What is a Safety Plan and how do you use it?
by Lacy Taylor, Mental Health Therapist at SBS
Have you ever had a friend or family member go to the hospital or ER and leave with something called a Safety Plan? It can be hard to understand what this document is, how is it used, and who should have one if it’s the first time you’ve seen one. A Safety Plan is a document explaining how to help yourself or someone else in a crisis. A Safety Plan can be developed by anyone; many free printable forms can be found online or there are free smartphone apps such as “My 3” and “Suicide Safety Plan.”
Definition of ‘Crisis’
First let’s explain what a crisis might be. A crisis is different for every person. To some, a crisis is an intense uncomfortable feeling, thought, or even an urge to engage in a possibly harmful activity. To others it might be feeling really down, overwhelmed, or out of control. The crisis might be triggered by a specific event or it may come out of the blue. Examples include urges to inflict harm on yourself, having thoughts of suicide, or abusing alcohol or drugs.
A Safety Plan has seven key parts laid out in a specific way for a person in crisis to use, starting at the top and going down the page.
The first part is identifying Warning Signs. Warning signs can be anything that person identifies as ways for themselves and their loved ones to know they are possibly building up to or are in a crisis situation. Examples can be specific thoughts, feelings, or certain actions such as isolating more, not answering calls or texts, crying a lot, sleeping all the time, not sleeping at all, drinking more etc.
Internal Coping Strategies
The next section is Internal Coping Strategies, which are healthy things a person having thoughts of self-harm or suicidal thoughts can do on their own (without the help of anyone else) to distract themselves from their problems. This area is important because often, given time, if someone utilizes internal coping strategies, their urges to inflict self-harm or attempt suicide will decrease, and they will return to feeling safe and may not have to utilize the next step of the safety plan. Examples of these coping strategies are reading, writing, coloring, listening to music, going for a walk, etc.
People and Social Settings
If a person has tried to distract themselves, and they still feel urges to harm themselves or continue to have suicidal thoughts, the next section is People and Social Settings that can provide a distraction. The people listed in this section do not have to know about how the person feels, but are merely people to talk to so they can focus on things outside of their present situation for a time. These people should still be positive supports. Places in this section should be safe places, preferably with people there. Examples are the local library, dog park, or it could be as simple as being in the living room if they live with other people.
People to Ask for Help From
If negative and harmful thoughts or urges are still troublesome, the next section is People To Ask For Help From. These people should trusted enough they can help them stay safe when needed. The people listed in this section should be given a copy of the Safety Plan in advance, ideally just after it is developed. They should have a conversation about what the Safety Plan is and how to use it. People listed in this section can help the person stay in a safe environment until the thoughts or urges decrease or help them get professional help if needed.
Professionals That Can Be Contacted During a Crisis
The next section is Professionals That Can Be Contacted During A Crisis. The person’s counselor, psychiatrist, primary care physician, local emergency room, and local crisis numbers are all going to be listed here if applicable. On every Safety Plan there should also be the National Suicide Prevention Hotline phone number (1-800-273-TALK), and the crisis text line called Hopeline: text “hopeline” to 741741. Both of these services have trained crisis counselors available 24 hours a day and are free to use.
How to Keep the Environment Safe
How To Keep The Environment Safe is the next component. Keeping the immediate environment safe from lethal means is very important when someone is in crisis. Examples of this are to not have more than a weeks’ worth of prescription medication and only a few doses of Tylenol or other over the counter medications on hand. Also remove any guns from the home, lock up knives, razors, and other sharp objects, and keep their bedroom door cracked open a little until they are safe again.
Things that are Most Important and Worth Living For
Last, and most important, is a list of Things That Are Most Important And Worth Living For. In a crisis situation people often forget about things in their life that are positive and hopeful. At the time, they might only see negative things in their life. This section helps to remind them the positive things in their life. Examples of things to list in this section are family, friends, pets, job, future, etc.
A Safety Plan should be shared with key people such as close friends, family, and mental health professionals. Conversations about how it is used are important so everyone understands how they can help someone in a crisis. A Safety Plan can be updated at any time if something is found to not be helpful or other supports are gained and can be added. Having ways to support each other through tough times is important, and a Safety Plan can help.