Table 3.

Electronically Delivered Safety Planning Interventions (n = 5).

Study	Intervention	Control	Participants	Sample Size	Study Design	Critical Appraisal Score (Quality Level)	Outcomes Measured	Findings
Boudreaux et al. (2017)	Web-Based Safety Planning Application (WBSPA)	n/a	Age: m = 39; sd = 14 Gender: men = 14 (47%) Clinical characteristics: Alcohol misuse = 9 (30%); Drug misuse = 9 (30%); Depressed mood = 16 (53%); Depressed disposition = 3 (10%) Race: White = 25 (83%) Ethnicity: Hispanic = 3 (10%) LGBTQ+ status: not reported Setting: Emergency department Population: general population	WBSPA = 30	Quasi-experimental	57.1	1. Suicide ideation: Self reported suicide intensity; ability to cope with suicidal ideation. 2. Service use: Number of ED visits related to suicide. 3. Feasibility and acceptability: Ability to register, view screens, complete all elements of the plan.	1. Suicide ideation: Suicide intensity was significantly lower post intervention (p < .05); Ability to cope with suicidal ideation was higher post intervention (p < .05) 2. Service use: Visits to the ED related to suicide decreased significantly (p < .001) 3. Feasibility and acceptability: All participants were able to register, view all screens, and create a one-page safety plan. Mean steps completed = 5.5 (sd = 0.9), with n = 27 (90%) completing at least 5 steps and n = 20 (67%) completing all steps. Qualitative feedback supported useability.
Dimeff et al. (2021)	Jaspr Health	TAU	Age: m = 34.4; sd = 15.2 Gender: men = 11 (35%); women = 20 (65%) Clinical characteristics: n = 19 (61%) had a history of non-suicidal self-injury Race: White = 27 (87%); Black = 1 (3%); Other = 3 (10%) Ethnicity: unspecified LGBTQ+ status: unspecified Setting: emergency department Population: unspecified	Jaspr Health = 14 TAU = 17	RCT	38.5	1. Suicide ideation: Suicide-Related Coping Scale (SRCS) (Stanley et al., 2017); Safety & Imminent Distress Questionnaire (SIDQ) (Boudreaux et al., 2017) including distress, agitation, coping ability, and readiness to go home subtests. 2. Acquired skills: number of new behavioral skills learned; thoroughness of exposure to new practices on a 5-point Likert scale from 1 = poor to 5 = excellent 3. Feasibility and acceptability: Satisfaction with the intervention on a 5-point Likert scale from 1 = poor to 5 = excellent; exposure to elements of the intervention during participation including: crisis stabilization plan; lethal means counselling; skills; people with lived experience of suicide (PLE)	1. Suicide ideation: post-intervention, SCRS scores improved significantly for participants in the intervention group (p < .001; d = 1.11); statistically significant time × condition effects showed that during the 2-h intervention, compared with TAU patients, Jaspr Health participants reported greater decreases in intensity of agitation and distress and greater increases in their ability to cope with thoughts of suicide. Within-condition effect sizes were large to very large for Jaspr Health participants’ decreases in agitation and distress (Cohen d = 0.61 and 1.00, respectively) and increases in coping ability (Cohen d = 0.90). In contrast, effect sizes for TAU participants were small. Specifically, a decrease in distress (Cohen d = 0.33), a small increase in agitation (d = 0.11), and an increase in coping ability (Cohen d = 0.32) were observed in the TAU group. 2. Acquired skills: participants reported learning a mean of three new behavioral skills (sd = 1.3) and engaged with four PLEs (sd = 2.63). 3. Feasibility and acceptability: mean rating of satisfaction was 4.4 (sd = 0.63). Intervention participants experienced a more thorough degree of exposure to elements of the intervention [crisis plan (m = 3.4; sd = 1.1); lethal means counselling (m = 3.5; sd = 1.31; skills (m = 3.7; sd = 1.38); PLE (m = 4.1; sd = 0.86)] on the 5-point scale.
