Training health care professionals in safety plan implementation to prevent suicide reattempts: A systematic review

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Background: With millions of suicide attempts occurring worldwide each year, suicide prevention is crucial. Brief intervention and contact, particularly a safety plan, provided in health care settings is effective in reducing suicide risk. However, little is known about the training of professionals in safety plan implementation and the impact of this training. Objective: To describe the characteristics and impact of safety plan training for nurses and other health care professionals in health care settings. Design: Systematic review. Methods: The Medline, Embase, CINAHL, PsycInfo, Cochrane Library and ScienceDirect databases were systematically searched in October 2025 for including studies published since 2008.Two authors independently screened titles and abstracts, then assessed full texts for eligibility and extracted data. Disagreements were resolved through discussion with a third author. The Joanna Briggs Institute critical appraisal tools were used to assess the quality of the included studies. PRISMA recommendations were followed for this reporting. Results: Among the 484 identified studies, four observational studies were included. Three studies were conducted in the United States and one in Argentina. They involved 666 participants including medical students, nurses, qualified health care professionals, and social workers.In three studies, training durations ranged from 2 and to 3 hours. In all studies, the training was conducted in person and combined theoretical inputs, practical safety planning recommendations and role plays.Knowledge assessed in one study seemed to improve immediately after training (mean: 3.45 (standard deviation (SD): 2.35) vs.: 5.98 (SD: 2.92), p < 0.0001) but declined at 6 months (5.98 (SD: 2.92) vs. 4.08 (SD: 2.77), p < 0.001).An improvement was observed immediately following the training or at 6 month in attitudes (two studies), behavioral change variables (three studies), and related factors including attitudes (three studies), perceived behavioral control (three studies), intention (two studies), emotions (one study), and behavior (two studies) and emotions (one study).Participants' satisfaction evaluated in two studies was positive in relation to the perceived usefulness of the training. Conclusion: Safety plan training programs have been described in few studies. The evaluation criteria varied. Studies findings suggested a positive impact of training, but attention should be given to a potential decrease in knowledge 6 months after training.

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