Conference Agenda

SERO is a self-management application for suicide prevention designed to support individuals at risk and their trusted contacts before, during, and after suicidal crises. It enables users to prepare actionable emergency strategies through a personalised safety plan that can be shared with trusted contacts. This is complemented by standardised self-assessment of suicidality using PRISM™-S, along with rapid access to crisis hotlines, personal emergency contacts.

Across the filtered observation period (November 2022 to December 2025), [EG1] 1,076 users engaged with the safety planning functionality, and 1,212 accessed the PRISM-S functionality. Safety planning engagement showed clear diurnal patterns, peaking in the afternoon (14:00-15:00) and lowest at night (00:00-03:00), whereas PRISM™-S scores were stable across time. These temporal patterns broadly align with established weekly and circadian rhythms observed in suicidality research, while also reflecting differences likely attributable to app-based self-reporting contexts.

Seasonal analyses showed a small but significant effect for PRISM™-S distances, with lowest values in summer and highest in winter (p=0.020), whereas safety planning use did not vary significantly across seasons. Sentiment analysis of app users’ free-text responses showed a predominantly negative affective tone (mean =-0.41) and was significantly associated with PRISM™-S crisis proximity, with more negative sentiment observed when perceived suffering was smaller. Sentiment also varied across time of day, with the most negative expressions occurring during nighttime hours, especially at 23h, and from 2h to 5h.

From an implementation perspective, the findings suggest that routine prompts and supportive interventions are more likely to be effective when scheduled during high-engagement periods. In particular, the results support a “week-start” prevention strategy, such as optional Monday check-ins, brief stabilisation exercises, or reminders to review crisis contacts. Clinicians may also consider concentrating follow-up or supportive messaging early in the week when appropriate.

Introduction

Evidence-based interventions specifically targeting suicidal ideation and behaviour in young people remain scarce. Digital tools show promise for young people, particularly by improving access to care and self-management during distress. Spark is a mobile app co-created with young people with lived experience of suicidal thoughts, and professionals in youth mental health care. This study evaluates Spark’s feasibility and usability and explores preliminary changes in suicide-related outcomes.

Methods

A single-arm pilot study with online pre- and post-assessments is being conducted among young people aged 12–17 years experiencing suicidal thoughts. Following parent/guardian consent and participant assent, baseline measures include socio-demographics, suicide-related coping (Suicide-Related Coping Scale-15; SRCS-15), suicidal ideation severity (Suicidal Ideation Attributes Scale—Modified; SIDAS-M), and self-reported suicidal behaviour. Participants subsequently receive a unique access code and can use the app for 10 days. Core components include a personal Safety Plan; hope-oriented tools such as a personalised Hope Box; emotion regulation and cognitive coping exercises, brief relaxation, a distraction mini-game and psychoeducation. Post-assessment repeats SRCS-15, SIDAS-M, and suicide behaviour items. Additionally, it assesses engagement, satisfaction, perceived usefulness, and usability using study-specific items. Recruitment occurs via online dissemination and referrals by healthcare professionals. An effective sample of 40 participants which complete the study, is targeted.

Results

Data collection is ongoing. Feasibility, engagement, and user experience will be analysed, alongside pre–post changes in SRCS-15 and SIDAS-M. Results will be presented at the ESSSB 21 conference.

Conclusions

This pilot will determine whether Spark is feasible and acceptable for young people with suicidal thoughts and will identify usability and implementation barriers. Findings will be used to refine the intervention and the implementation planning. Furthermore, they may provide inputs for future controlled effectiveness evaluations.

Introduction:

Despite substantial research efforts, effects of interventions for suicidal thoughts and behaviors remain modest. Innovative approaches are needed to address this issue and overcome limitations of existing interventions. Digital tools, such as smartphone applications, are well suited to provide continuous support and may help bridge particularly vulnerable phases, such as the period following discharge from psychiatric inpatient to outpatient treatment. In this study, we aim to test the feasibility of a newly developed app that integrates evidence-based and innovative candidate interventions targeting critical processes and empirically established precursors of suicidal thoughts and behaviors, including a safety plan intervention and an autobiographical memory self-efficacy training. The app is designed to offer both crisis support and psychological interventions in a personalised, needs-oriented manner, with components tailored to different phases, ranging from acute crisis to periods of low symptom severity.

