An Empirically Based, Recovery-Orientated Framework for Safety Planning Interventions for Suicide Prevention: An Integrative Literature Review and Critical Meta-Autoethnographic Synthesis.

INTRODUCTION

Safety planning interventions are increasingly used in suicide prevention, yet their design and delivery often lack alignment with personal recovery principles.

AIM: To explore with lived experience, empirical literature on safety planning for suicide prevention and examine the relationship between change mechanisms and personal recovery concepts.

METHOD: An integrative literature review was conducted combined with critical meta-autoethnographic synthesis. Data were analysed using the Donabedian Model of Healthcare, the Conceptual Framework for Personal Recovery, lived experience and translated using reciprocal and refutational synthesis.

RESULTS

Fifteen studies were included. An empirically based recovery-orientated framework was developed comprising three phases of personal development-Inspiring, Discovering and Embodying-and three mechanisms of change-Learning, Introspection and Self-reflection. The framework reconceptualises the clinicians' role as 'facilitator' highlighting the importance of relational, personalised approaches.

DISCUSSION: The findings challenge dominant biomedical approaches, offering a more personalised, recovery-focused understanding of safety planning interventions.

IMPLICATIONS FOR PRACTICE: The framework supports delivery of person-centred care, policy implementation, service redesign and workforce training aligned with NHS and WHO guidance.

RECOMMENDATIONS: Future research should evaluate the framework's effectiveness and explore its application in diverse populations and settings.