Co-creation of Tools for People in Detention With Suicidal Thoughts and/or Behavior

People in detention are at significantly higher risk of suicide compared to the general population. In Belgian prisons, the suicide rate is five times higher than average. Despite the availability of suicide prevention tools, many are not scientifically validated or adapted to the detention context, leading to inconsistent use and missed warning signs.

This study aims to evaluate and adapt three evidence-based suicide prevention tools-the Safety Plan, the guideline for the care and evaluation of suicidality , and the Risk Formulation template-for use in detention settings. Through interviews with both professionals working in prisons and individuals in detention, the study explores how these tools can be made more relevant, practical, and effective in this unique environment.

The research involves 40 participants: 20 professionals and 20 individuals in detention. Interviews will gather feedback on the tools' usability, clarity, and fit with the realities of prison life. The ultimate goal is to improve suicide prevention practices in detention by offering tailored, scientifically grounded tools that support both staff and detainees.

Study Overview

• Status: Recruiting
• Conditions: Suicidal Ideation; Suicide; Suicide Prevention
• Intervention / Treatment: Other: Co-creation process for suicide prevention tools in detention

• Study Type: Observational
• Enrollment (Estimated): 40

Contacts and Locations

• Study Contact: Name: Eva De Jaegere, PhD; Phone Number: +32 (0)9 332.07.75; Email: eva.dejaegere@ugent.be
• Study Contact Backup: Name: Kirsten Pauwels, Msc; Phone Number: +32 (0)9 332.07.75; Email: kirsten.pauwels@ugent.be

Study Locations

• Belgium
  • East-Flanders
    • Ghent, East-Flanders, Belgium, 9000
      • Recruiting
      • Flemish Centre of Expertise in Suicide Prevention, Ghent University
      • Contact: Eva De Jaegere, PhD; Phone Number: +3293320775; Email: eva.dejaegere@ugent.be
      • Sub-Investigator: Eva De Jaegere, PhD
      • Contact: Roberto N Di Bisceglie, MSc; Phone Number: +32 (0)473265176; Email: roberto.dibisceglie@ugent.be

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Participants will be drawn from Belgian detention facilities and the prison-based care network. Specifically:

• Professionals working in detention: Psychologists, psychiatrists, social workers, nurses, and other healthcare staff working within Belgian detention centers who have had experience in suicide prevention.
• People in detention: Adults held in selected Belgian prisons who are clinically stable and able to participate in a one-hour interview. Referrals will be made by prison psychologists, social workers, or healthcare staff.

Description

For professionals working in detention:

Inclusion criteria:

• Aged 18 years or older
• Currently working in a professional care role within a prison setting (e.g., psychologist, psychiatirst, social worker, nurse, etc.)
• Experience in supporting or treating incarcerated individuals with suicidal thoughts or behaviours

Exclusion Criteria:

• Under the age of 18
• Not employed in a professional caregiving role within detention (e.g., correctional officers or security staff)

For people in detention:

Inclusion criteria:

• Aged 18 years or older
• Experienced suicidal thoughts within the past three years

Exclusion criteria:

• Under the age of 18
• Significant cognitive limitations that would make the participation in an interview infeasible
• Insufficient command of the Dutch language to understand and respond to interview questions

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Individuals in detention; Participants are individuals in detention which is invited to participate in semi-structured interviews. If they agree, their referrer will schedule a date for the interview at the prison with the researcher.	Other: Co-creation process for suicide prevention tools in detention; The intervention consists of a co-creation process involving detained individuals and detention professionals through semi-structured interviews. For professionals, the interviews will focus on the usability, applicability, and implementation of three suicide prevention tools. Interviews with individuals in detention will focus only on the Safety Plan. They will be asked about what helps them in moments of crisis and their views on the Safety Plan in detention. The goal is to collect feedback on usability, perceived barriers, and suggestions for real-world implementation in the detention context. Interviews are repeated up to three times per professional participants depending on availability and co-creation progress. For individuals in detention there is only one interview. Feedback from all participants will be used to adapt and refine the tools for future use in detention facilities.
Professionals working in detention; Participants are professionals working in detention settings, such as psychologists, psychiatrists, social workers, and nurses. They are invited to participate in semi-structured interviews. If they agree, the researcher will contact them to schedule a date for the interview at the prison.	Other: Co-creation process for suicide prevention tools in detention; The intervention consists of a co-creation process involving detained individuals and detention professionals through semi-structured interviews. For professionals, the interviews will focus on the usability, applicability, and implementation of three suicide prevention tools. Interviews with individuals in detention will focus only on the Safety Plan. They will be asked about what helps them in moments of crisis and their views on the Safety Plan in detention. The goal is to collect feedback on usability, perceived barriers, and suggestions for real-world implementation in the detention context. Interviews are repeated up to three times per professional participants depending on availability and co-creation progress. For individuals in detention there is only one interview. Feedback from all participants will be used to adapt and refine the tools for future use in detention facilities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of Suicide Prevention Tools in the Detention Context	This outcome measure assesses the usability, applicability, and improvement potential of three suicide prevention tools based on qualitative feedback from professionals working in detention and individuals in detention. Through semi-structured interviews, the study explores how these tools are experienced in practice, identifies perceived strengths and limitations, and gathers concrete suggestions for adaptation to better fit the detention environment.	Each participant is assessed during one (for incarcerated individuals) or up to three (for professionals) interviews

Collaborators and Investigators

• Sponsor: University Ghent
• Investigators: Principal Investigator: Gwendolyn Portzky, PhD, Flemish Centre of Expertise in Suicide Prevention (Ghent University)

Study record dates

Study Major Dates

• Study Start (Actual): October 27, 2025
• Primary Completion (Estimated): May 1, 2026
• Study Completion (Estimated): May 1, 2026

Study Registration Dates

• First Submitted: September 12, 2025
• First Submitted That Met QC Criteria: November 26, 2025
• First Posted (Actual): December 2, 2025

Study Record Updates

• Last Update Posted (Actual): December 2, 2025
• Last Update Submitted That Met QC Criteria: November 26, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Suicide prevention; incarceration; Safety Planning; prison; Safety Plan; detention; Risicoformulering; risk formulation
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Behavior; Suicide Prevention; Suicide; Suicidal Ideation
• Other Study ID Numbers: ONZ-2025-0349

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No