How to Create and Use the Suicide Safety Plan

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I have used the suicide safety plan myself and it is incredibly helpful during times of crisis.

 

It's incredibly hard to work while depressed or suicidal, much less function. It is best that you not complete the suicide safety plan in the middle of a crisis (but I’ve done it). It can be done during a therapist appointment, at your convenience, or right now.

 

Get the Suicide Safety Plan
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Get the Suicide Safety Plan

Join our mailing list to receive an example of the suicide safety plan filled out AND a blank version of the suicide safety plan.

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Follow along to fill out the template. It should take about 30 minutes to fill out.

Suicide Crisis Intervention Plan

Safety plan for suicidal patients According to the Suicide Safety Plan by Barbara Stanley, PhD and Gregory Brown PhD:

"The purpose of the Safety Planning Intervention is to provide people who are experiencing suicidal ideation with a specific set of concrete strategies to use in order to decrease the risk of suicidal behavior.

The safety plan includes coping strategies that may be used and individuals or agencies that may be contacted during a crisis. The Safety Planning Intervention is a collaborative effort between a treatment provider and a patient and takes about 30 minutes to complete."

Follow along to fill out the template. It should take about 30 minutes to fill out.

Suicide Crisis Intervention Plan

Safety plan for suicidal patients According to the Suicide Safety Plan by Barbara Stanley, PhD and Gregory Brown PhD:

"The purpose of the Safety Planning Intervention is to provide people who are experiencing suicidal ideation with a specific set of concrete strategies to use in order to decrease the risk of suicidal behavior.

The safety plan includes coping strategies that may be used and individuals or agencies that may be contacted during a crisis. The Safety Planning Intervention is a collaborative effort between a treatment provider and a patient and takes about 30 minutes to complete."

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What is a safety intervention?

A safety intervention is defined as an attempt to change how things are done in order to improve safety. For the suicide safety plan, this is an intervention as to how to make sure you're safe and that nothing happens to you while you're feeling suicidal.

Remember to write out all the steps first. Then when you’re going through a suicidal crisis, work through the steps systematically. Go through the suicide safety plans step-by-step.

Step 1: Warning Signs

What are the warning signs or leading indicators that something is going wrong? How do you know something is going wrong?

Being bipolar, I have some indicators that tell me when I'm going to have manic episode. It's the same thing with the suicide safety plan. There may be signs that let you know when you're going to be suicidal.

For me, that was feeling overwhelmed. Whenever I felt like life was getting to be too much, and I couldn't handle it, it would tell me that I was on the path to being suicidal.

But it was more than simply just being overwhelmed that gave me the signs. I was also sleeping more. I would have some days where I would sleep 12 to 14 hours in one night. I just couldn't get up to face the day. So I would wake up at around eight hours of sleep, but I would lay in bed and try and sleep for another four hours.

Another sign would be that I would be increasingly irritable. I would snap at the kids. For no reason. Every little thing would grate on my nerves. The dishes not being done would be enough to set me off in a rage.

I would also isolate myself from the kids, generally by being fixated on my phone. I would focus on my phone for hours on end, looking at my email, checking Facebook, or reading the New York Times. It was not a healthy place for me.

All of the signs leading up to suicidal thoughts were in place. I was overwhelmed and I was trying to cope insufficiently for sleeping or isolating myself from the kids. These signs would alert me that I needed to go on to step two.

Step 2: Internal coping strategies

Internal coping strategies are strategies you can use without contacting someone else when you’re having suicidal thoughts. Sometimes, just using the internal coping strategies are enough to keep your suicidal thoughts at bay.

Sometimes listening to the iPhone app, Insight Timer, does wonders. Inside Timer provides both free music and spoken meditations. Some of my favorite medications include:

1. Safe in the Light of Love, by Bethany Auriel-Hagan, 11 minutes

2. Always Feeling Protected the Canopy of Protection Meditation, by Arielle Hecht, 14 minutes

3. Practicing Gentle Kindness Towards Ourself, by Sarah Blondin, 10 minutes

4. Let Go of Your Story, by Michelle Taffe, 19 minutes

5. Sources of Life – Guitar and Strings, Hawaii Healing Music, 14 minutes

Another method is walking. Walking provides bilateral stimulation which means your exercising both sides of your brain when you’re walking.

I like to take a walk around my neighborhood. I enjoy the smells of fresh cut grass in the summers. There’s also the sensation of freshly falling snow in the winter. You can immerse yourself in nature as a distraction from suicidal thoughts.

There are also breathing techniques that you can use to help quiet the mind. Personally, I like the Winhof breathing technique. You can read more about it here.  It basically consists of 30 power breaths, and 1 recovery breath.

Step 3: People and social settings that provide distraction

Not if you’ve done step two, and feel no relief from your suicidal thoughts, go onto step three. Think of people and social settings that can provide some distraction.

