Safety plan use and suicide-related coping in a sample of Australian online help-seekers

Suicide safety plans can improve suicide-related coping skills and reduce suicidal thoughts and behaviours (STBs). However, little is known about their use and impact outside of treatment settings, where most suicidal crises will occur. The current study explored the prevalence of safety plan use among an online sample of help-seekers with lifetime STBs, and whether STBs and suicide-related coping differed between those with and without safety plans. An exploratory aim was to investigate barriers to safety plan use.

Participants (N = 1251) completed an online, anonymous survey at a mental health support website (Beyond Blue). The survey measured lifetime STBs, past-month suicidal ideation, suicide-related coping, help-seeking intentions and behaviour.

Despite high levels of past-month suicidal ideation and past-year help-seeking, most participants (89.5 %) did not have a safety plan, and most of those were not familiar with the concept (70.5 %). Participants with safety plans reported a higher rate of past suicide attempts, but higher suicide-related coping and help-seeking behaviour. Among participants without safety plans, negative attitudes toward safety planning were positively associated with suicidal ideation and negatively associated with suicide-related coping.

Participants were primarily female, English-speaking visitors to a mental health support website. Cross-sectional design precludes conclusions being drawn about safety planning effectiveness over time.

This study highlights the low prevalence of safety plan use among online help-seekers with lifetime STBs and the need to better promote safety planning as an intervention with autonomous benefits, including crisis preparedness and improved suicide-related coping skills.