BOSTON, April 24, 2026 – Rural-residing adolescents are twice as likely to die by suicide compared to their urban-residing peers. To better support crisis care for rural youth, researchers developed Plan & Protect, a technology-guided safety planning program for youth with suicidality seeking care in rural emergency departments. Plan & Protect aims to enhance accessibility, usability, and fidelity of safety planning in resource-limited emergency departments, with a goal of supporting more effective crisis care for adolescents in rural communities. The program and findings from the study will be presented at the Pediatric Academic Societies (PAS) 2026 Meeting , taking place April 24-27 in Boston.
Emergency departments are key access points for youth experiencing mental health crises. Correspondingly, rural emergency departments are well-positioned to implement safety planning interventions. Given their limited mental health resources, digital interventions are especially promising.
"This project, Plan & Protect, was developed in response to the recognition that adolescents in rural communities often rely on emergency departments during moments of crisis, yet safety planning in these settings can feel rushed or disconnected from their experiences," said Nikolas G. Hernandez, medical student at Geisel School of Medicine at Dartmouth and lead author of the study. "By working directly with youth, we found that adolescents preferred safety planning tools that are simpler, more personalized, and more engaging, which directly informed the development of this intervention. Plan & Protect aims to support more effective and accessible crisis care for youth in rural communities."
Researchers conducted semi-structured interviews with rural-residing adolescents (aged 12-17) presenting to a rural emergency department. Youth reported that the incorporation of colorful imagery and relatable content enhanced their engagement, while clear prompts and examples facilitated reflection without feeling overwhelming. Participants also emphasized unique psychosocial challenges faced by rural-residing youth, including resource limitations, need for connection, privacy concerns, and stigma, which informed the tailoring of the safety plan to better meet the specific contextual needs of this population.
Additional information is included in the below research abstract. The PAS Meeting connects thousands of leading pediatric researchers, clinicians and educators worldwide. View the full schedule in the PAS 2026 program guide
