Suicide Safety Plan

These steps can be followed in order to help overcome a suicidal crisis.

Mental health challenges, such as depression, can also be accompanied by suicidal thoughts. Managing these thoughts can be difficult, and it’s easy to lose sight of the people and things we care about.

A Suicide Safety Plan is designed to provide assistance and direction when/if we are facing overwhelming suicidal thoughts. Its purpose is to guide us through difficult times and prevent thoughts of suicide from getting even worse, or us acting on them.

Studies have shown that simply creating a Suicide Safety Plan can, itself, reduce the risk of suicide.[1] The process of creating a Suicide Safety Plan reminds us of the important people we have in our lives and that we have multiple resources available to us.

We recommend keeping two copies that you can quickly and easily access:

  • Printed (e.g., on a piece of paper in your wallet)
  • Digital (e.g., accessible both on- and off-line on your phone)

A Suicide Safety Plan consists of six steps:

  1. Warning signs and triggers
  2. Self-care coping strategies
  3. People and places that can be used for distractions
  4. People that can be contacted in a crisis (and their contact details)
  5. Mental health professionals and crisis support lines
  6. Steps to make our environment safe
  7. Reasons to stay alive

We’ll go through each part in detail below:

CREATING A SAFETY PLAN

Creating your safety plan with a trusted friend, family member, or professional can be very helpful.

  • This can also help reassure the people who care about us, so they know we will contact them if we’re in a crisis.

This can be a ‘living’ document that you revise and add to as you learn more about yourself and how best to manage your mental health.

STEP 1. WARNING SIGNS AND TRIGGERS

Under this heading, we want to list anything that can trigger negative emotional spirals that lead to thoughts of suicide.

Here are some examples to help get you thinking about your own warning signs and triggers:

  • Situations: Feeling rejected in some way
  • Thoughts: “I’m a failure, why do I even try anymore”
  • Emotions: Feeling immense shame or guilt
  • Urges: To get drunk or abuse drugs
  • Behaviours: Having gotten little or no quality sleep for several nights in a row

STEP 2. SELF-CARE COPING STRATEGIES

In this section, we want to list the strategies for managing suicidal thoughts that work best for us and that we can implement on our own.

For example:

  • Relaxation techniques: Engaging in deep breathing or visualizations
  • Physical Activity: Going for a walk, jog, or bike ride
  • Distractions: Playing an easy, stress-free game on your phone or gardening

STEP 3. PEOPLE AND PLACES THAT CAN BE USED FOR DISTRACTIONS

Here we want to brainstorm ways we can surround ourselves with people we care about or move ourselves to a more public setting that can help distract us from intrusive suicidal thoughts.

Think about the people and places in your life that make you feel good or that you have enjoyed in the past. These could include:

  • Places: Your favourite coffee shop or park
  • People: List of friends or family members you could contact or visit

Try to have a few different options listed in case one isn’t available when you need it. For example, if you find suicidal thoughts come on more strongly late at night, make sure to include someone who is comfortable messaging or talking with you in later hours of the evening, or a social setting that will be open, like a 24-hour cafe.

STEP 4. PEOPLE THAT CAN BE CONTACTED IN A CRISIS (AND THEIR CONTACT DETAILS)

Suicidal thoughts can be so overpowering that we forget about the people who care about us and want to help. Having their contact information on hand makes it easy to reach out during a crisis.

Create a list of people you are comfortable talking with about your suicidal thoughts and who are comfortable helping you out if a crisis occurs.

For example:

  • Friend: work phone, cell phone
  • Brother: work phone, cell phone
  • Parent: work phone, cell phone

Try to list at least three support persons who are able to provide support, are aware of existing resources you can access, and know that they are part of your safety plan.

STEP 5. MENTAL HEALTH PROFESSIONALS AND CRISIS SUPPORT LINES

Here we want to list contact information for mental health professionals or resources who can help us through suicidal crises.

  • Therapist: work phone, cell phone, office hours available
  • Hospital: address of nearest hospital
  • Crisis Line: local crisis number

STEP 6. MAKING OUR ENVIRONMENT SAFE

A list of things to remove or restrict access to in our immediate environment and someone we can ask to help with this. For example:

  • Potentially harmful objects: Removing knives or firearms from your household
  • Limiting access to: Alcohol, drugs (prescription and non-prescription, as well as recreational drugs), and other substances that could lower your inhibitions or affect your mood negatively
  • Friend who can help: Name, cell phone

STEP 7. REASONS TO STAY ALIVE

A list of all the things we care about (people, places, hobbies) or have enjoyed before (happy memories, positive experiences, or simple pleasures).

ADDITIONAL TIPS

  • Practice the strategies you’ve written down in Step 2, so you know what works best for you.
  • Imagine yourself calling each person you listed for Step 4. Is this someone you feel comfortable talking to about suicidal thoughts? If not, replace them with someone else who would be comfortable.
  • Share your plan with a trusted friend and/or mental health professional.

Next Steps


References

  1. Stanley, B., Brown, G. K., Brenner, L. A., Galfalvy, H. C., Currier, G. W., Knox, K. L., Chaudhury, S. R., Bush, A. L., & Green, K. L. (2018). Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA psychiatry, 75(9), 894-900. https://doi.org/10.1001/jamapsychiatry.2018.1776