Rapid Personalization of Safety Plans for Psychiatrically Hospitalized Veterans at High-Risk for Suicide

Veterans psychiatrically hospitalized face significantly elevated suicide risk, particularly in the three months post-discharge. While Safety Planning is a required component of discharge planning, many safety plans lack personalization thereby reducing their effectiveness. The proposed intervention, Personalized Safety Plans (PSP), will be developed for rapid delivery on acute inpatient psychiatry units. PSP is a single-session intervention followed by twice monthly brief, personalized coaching sessions during the three-month high-risk discharge period. PSP will be iteratively refined and finalized in a case series (N = 15) then evaluated in a pilot randomized controlled trial (N = 96) comparing PSP to Safety Plans as Usual among psychiatrically hospitalized Veterans. Overall, the study aims to: 1) iteratively refine PSP; 2) examine PSP's preliminary effectiveness in reducing suicide ideation and increasing adaptive coping; 3) identify barriers and facilitators to implementation; and 4) develop a fidelity measure to support future personalization monitoring.

Inclusion Criteria: Participants will be Veterans who are: * admitted to VABHS inpatient psychiatry for suicide risk * display sufficient English comprehension and cognitive capacity to understand the study and provide informed consent * have been medically cleared by attending physician Exclusion Criteria: The exclusion criteria for Veterans in this study are: * current psychosis * current mania * dementia or other significant cognitive impairment * being inaccessible and discharged from the unit less than 48 hours after being identified by study staff * prisoner status