There is so much mystery surrounding “safety plans.” This post is all about helping you understand what they are, what they are intended to do, and how to fill one out.
While ideally, you’d have a mental health professional’s help constructing one for you or your loved one, you can fill out a safety plan for yourself or someone else. Not everyone has access; sometimes you need one before your appointment, which can help guide you.
What is a Suicide Safety Plan?
It’s a concise list of warning signs, coping strategies, and sources of support. A suicide safety plan is like a roadmap that offers an immediate plan of action so you have a guide when your brain goes into tunnel vision, swirling with a tsunami of intense and difficult emotions that make it impossible to make an informed decision.
Hopefully, the plan short-circuits suicide with the coping strategies and connections identified prior to a crisis. Of course, a safety plan is not a perfect solution and has limitations. However, it does help to think through a crisis plan before one hits and therefore is shown to lower risk.
It also helps you identify signs that you might be headed into crisis so you can reset your brain, prepare or blunt the crisis before it happens.
Anatomy of a Safety Plan–The Brown and Stanley
“In the Brown and Stanley model,
Step 1 asks the patient to list warning signs that suggest they are heading toward an emotional crisis [*], and
Step 2 asks the patient to list internal coping strategies [*]. In
Step 3, the patient is asked to list social contracts that may distract the patient from the crisis [*], whereas
Step 4 asks the patient to list family members or friends who may offer help [*].
Step 5 asks the patient to list professionals and agencies to contact for help [*], and
Step 6 looks into making the patient’s environment safe by removing firearms [*].
Patients are also assessed on their likelihood to utilize each step in this model [*]. The answers the patient provided to each of these steps create an individualized safety plan, “a prioritized list of coping strategies and sources of support patients can use who have been deemed to be at high risk for suicide” [*].
The goal of the safety plan worksheet is to help the patient create a safety plan that is “brief, in the patient’s own words, and is easy to read” [*].”
*Citation: Safety planning guide: a quick guide for clinicians. [ Nov; 2021 ]; Stanley B, Brown GK. https://suicidesafetyplan.com/forms/ 2009 2:2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786576/
Downloads of Safety Plan Templates and Examples
These are safety plans for those who have struggled with or attempted suicide. And I also included a version for all of us, a coping card.
- Suicide Safety Plan Templates (not filled in)
- Stanley Brown Safety Plan Template– This is the safety plan most commonly used
- My Suicide Safety Plan (source: Dr. Tracey Marks)
- Make a Safety Plan online
- An Adolescent safety plan from Kimberly O’Brien PhD, LICSW includes a safety plan for the adolescent, one for the parent(s) on behalf of the child, and also a “Safety Scale” for monitoring your child’s mood or level of hopelessness so you are not repeating “Are you thinking of suicide?” so often it gets exhausting.
- Get Kimberly O’Brien PhD, LICSW’s manual for the suicide safety plans, and the template here. (Image of the safety scale and a video snippet link below.)
- See Dr. O’Brien talk about this safety plan on video
- See more about Kimberly’s Safety Plan for adolescents in this post, Helping Teens with Suicidal Thoughts, Make a Safety and Coping Plan, on SpeakingofSuicide.com.
- CRP = Crisis Response Plan– This type of crisis plan is written in the patient’s handwriting on an index card (Crisis Response Planning, CRP, was developed by Drs. David Rudd and Craig Bryan and was used initially for military veterans.) Examples can be seen if you scroll down.
- The Coping Card– Below is a streamlined and simplified version of a safety plan for everyone, which I call a coping card and do with students in middle schools, high schools, and universities. It’s a plan of what a person might do when they run into an adverse life event because no one has a perfect life with no speedbumps. And having a plan and thinking about who to talk to is important to think about ahead of time.
- Suicide Safety Plan Templates (filled-in examples)
- Example Safety Plans for Youth and some for adults
- This is an example of a safety plan submitted by Stacey Fredenthal PhD, LCSW.
- This youth safety plan from Kimberly O’Brien PhD, LICSW includes one for parent(s) on behalf of the child. The safety plan pdf with examples is here.
- Get Kimberly O’Brien PhD, LICSW’s manual for the suicide safety plans, and the template here.
- If you, a loved one, or a patient is having difficulty filling in “Reasons for living.”
- Or it might be that you ask an additional question to try and elicit a response. The question, “What has kept you alive in the past?” is often used in this case.