In the step, think of the names of two people who are important in your life. Would they be willing to help you when you’re in crisis? At times, and maybe the names of your husband or boyfriend. I’ve also put down the names of my best friends here.

Or, it may be someone that you’ve met in a Facebook support group. Think of all your supports and relationships out there. Who do know that will support you in a crisis?

Now, think of two places that would provide some distraction. Should you be at home alone when you’re having suicidal thoughts? For me, I enjoy going to the coffee shop or if it’s not too late, the library.

Think of two places you enjoy going. You’re just trying to change the atmosphere. It can be upbeat in a coffee shop. It can’t be quiet and comforting in the library.

Once you change your environment, it may be enough of a lift to get you out of suicidal thoughts.

Step 4: People whom I can ask for help

Now, think of three people you can ask for help. These can be the same as the people you go ask for a distraction. These are the people for you are willing to sit down with; and are willing to sit down with you when you’re in crisis.

In this section, I have my husband and two therapists. If you’re close to a parent, you can put down his or her name.

Think of all the relationships that you have. You’re close to some people, and others you just happen to find yourself in the same place as them. Think of your close relationships and think of the people you can ask for help.

When you’re actually in crisis, these are the people that you actually tell that you are having suicidal thoughts.

At times, sitting down and talking with the people whom you can ask for help is enough to stall the suicidal crisis. It can be for 15 minutes or an hour, but you’ll emerge from the conversation feeling better.

Other times, you might have to escalate and contact the professional or agency in step five.

Step 5: Professionals or agencies I can contact during a crisis

Here you can write down the phone number for your psychiatrist, therapist or if you don’t have those two, your primary care physician.

Also, if you’re in a different country, write down the suicide prevention hotline for that country.

It’s incredibly important that a medical professional knows that you’re suicidal. If you’ve gone through steps one to four, and haven’t found any relief, it’s okay to contact a medical professional.

I remember that when I was committed to a psychiatric hospital, I let both my therapist and psychiatrist know that I was suicidal. It was through my psychiatrist’s recommendation that I go to the emergency room, and later the psychiatric hospital.

I remember that I was reluctant to go to the emergency room, but it was the beginning of a long road to recovery for me.

It’s necessary to fill out this part of the plan so that a medical profession is involved if the suicidal thoughts are serious enough. (I didn’t want to fill out this part of the plan. But I can’t always do it all by myself.)

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Step 6: Making the environment safe

I’m going to be honest, sometimes I go straight to step six and make the environment safe first. If my suicidal thoughts are that bad, this is probably the first step I would do.

Think of two ways to make the environment safe. For me, that was telling my husband to lock up my prescription drugs. The second thing was to make sure I stayed out of the kitchen.

Staying out the kitchen was critical for me because of all the knives. Sometimes I suicidal thoughts would get bad enough that I would want to cut myself open with a knife. I was that hopeless at times.

So now it’s your turn. It might mean not going into the car because you may have a proclivity for driving fast when you’re suicidal. It might mean staying in your first floor living room because the rest of the house isn’t safe.

Making the environment safe is critical. If you’re suicidal thoughts are that bad, don’t forget this step.

Step 7: What is life worth living for?

This isn’t a 30 days of gratitude challenge. Think of one thing that life is worth living for. It may be your family, your friends, or even your pet.

Don’t skip filling out this step. When you’re in the middle of crisis, try to think of that one critical thing to keep on going.

For me, it is my family. My husband and my kids keep me going. I would think about what my two-year-old would look like at five-years-old.

I remember when I was feeling this suicidal, sometimes it would be the curiosity about how a project would finish at work that would keep me going. How and when would the project wrap up?

Nevertheless, find a reason that life is worth living for. It can save your life.

Download the suicide safety plan.

Step 8: Save it in a place you’ll find

Now you don’t have to print out the suicide safety plan and post it on refrigerator. But, you’ll need to put it in a place that you’ll always go to when you’re feeling suicidal. For me, between work, school and home, there’s no one place to put it.

But, I always have my phone on me. So I save it in my Dropbox, in the main folder. To quickly find it, I named it “0_Suicide Safety Plan.” You can save it in your Evernote or whatever other file store system you have on your phone.

Or if you have a laptop that you always have with you, you can do the same thing. I would save it on your desktop.

Conclusion

Now you have a suicide safety plan that you can turn to when you’re feeling suicidal. You’ve given yourself a huge resource and the support don’t need to help weather the storm.

Remember, that feeling suicidal is just another feeling. It may be more extreme than others, but remember that the moment will pass as long as you stay living.

It may feel like the world is ending, but the suicidal safety plan gives you some hope, that you’ll get through this process, and there is light at the end of the tunnel.

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