Denneson et al. (2019)	Virtual Hope Box (VHB)	Enhanced TAU (e-TAU)	Age: m = 47.5; sd = 14 Gender: men = 80 (68.4%); women = 37 (31.6%) Clinical characteristics: not reported Race: White = 84 (71.8%); Other = 24(20.5) Ethnicity: Hispanic = 9 (7.7%) LGBTQ+ status: not reported Setting: behavioral health treatment programs Population: veterans	VHB = 58; e-TAU = 59	RCT	38.5	1. Suicide ideation: the first five items on the Beck Scale for Suicidal Ideation (BSS) (Beck et al., 1988) 2. Resilience: Coping Self-Efficacy instrument (CSE) (Chesney et al., 2006)	1. Suicide ideation: no statistically significant difference detected between groups over time on the BSS. 2. Resilience: larger increases in coping-self efficacy as measured by the CSE occurred in the VHB group over time.
Melvin et al. (2019)	BeyondNow App	n/a	Age: m = 19.8; sd = 6.0 Gender: women = 24 (66.7%) Clinical characteristics: depressive disorder = 29 (80.5%); anxiety disorder = 20 (55.5%); borderline personality disorder/traits = 7 (19.4%); eating disorder = 6(16.7%); trauma disorder = 3(8.3%) Race: not reported Ethnicity: non-aboriginal Australians = 36(100%) LGBTQ+ status: not reported Setting: tertiary mental health services Population: general population	BeyondNow = 36	Quasi-Experimental	71.4	1. Suicide ideation: Columbia Suicide Severity Rating Scale (C-SSRS) (Posner et al., 2011); Suicide-Related Coping Scale (SRCS) (Stanley et al., 2017); Coping Strategy Usage Questionnaire (CSUQ) (Melvin & Gresham, 2016 in Melvin et al., 2019) 2. Resilience: Suicide Resilience Inventory-25 (SRI-25) (Gutierrez et al., 2012); 3. Feasibility and acceptability: frequency of use, difficulty, recommendation of the app to a friend, qualitative question about best features of the app.	1. Suicide ideation: there was a statistically significant reduction in severity (p < .001) and intensity (p < .01) of suicidal ideation post-intervention, and a significant increase in suicide-related coping over time (p < .01). 2. Resilience: There was no statistically significant increase in resilience as measured by the SRI-25. 3. Feasibility and acceptability: participants entered between 2.78–6.28 entries. Majority of participants used the app to edit their safety plans (77.3%) and reported using the app ‘occasionally’ (63.6%). 81.8% used the app when experiencing suicidal thoughts and 69.2% used the app during a suicidal crisis. The majority (90.9%) found the app ‘very easy’. 100% of participants would recommend the app to a friend. Three themes of hope, connection, and utility were revealed using thematic analysis of qualitative data collected to determine feasibility and acceptability.
Spangler et al. (2020)	Internet Based Safety Plan (IBSB)	n/a	Age: m = 29.2; sd = 13.7 Gender: women = 56.7% Clinical characteristics: major depressive episode = 118(78.9%) Race: not reported Ethnicity: not reported LGBTQ+ status: not reported Setting: virtual Population: visitors to an internet-based depression/suicidal screening website	IBSB = 150	Quasi-Experimental	57.1	1. Feasibility and acceptability: At baseline, participants were asked to rate the following on a 10-point Likert scale (1 = not at all to 10 = yes, definitely): (1) ability to cope with distress; (2) availability of resources if they begin to experience suicidal urges; (3) level of safety. After participating in the development of a safety plan, participants were asked to rate the following on a 10-point Likert scale (1 = not at all to 10 = yes, definitely): (1) if they experience thoughts of self-harm; (2) whether their SP could help them cope; (3) whether they could stay safe; and (4) whether they could think of resources. They also rated the likelihood that they will remember and use their SP, and its perceived usefulness on a Likert scale (1 = not at all to 10 = yes, definitely).	1. Feasibility and acceptability: Participants reported that they believed moderately that the IBSP could help them remember that they have resources (m = 5.73; sd = 3.07), that they would remember making the safety plan (m = 5.69; sd = 2.87), and that they may actually use it (m = 4.83; sd = 2.98). The ratings of IBSP in helping participants to cope (m = 5.00; sd = 2.81) and stay safe (m = 5.23; sd = 2.95) were also rated moderately. Participants were more likely to report the belief that the IBSP could help others with suicide ideation (m = 6.08; sd = 2.96) than themselves (m = 4.91; sd = 3.03), a difference that was statistically significant (p = .001).

Note. I = intervention group; C = control group; ED = emergency department; TAU = treatment as usual; RCT = randomized control trial.