Jay’s study: Developing tailored implementation of a personalised safety planning toolkit for adults experiencing self-harm and suicidality.

Jay s study: Developing tailored implementation of a personalised safety planning toolkit for adults experiencing self-harm and suicidality.

Background Self-harm is amongst the strongest known risk factors for suicide (Geulayov et al., 2019) and rates are increasing (McManus et al., 2019) with an estimated average cost to the NHS of £162 million.

Safety planning is a recommended intervention by National Institute of Clinical Excellence self-harm guidance (NICE, 2022). People seek support with self-harm and suicidality from a variety of agencies.

This research proposal addresses significant clinical and lived experience need for implementation of a personalised suicide and self-harm intervention that can be tailored to a range of contexts (Department of Health & Social Care, 2023).

Aim To refine a co-produced personalised suicide and self-harm safety planning toolkit and develop theoretically underpinned, tailored implementation guidance to support embedding and integration across health, social care, and voluntary sector services.

Objectives 1: Develop theoretical underpinning for a prototype safety planning toolkit by conducting a mixed-method evidence synthesis. 2: Carry out a qualitative study with staff across agencies and professions to identify context specific barriers and facilitators to personalised implementation. 3: Co-produce of a tailored implementation logic model and safety planning toolkit. 4: Synthesise the data from the literature, a qualitative study and co-production workshops 5: Identify relevant personalised safety planning intervention outcomes and methods in preparation for future feasibility testing.

Methods and timelines for delivery The starting point for this study is a previously co-produced prototype personalised suicide and self-harm safety planning toolkit.

The research will be conducted in five settings where people seek help for self-harm and suicide across the north of England.

The study is delivered in three work packages and underpinned by Normalisation Process Theory and involves people with lived experience throughout. Approvals Months 0-1 Application for ethical and HRA approvals and staff recruitment.

Months 1-6 WP1: Evidence synthesis A mixed method evidence synthesis will provide a theoretical underpinning for personalisation and tailored implementation.

Months 2-9: WP2: Qualitative study Between 5 & 9 focus groups with (n=54) staff from five settings (primary care, ambulance, secondary mental health, voluntary sector and senior leaders) will provide insight into the implementation context.

Months 2-14: WP3 Co-production Four co-production workshops with ten staff and ten people with lived experience will generate guidance to support tailored implementation.

Months 8-18: Synthesis of data Data synthesis across work packages will generate a logic model and refined toolkit for tailored implementation of personalised safety planning. Identified outcomes will be incorporated into a draft feasibility protocol.

Anticipated impact and dissemination Impact- Close links and prior engagement work with partners from multiple agencies will support embedding the findings into routine practice at local and regional levels. The study will contribute to national guidelines and the direction of suicide prevention through our national networks.

Dissemination- A comprehensive dissemination plan includes involvement from PPI partners and targets academic, clinical, commissioning and lived experience audiences and will include journal articles, blogs, meetings and conference presentations.