Methods:

We plan to recruit 20 participants from the Psychiatric University Hospital Zurich who will use the app for two weeks following hospital discharge. The primary aim is to assess feasibility using self-report measures and app usage data. Secondary exploratory analyses will examine changes in psychiatric outcomes, including the severity of suicidal thoughts and related measures.

Results:

We will present the development framework for the feasibility study. The app is currently in the development phase. Ethical approval is expected by July 2026, with participant recruitment planned to begin shortly thereafter.

Conclusions:

This study evaluates the feasibility of a modular, evidence-based and stakeholder-informed development framework, focusing on acceptability, usability, and clinical integration to inform future large-scale evaluations of the app. If feasible and effective, the app may serve as an adjunct tool for clinicians in both inpatient and outpatient settings, supporting transitions to follow-up care and potentially complementing ongoing outpatient treatment.

Introduction:

Although safety plans are widely used, there is limited evidence from people with personal experience on their usefulness or effectiveness.

In this research we have co-produce a toolkit and implementation plan based on lived experience perspectives, rethinking what constitutes meaningful safety planning that supports individuals’ unique needs and preferences.

The research is dedicated to Jay who sadly died by suicide. Jays mum, Paula, has been an integral part of the study from the outset.

Methods.

A mixed-methods study with lived experience involvement throughout, which included:

1. Evidence synthesis - to provide context sensitive theoretical underpinning for personalisation and tailored implementation of the toolkit.
2. Qualitative focus groups with practitioners (total 35 participants) - five settings across north of England (secondary mental health, primary care, ambulance services, third-sector, policymakers) exploring context specific barriers and enablers to implementation of personalised safety planning.
3. Co-production workshops - bringing together practitioners and people with lived experience to develop the toolkit and implementation plan.

Results

The data identified 5 themes important for meaningful safety planning.

1. From “tick-box” to a collaborative approach.
2. From one-off intervention to pathway/journey.
3. From crisis response to system wide approach.
4. Supported, trained and resourced support people.
5. Focus on person-centred outcomes/impact, not targets.

The co-production group used these themes to develop an interactive personalised safety planning toolkit and implementation plan for use by individuals and their support people.

Conclusions

Our research adds to evidence for the need to move away from one‐off standard approaches limited to crisis situations and demonstrates that safety planning is preferred when carried out as a collaborative journey.

The toolkit we have developed details the core elements needed to support a personalised, meaningful and impactful safety planning journey. The implementation plan outlines the actions needed to overcome barriers and enhance enablers for successful implementation across different contexts where people seek support.

Self-harm represents a major public health challenge, and emergency departments (EDs) are key settings for both the clinical management of self-harm and preventive intervention, as they are often the first point of contact following an episode. However, ED care is frequently constrained by fragmented assessment practices, limited opportunities to build connection and trust, and poorly structured follow-up pathways, resulting in variable care and suboptimal continuity after discharge.

The PERMANENS project presented here is a European research initiative aimed at developing a user-centred clinical decision support system (CDSS) to support healthcare professionals in the assessment and management of adults presenting with self-harm in the ED. Its final deliverable, PERMANENS-AID, is a web-based software prototype integrating three components: interpretable machine learning based prediction models using routinely collected clinical information to estimate the risk of self-harm repetition and suicide; an evidence-based, guideline-informed clinical knowledge base translated into a structured guided care pathway; and an accompanying training website supporting ethical and appropriate use in clinical practice. Risk estimates generated within the CDSS are intended for clinician use only and are presented solely to contextualise individual risk relative to age- and sex-matched peers, explicitly framed as non-causal and supportive of structured professional judgement. The development process followed an iterative co-design approach involving emergency mental health professionals and people with lived experience of self-harm, prioritising transparency, interpretability, and feasibility in real-world settings.

By the time of presentation, PERMANENS-AID will have undergone pilot real-time testing in the ED with clinician–patient dyads, focusing on clinician usability, workflow integration during routine assessments, and patient experience of communication and therapeutic interaction.

By combining contextualised risk stratification with structured, person-centred, evidence-based care guidance, PERMANENS-AID represents a step toward complementary clinically usable decision support for self-harm management in emergency settings and provides a foundation for future multi-site evaluation and responsible implementation.