Designing Safety Plans with Suicidal Individuals

A safety plan is a written list of those activities that allow us to do three things:

  1. Recognize when a crisis is occurring
  2. Recognize who our supports are
  3. Make immediate next-steps for planning

Safety plans are not checklists, and they should not be used in place of having a real conversation. They help provide a sense of control and a reminder to suicidal individuals that they have resources to rely on.

Warning Signs

Warning signs are anything that indicates a suicidal crisis might be coming. This are unique but some examples could be a change in physical or mental health status, a fight with someone, academic or occupational difficulties, financial problems, and anything else that will trigger your suicidal thoughts.

You can ask questions like:

  • What do you think led you to feeling suicidal?
  • How is today (or when you felt suicidal) different from yesterday?
  • What things would have to change to take these suicidal feelings away?

Support Network

Your support network is all of the resources you draw on to help yourself get through a crisis. They include internal supports, external supports, and peripheral supports. You can read more about this on my support network article.

Internal Supports

  • Future Hopes and Dreams
  • Positive Value System
  • Religion and Spirituality
  • Past Experiences
  • Listening to music
  • Taking a hot bath

External Supports

External supports are those friends and family who we’re close to, and can rely on when our internal supports just aren’t good enough.

  • Friends
  • Family
  • Pets
  • Boss / Colleagues
  • Mentor

Peripheral Supports

Peripheral supports are the professionals we move to when our external supports are not qualified.

  • Counsellor / Therapist
  • Crisis Lines
  • Mobile Crisis Teams
  • Information and Referral Services
  • Social Service Agencies

Strategies for Reducing Risk in a Crisis

There are a number of steps a person can take depending on their level of suicide risk. The traditional model is a three-pronged approach.

Low Risk

Low risk focuses on active listening. By exploring with the person what led them to have these suicidal thoughts you can help them feel some catharsis and emotional relief. There is no need to be directive here, or even to offer resources unless the person wants them.

Medium Risk

In medium risk situations it is important to focus on a collaborative safety model. This may include counseling on access to lethal means, referrals and follow up. This ensures that someone who might attempt suicide in the medium term is able to access enough support.

One important element about referrals: the referrals that have the best uptake are existing or past referrals, while the lowest rate of taking action is to new referrals. (Gould, et. al., 2012)

High Risk

In high risk suicide situations we will focus on emergency referrals and unilateral intervention. Mobile crisis teams, hospitals and police will be the appropriate referrals at this stage.

In the case of a suicide attempt in progress, getting an ambulance will be of utmost priority.

Sample Safety Plan

Stanley & Brown (2008) wrote a safety plan and accompanying manual that can be used with adults, particularly veterans. It would require some changes to the wording for use with youth but the principles are the same.

Bibliography

Gould, M.S., Munfakh, J.L.H.,  Kleinman, M., Lake, A.M. (2012) National Suicide Prevention Lifeline: Enhancing Mental Health Care for Suicidal Individuals and Other People in Crisis. Journal of Suicide and Life Threatening Behavior. doi: 10.1111/j.1943-278X.2011.00068.x

Stanley, B., Brown, G.K. (2008) Safety Plan Treatment Manual to Reduce Suicide Risk: Veteran Version. Department of Veterans Affairs.



Cite this article as: MacDonald, D.K., (2015), "Designing Safety Plans with Suicidal Individuals," retrieved on October 23, 2017 from http://dustinkmacdonald.com/suicide-safety-planning/.

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