- It might take more time. Do write down the heading “Reasons for living” then move to the next heading and come back to “Reasons for Living” if someone needs time to process. These are things and people who are important to you and sometimes it takes time
- Resource if you or someone you know has a child who has attempted suicide.
- A 55-minute documentary called “After Your Child’s Suicide Attempt.” on YouTube
- The documentary, “After Your Child’s Suicide Attempt,” broken down into chapters
- Parent Resources are here
Video to Help with A Safety Plan
You’ll get commentary from both parents and experts on the topic of safety plans.
- The safety plan part of the video “After Your Child’s Suicide Attempt”
- Dr. O’Brien talks about the Scale pictured below (It’s at the very beginning)
Image examples of safety plans below
This is one I did, as a non-clinician on a Word doc, for someone I know until she could meet with a mental health professional. But even if she did not, she would have something.
Below is an example from CRP, the Crisis Response Plan, developed first for veterans but also used in other groups, too.
The Coping Card
This is a streamlined, simplified version for everyone. I do this with students, adults, and not just people with suicidal thoughts. This is a plan for managing life’s adverse events. I’ve done this with 500 students and 30 students. When I do this with a large group, I usually have a presentation and I tell stories, do the first part, “Reasons for Living.” Then I tell more stories and strategies, and do the next section. So it’s spaced out.
When I have done it that way, most every student leaves with a completed card. Even if they don’t keep it, making the plan helps them think about what they would do in an adverse situation. A link for the eBook for this is below.
Coping Card Activity (PPT and PDF) The coping card activity for everyone
My child has been suicidal. What do I do now?
A what to do, what to say guide for caregivers.
This free 20-page eBook focuses on how to manage the conversations & emotions you are experiencing after a child has confessed to suicide, attempted suicide, or is coming home after a hospital stay after an attempt.
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Sources
Safety planning guide: a quick guide for clinicians. [ Nov; 2021 ]; Stanley B, Brown GK. https://suicidesafetyplan.com/forms/ 2009 2:2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786576/
Safety Planning: Why It Is Essential on the Day of Discharge From In-patient Psychiatric Hospitalization in Reducing Future Risks of Suicide
Schuster H, Jones N, Qadri SF. Safety Planning: Why It Is Essential on the Day of Discharge From In-patient Psychiatric Hospitalization in Reducing Future Risks of Suicide. Cureus. 2021 Dec 23;13(12):e20648. doi: 10.7759/cureus.20648. PMID: 35106206; PMCID: PMC8786576.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786576/
Why does safety planning prevent suicidal behavior? American Psychological Association
AnneMoss Rogers is a leading wellness and suicide education expert and one of the top mental health speakers and suicide prevention speakers. Known for her powerful, motivational keynotes, AnneMoss combines her personal story of loss with proven strategies to help organizations build a wellness culture that drives results and saves lives. She speaks at conferences, workplaces, K-12 schools, and universities, delivering impactful presentations that inspire change and promote mental health awareness.
AnneMoss does this work in memory of her son, Charles, who struggled with anxiety, depression, and addiction, and died by suicide at age 20 in 2015.
I am dismayed by a recent article in Psychiatry Advisor by Ron Goldberg. He reports a study that found no link between safety planning and reducing adolescent suicide. He did admit that limited research was available. I strongly believe the limited evidence might find a weak association but if even one adolescent finds a safety plan to be helpful then the exercise is worthwhile. How do we make them more useful to more adolescents?
P.S Enjoyed your keynote and presentation at the Vermont Suicide Prevention Symposium.
I answered this and now it is gone. So I will try again.
First, thank you for your compliments. You make me blush.
I agree with you on the study. So many studies say differently.
I think if we throw a safety plan at a parent and child in the ER, then we would get those results. The hospital process is not always very compassionate, but more of a check-the-box approach. Some do it very well, however.
I like Dr. O’Brien’s the best. And then the CRP, Crisis Response Plan, which was first developed for the military. The link below is the one from Dr. O’Brien: https://www.khmobrien.com/adolescent-safety-and-coping-plan
Dr. O’Brien talks about it at the beginning of this video. https://youtu.be/A8jWIzOVM8c?si=-ztNBP_j8XdaIhGk
>video chapters are here: https://www.youtube.com/playlist?list=PL7E-oJDps0zXb9YLP7Cssb0rYT7W2oJS4 and
>full video here: https://youtu.be/BfXjdmfyBmI?si=jl1hIRkTK90kLbOs)
Dr. O’Brien and I are going to do a breakout on Safety Planning at the December Suicide Prevention conference in Utah.
