A safety plan is a prioritized list of coping strategies that someone at risk of suicide can use before or during a crisis. A safety plan includes six steps (Stanley & Brown, 2008):
- A list of warning signs: Ask, “what do you experience when you start to think about suicide or feel extremely distressed?” The list should include thoughts, images, moods, situations or behaviors that might trigger suicidal thinking or indicate that a crisis is about to occur.
- Internal coping strategies: Ask, “what are some things that you can do to take your mind off your problems by yourself without having to contact another person?” Examples might include watching TV, reading, listening to music, going on the internet, exercising/going for a walk, cleaning, playing video games, playing with a pet, or cooking.
- People and social settings that provide distraction: Ask, “who takes your mind off of your problems,” or “where are some safe, healthy places that you can go to?” Examples of places might include bookstores, coffee shops, the gym, the library, a shopping mall, a park, a church, or a friend’s house.
- People whom I can ask for help: Ask, “who are the people that you feel comfortable confiding in or reaching out to in a crisis?”
- Professionals or agencies to contact in crisis: Professionals or agencies to list here include the person’s psychiatrist and/or therapist, the Suicide Prevention Lifeline, Grassroots Crisis Line, Maryland Crisis Line, the nearest hospital, local urgent care services, churches/congregations, or 911.
- Making the environment safe: Ask, “what means would you consider during a suicidal crisis?” Ways to make the environment safe includ removing access to firearms and removing other lethal means, including limiting the supply of pills on hand.
A person at risk of suicide should write his or her plan down and keep it somewhere easily accessible, like on their bedside table, in their wallet, or on their smartphone by taking a picture of it. The goal is to start with step one and progress through the steps, using the least number necessary to stay safe. If, after completing a step, a person is still having suicidal thoughts, he or she can proceed to the next step.