Safety Planning for Veterans

SAFE VET, a brief intervention and intensive follow-up program for suicidal veterans, was found to be extremely acceptable to both veterans and mental health service providers. The intervention also showed promise in helping veterans cope with suicidal crises and seek mental health services following a crisis.

The Suicide Assessment and Follow-up Engagement: Veteran Emergency Treatment (SAFE VET) intervention is based on Safety Planning, a brief intervention designed for use in emergency departments (EDs) and other emergency settings. Both interventions engage the suicidal patient and the mental health care provider in developing an individualized safety plan based on four evidence-based risk reduction strategies: (1) means restriction; (2) problem-solving and coping skills (including ways the patient can distract him- or herself from suicidal thoughts and impulses; (3) using social support and mental health and crisis services; and (4) seeking additional mental health treatment. The plan is tailored to the specific patient and his or her warning signs, favored activities, and social and professional supports. SAFE VET is augmented by intensive telephone follow-up by an acute services coordinator who involves the veteran’s family in this process.

SAFE VET was implemented at five Veterans Administration facilities. An evaluation of this implementation found that ED and urgent care mental health providers were extremely supportive of the program, as it helped them address the needs of suicidal veterans without hospitalizing them. Prior to the implementation, providers would offer voluntary hospitalization to most suicidal patients for lack of a better option that would ensure patient safety. SAFE VET was also extremely popular among the patients, 93 percent of whom agreed to participate when offered the opportunity. Eighty percent of suicidal veterans exposed to SAFE VET received mental health services within six months of their visit to the VA (compared to 10-40 percent that other research shows receive such services).

A follow-up study will evaluate the effectiveness of SAFE VET on outcomes including attempted suicide, suicidal ideation, use of mental health referrals, and use of coping strategies.

Knox, K., Stanley, B., Currier, G., Brenner L, Ghahramanlou-Holloway M, & Brown G. (2012). An emergency department-based brief intervention for veterans at risk for suicide (SAFE VET). American Journal of Public Health, 102(Suppl. 1), S33-37.

Note:  The September 6th issue of the Weekly Spark included a Research Summary describing Safety Planning, the brief intervention upon which SAFE VET is based. This Research Summary can be found in the Weekly Spark archives.