In the event of a crisis, hospital should ALWAYS be a last resort, should nothing else help! Just because someone has thoughts of suicide, doesn’t necessarily mean that they will act on them but I also feel that if you are having chronic thoughts of suicide but with no intent, then this group of very vulnerable people don’t get taken seriously or receive the same understanding & support as those who have intent/or have attempted but that’s just my opinion. My mum is very much of the belief that those who really want to end their lives, don’t talk about it! I pointed out to her, but what about the ones who did talk about it & still went on to attempt to take their own lives? I’m one of them people, I openly discussed how I felt & I still followed through with the plan, I can’t remember the last time I tried anything but I’ve got to the point where I have no desire to try anymore as I’ve failed so many times before, either I don’t deserve peace from my brain or I’m not trying hard enough.
Cheyenne- Thank you for being so open and vulnerable and explaining how it feels from the point of view of someone who lives with these thoughts. This will be very helpful to help other people see from another point of view.
AnneMoss – I feel honoured that you included my ‘Safety Plan’ in this post, although I do feel it needs updated, so when you have some free time, could you send me the latest one that I emailed you please? I know that I want to officially add you under ‘Reasons for Living’ 🥰
Ok. I will try to remember to do that!
Thanks love, I’m in no rush for it, so send it whenever you can. I’ve came to a standstill with ‘feeling my feelings’ & as much as I know that the road to recovery or healing isn’t linear, it’s got me thinking that I’ve buried the pain so much that it can never be accessed.
Thanks for sharing these Safety Plans with us.
The most difficult thing for myself is that I don’t really feel that can share how I really feel when in my daily thoughts and emotions (let alone in my darkest moments) and so I find myself halting when the Plan asks me to list trusted people who I can turn to. And because I can think of no one, such can often make me feel very alone.
I really don’t feel that there is simply no one.
The way I cope with this is to imagine the pain that others would maybe feel if l were to leave this life. And so I just sit in my feelings and tell myself to accept what l feel and that it will eventually pass from me. Sometimes it’s easy and other times, not so.
But saying all this l still believe that these plans are extremely important and encourage folk to try to put these in place as a safety measure. If things became too overwhelming, l would hopefully read my poster that is on my fridge, urging me to phone for an ambulance and then have the courage to do so. This is a piece of sage advice from a psychiatrist that I dealt with after losing my partner to suicide.
Usually that one and the “reasons for living” are sticking points for people. Choosing someone is hard. But having that conversation ahead of time and sort of interviewing people when they don’t know they are being interviewed is one way to filter out the ones who will always offer unsolicited advice when you need them to listen. Others are close enough and you can specify that you want them to listen and not offer advice.
Here in the USA we have warm lines. They are not crisis lines but they are people you can call when you feel those initial feelings of worthlessness. It can circumvent a crisis. I know you have Samaritans but not sure if you have a warmline (warmlines.org). And does the UK have suicide loss support groups. Because in those, there are usually people who are also struggling with thoughts of suicide.
At any rate, you can let it marinate and fill in slowly those who might make the list. They’d be the honored ones. No matter what you do, I really appreciate your candid post here. I am going to bet there are others who feel as you do and maybe when they read this they will feel less alone.
Good info.
However it’s hard even stand up, not only take a walk or bike when depressed.
Future without my daughter also doesn’t show hope or light.
I’m reading a book “Suicide. The forever decision”. It will help me, help to understand my daughter and what’s too late, and help me to support other people who need help.
I did not think I could survive losing my son. I had trouble getting out of bed, too. I can only share what I did. I
told myself to put my feet on the floor and said that was all I had to do. Then I gave myself one more step. So when things felt insurmountable, I just broke it down in microsteps and sometimes I had to write it on post it notes as weird as that sounds.
Eventually I’d be outside with my shoes on wondering how it happened. I would run back then with my leaded limbs. I would start off crying but by the end, I had cried myself out. It was hard to get out of bed for a long time. I cried first thing in the morning I don’t know for how long.
It was like I was underwater in another universe that moved really slowly.