Suicide safety plan engagement: Temporal dynamics and momentary predictors

Area of Science:

• Psychology
• Clinical Psychology
• Mental Health Interventions

Background:

• Suicide safety planning is an evidence-based intervention.
• Little is known about the proximal predictors and timing of safety plan use in daily life.
• Suicide ideation is recognized as dynamic and fluctuating.

Purpose of the Study:

• To examine proximal predictors of safety plan use.
• To understand when safety plans are utilized in relation to immediate changes in psychological states.
• To identify state-dependent triggers for safety plan engagement.

Main Methods:

• Intensive longitudinal methods with a 10-day ecological momentary assessment (EMA) protocol.
• Fifty-two undergraduate students with recent suicide ideation completed EMA five times daily.
• Assessed facets of suicide ideation, negative affect, perceived stress, and safety plan use; analyzed using multilevel models.

Main Results:

• Forty-six percent of participants used their safety plan, reporting high helpfulness.
• Elevated suicidal intent (OR=1.38) and perceived stress (OR=3.43) significantly predicted subsequent safety plan use.
• Safety plan use was state-dependent, triggered by acute increases in intent and stress, and showed temporal clustering (ρ=0.21).

Conclusions:

• Safety plan use is triggered by acute elevations in suicidal intent and perceived stress.
• Intervention targets for safety planning should focus on these proximal, state-dependent factors.
• Findings underscore the importance of timing and context in the application of suicide safety plans.