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New research supports a personalised approach to safety planning for adults at risk of suicide, to save more lives.

Patients with lived experience have called for healthcare providers to take a more personalised approach to suicide prevention, to help save more lives.

Figures released by the Office for National Statistics in August 2024 show that in 2023 there were 6,069 suicides registered in England and Wales (11.4 deaths per 100,000 people); a 7.6 % increase on the previous year and the highest suicide rate seen since 1999. The female suicide rate reached its highest level since 1994.

In the North East, the number of suicides increased by 15 % – to 14.5 deaths per 100,000 people, which is the second highest suicide rate in England after the North West, at 14.7 deaths per 100,000 people.

This latest rise has led the Samaritans charity to call for government to invest in suicide prevention as it has with smoking reduction.

Across England, people at risk of suicide or who have attempted suicide are often given a ‘safety plan’ by a health or care provider, to help them to manage their future risk. The plan might include advice to make an environment or situation safer, and who to call in a crisis.

However, recent research carried out in our region as part of a project funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC), found that many patients feel that these plans are not effective, with some describing them as a ‘tick box’ exercise.

The findings support earlier research, also funded by the NIHR ARC North East and North Cumbria, which explored people’s experiences of the care plans they received in hospital A&E departments following a mental health crisis.

The study, published in the International Journal of Environmental Research and Public Health, found that personalised safety plans with tailored advice were the most useful for patients, especially plans that considered what had or hadn’t worked for that person, in the past. It also found that patients who receive a generic care plan may have an increased risk of repeat self-harm and re-attendance at A&E.

Addressing a ‘pressing need’.

To address this pressing need to move away from standard risk assessment tools, academics and mental health experts from the North East and North Cumbria have been working with people from a range of backgrounds, including those who have experience of self-harm and suicidality, to create a guide which can be used by both patients and health care professionals, to support the development of personalised safety plans.

Making it personal.

A personalised safety plan is one which is created in partnership with each person based around their own experiences, needs and values – and is tailored to that individual. Developing the plan can involve family, friends, or other trusted people, and the plan can contain things that the individual will find personally practical and helpful to help cope with distress or if they’re in crisis.

The project has been co-led by Katherine McGleenan from the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust. Katherine is a mental health practitioner and qualified mental health nurse, with more than 20 years of experience in supporting adults experiencing suicidality.

Katherine said: “Often, feeling suicidal is temporary, even if someone has been struggling to cope for a long period of time. This is why getting the right kind of support at the right time is so important.

“By working with people who have experienced suicidality themselves, we can focus on the things that people have told us were most helpful. Each person’s plan will be different and at the heart of each plan is that individual person and their own needs, preferences, what and who helps them the most, and what works for them. It’s the opposite of a standard safety plan or ‘tick box exercise’. The guide we have developed focuses on the areas that are important to people when safety planning, so it can be tailored for each person.

“We hope that if more people have effective, personalised, safety plans, and are therefore supported in a more planned way, this will not only help the individual, but could also reduce pressures on emergency services. This study has the potential to contribute to national suicide prevention strategy and guidance.”

Underpinned by real-life experience.

The project team included people with lived experience of suicidality, including those who have attempted suicide or who have lost loved ones to suicide. Workshops were also carried out with people who work with those experiencing suicidality, including police, paramedics, mental health professionals, and the voluntary sector.

Paula Mart from Penrith is one of the key collaborators on the project. She lost her daughter Jaymie to suicide in 2012.

Paula said: “Jaymie was only 32 when she died. She was a beautiful, talented, amazing girl who lived life to the full and touched so many lives. She had completed a degree in Sports Science and Nutrition and represented Scotland internationally as downhill mountain bike champion. She had been in hospital previously after an attempt to take her life, but she wasn’t given a safety plan, and we weren’t given any information on how to help her. It was a case of them asking ‘are you going to do this again? No? Okay, off you go’.

“If my daughter had a personalised safety plan and had known what to do when she was in difficulty, I am convinced she would have been with us today. This is why I am so passionate about this work, and Jaymie’s spirit is my inspiration. A personalised safety plan goes so much deeper than just a piece of paper. It holds the hope for someone.”

What makes this approach different?

The guide helps to create a safety plan that is personal to the individual. The plans take a stepped approach – helping people manage fleeting thoughts of suicide through to situations where the desire to die becomes so overwhelming that someone no longer thinks they can keep themselves safe.

The work been co-led by Jill Barker, Principal Lecturer, Teesside University. Jill is also an experienced mental health nurse.

Jill said: “Each death by suicide is a preventable death. Personalised safety plans are relatively easy and low cost to develop and put in place. You also don’t need to be an expert to support someone to develop one.

“Our research with people who have experience of suicidality has shown that a more tailored and personalised approach is preferred. People can get immediate benefit from it. Working with peer researchers with personal experience of suicidality was a privilege and provided a rich research experience that shaped and informed the project throughout.”

Actively engaging people in their own care.

The work has also been co-led by Professor Darren Flynn, Department of Nursing, Midwifery and Health, Northumbria University. Professor Flynn is also a Practitioner Health Psychologist.

He said “Our research identified the importance of the interactions between practitioners and individuals who are experiencing suicidality to ensure safety plans address their personal needs, preferences, and values. There is a pressing need to move away from uniform risk assessment tools to a person-centred approach, where people are actively engaged in shaping their care and support.”

The Cumbria, Northumberland, Tyne and Wear (CNTW) NHS Foundation Trust is the region’s largest mental health trust and is supporting this project.

Dr Uri Torres, Consultant Psychiatrist and Associate Medical Director for Safer Care at CNTW, said: “Supporting people to make a truly personalised safety plan is a vital part of our approach to self-harm and suicide prevention, as this research has shown. This is a key priority for our Trust, and – informed by the findings from this research project and the guide the team have created – we have recently developed a new training package which will be launched to staff across our Trust very soon, focussed on how and why to develop a personalised safety plan in partnership with individuals we support.”

Watch the video

The team have developed a short film which helps to explain the project in simple terms, in the hope that it will support understanding and awareness – and encourage more health and care leaders to consider adopting the approach.

The film includes a moving testimonial from Paula Mart from Cumbria, who lost her daughter Jaymie to suicide. Paula’s story has influenced this work from the outset.

Next steps

In September 2024, the project team secured NIHR Research for Patient Benefit funding to trial this personalised safety planning framework in different health and social care settings in our region and beyond.

That work is now complete, and a series of roadshows have been planned for Spring 2026 to share the toolkit and discuss how to support its implementation.

Find out more about the roadshows

Where to get help

If you are struggling with your mental health and feel like you need help, there are resources available to support you.

Visit: Samaritans | Every life lost to suicide is a tragedy | Here to listen

Or call: 116 123 for free, 24 hours a day

Visit: Urgent help: Zero Suicide Alliance

Visit: Home – Mind

Visit: Every Life Matters – Suicide Safer Cumbria (every-life-matters.org.uk)

You can also find out more about developing your own safety plan on the Every Life Matters website: Safety Planning – Every Life Matters (every-life-matters.org.uk)