Beyond Now: Evaluating the effectiveness of a self-guided suicide safety planning app for people at risk of suicide

Beyond Now is a publicly-available, free smartphone app available in Australia. It enables people to create a safety plan: a personalised summary of coping strategies and emergency contacts that a person can access during an acute suicidal crisis. Structured in a stepwise fashion, safety plans support suicidal people to problem-solve their way through a crisis. Based on the Safety Planning Intervention (Stanley & Brown, 2012) and further refined through consultations with users and practitioners, the steps in Beyond Now to be filled out include recognition of warning signs, making the environment safe (means restriction), reasons for living, coping strategies, people and places to connect with to distract from suicidal thoughts, family and friends to contact to disclose suicidal thoughts to and assist during a crisis, and professional and emergency services. Beyond Now users can enter text, photos and videos, and import contacts from their address book to fill out the various steps. A convenience sample of participants will be recruited from the pool of Beyond Now users who have downloaded and completed a safety plan using the app within the previous 2-4 weeks. These potential participants will be informed about the study via an app notification. If participants consent to take part, there will be a three-month observation period, with surveys at baseline, one month (T1) and three months (T2); and weekly brief surveys to measure treatment engagement and perceived plan usefulness. All surveys are conducted online through the participant’s mobile device. The estimated time to complete the surveys is as follows: baseline survey (30 minutes), one month and three-month follow up (15 minutes each), weekly treatment engagement surveys (1 minute each). Participants are also asked to separately consent to have their app usage and plan content tracked during the three-month observation period. Data collected in this study will be used to measure: - Whether there are differences in suicidal ideation and suicide-related coping for users who engage in safety planning on their own, compared to users who engage in planning with a clinician - Whether any changes in suicidal ideation and suicide-related coping are dependent on how much a person uses their plan, and to what extent the content of their plan is specific and personalised (plan quality) - Whether plan usage is affected by distress tolerance - Whether causality orientation affects plan quality, plan use, and differences in suicidal ideation, suicide-related coping outcomes - Whether plan usage affects changes in feelings of autonomy, competence and relatedness (self-determination needs) among users