Plan and Protect: Safety Planning for Teens in Rural Emergency Departments

The goal of this observational study is to determine whether implementing a culturally sensitive, tablet-based safety planning program called Plan \& Protect (P\&P) within rural emergency departments can improve home safety and reduce suicide risk in adolescents presenting with suicidality. The main questions it aims to answer are: * Will implementing P\&P increase caregiver-reported home safety (reduce access to firearms and unsafe medication storage) for adolescents 12-17 years old presenting to rural EDs with suicidal ideation, self-harm, or mental health crisis? * Will implementing P\&P decrease adolescent-reported perceived suicide risk and related outcomes (e.g., suicide events, and attendance at follow-up mental healthcare)? Researchers will compare outcomes for adolescents and caregivers receiving P\&P (implemented as the new standard of care at sites during the intervention periods) to those receiving usual care (prior to P\&P implementation at those hospitals) to see if P\&P increases home safety and decreases suicide risk and related healthcare utilization. Participants will, if clinically appropriate: * Complete the tablet-based P\&P modules during their ED visit * Complete self-report measures at baseline, \~30 days, and \~3 months post-discharge * A subset will also participate in semi-structured interviews

Inclusion criteria for children: * 12-17 years of age (and their parent/caregiver(s)) * Ability to speak and complete surveys in English * History of emergency department visit for suicidality, self-harm or mental health crisis * Medically stable Exclusion criteria for children: * Cognitive or developmental delays that preclude program participation based on clinical team assessment * Diagnosis of psychosis * Primary diagnosis of an eating disorder * Parent/guardian not able to provide consent in English * Clinical team concern for patient or staff safety based upon active behavioral concerns * Parent/guardian not available to provide consent (e.g youth is in child protective custody/ward of the state) Inclusion criteria for parents/caregivers: * Parent or caregiver of an eligible child * 18 years old or older * Ability to speak and complete surveys in English Exclusion criteria for parents/caregivers: -Inability to understand key aspects of the study