The Living Safety Plan-Kingston (LSP-K)
Living Safety Plan Kingston (LSP-K) is an evidence-informed, person-centered approach to suicide prevention.
Overview
Background
Living Safety Plan Kingston (LSP-K) is an evidence-informed, person-centered approach to suicide prevention. It was developed over the course of ten years by Providence Care clinician, Dave Carmichael, in the context of long-term work with clients living in the community experiencing suicidal ideation. The unique nature of the plan, which includes a focus on meaning not found elsewhere in the literature, was recognized in 2018. The initial work generated a series of projects exploring the evidence for safety planning in general and the qualitative experience of using the LSP-K in particular. The approach was officially adopted as part of the suicide prevention clinical pathway by Providence Care Community Programs in 2024 and a training was developed to support its rollout. In addition to demonstrating good evidence through recent projects, the LSP-K approach meets the safety planning requirements set out by Accreditation Canada in 2023.
The Tool
The LSP-K transcends traditional safety planning practices by centering on active engagement in meaningful activities, relationship building, and promoting hope through existential reflection. The LSP-K gathers together key information and presents it in a step-by-step fashion intended to keep a person safe when suicidal thoughts arise. It includes the key components of traditional safety plans but ultimately goes further through the formulation of an overarching mission or purpose statement and the collection of ‘words of others.’
The Process
The LSP-K process is intended to provide longer-term scaffolding for clients to work toward discovering the ‘why’ to live, through exploring what they mean to others and what they contribute to the world in the form of meaningful activities and relationships. It is this process that turns the document into a ‘living’ therapeutic tool. The process also involves risk assessment, means restriction counselling, health education, identification and activation of key supports, and problem-solving. While a draft of the tool can be completed in one session; the tool is intended to be completed over time and refined in an ongoing way. The LSP-K is a client-focused, collaborative, and dynamic process that is initiated with the therapist, and engages the client and their social network.
Key Benefits
This is an example of a mature Living Safety Plan (LSP). This document represents an LSP that has been continuously and collaboratively refined over time.
Related Research and Projects
The value of this approach was supported by this working group’s systematic review, qualitative case study (manuscript in development), and QI project (ongoing).
Systematic Review
Systematic Review Marshall CA, Crowley P, Carmichael D, et al. Effectiveness of Suicide Safety Planning Interventions: A Systematic Review Informing Occupational Therapy. Can J Occup Ther. 2023;90(2):208-236. doi:10.1177/00084174221132097
Quality Improvement
Implementation Science and Quality Improvement methodologies guided the development of a clinical pathway, a series of training modules, and ongoing clinical supervision to support effective utilization of the LSP-K. The project’s efficacy is being evaluated through pre- and post-training clinician surveys, pilot group feedback, chart audits, and fidelity measures. Initial feedback from training sessions and preliminary chart audits indicate that clinicians across Providence Care Community Programs view the LSP-K approach favorably and are integrating the tool into their practice. Data from pre-post training sessions suggest increased clinician confidence in managing suicidality.
Living Safety Plan-Kingston (LSP-K) References
Download our complete Reference list.
Accessing the Tool and Training
Three training modules are available. Module 1 provides an overview of the subject, Module 2 shares general guidance related to risk screening and assessment, and Module 3 provides training on creating Living Safety Plans with clients. The modules include video examples as well as an editable copy of the Living Safety Plan tool. Please contact the authors to request access to one or all of the modules. Completing all three modules takes approximately 2 hours.
Living Safety Plan-Kingston Request Form
Authors: Dr. Deji Ayonrinde MD, FRCPsych, MBA1,2, Kathy Baker RN1, Dave Carmichael OT Reg. (Ont.)1, Karin Carmichael1, Pavlina Crowley OTR/L1, Terry Landry OT Reg. (Ont.)1, Dr. Carrie Marshall PhD OT Reg. (Ont.)3, Susanne Murphy OT Reg. (Ont.)2, Dr. Katherine Waller Ph.D., C. Psych.1, Kim Schryburt-Brown OT Reg. (Ont.)1, Gordon Unsworth OT Reg. (Ont.)1, Anuson Wijayaratnam RN.1
Affiliations: (1) Providence Care, (2) Queen’s University, (3) Western University
