address this gap, aiming to provide timely support. Using a human-centered design, this study is split into two phases:
- Phase 1 evaluates barriers and facilitators for using safety plans in real-time. It involves interviews with patients and providers, discussing the use of mobile safety plans and potential JITAIs. Feedback on motivational and self-control challenges will be a primary focus.
- Using Phase 1 feedback, researchers will design prototypes of real-time motivational interventions to boost safety planning engagement. Another round of interviews will collect feedback on these prototypes, using a “think aloud” approach to understand user interaction.
The project aligns with d3center priorities, emphasizing adaptive mobile interventions that offer personalized real-time support. This research will inform the development of future interventions for those with substance use and suicidal urges, a group that critically needs innovative suicide prevention strategies. The study will engage two participant groups: those with prior engagement in a longitudinal study on suicidal thoughts and behaviors, and psychiatric providers. The goal is to improve the real-world application of safety plans, making them more effective and relevant to those at risk.