Safety Planning

What is Safety Planning?

Safety planning is a process where you work with a healthcare provider, counsellor, or crisis worker to create a written plan that helps keep you safe during times when you might be thinking about suicide or self-harm. It is a personalised, step-by-step plan that you can use when you are in crisis to help you stay safe and get through difficult moments.

Why Safety Planning Is Important

• Life-saving tool: Safety planning has been shown in research worldwide to reduce suicide attempts and save lives.
• Immediate access: Unlike therapy appointments or medication, your safety plan is always available when you need it.
• Personal control: It puts you in charge of your own safety and gives you concrete steps to take.
• Crisis preparation: It helps you prepare for difficult times before they happen, when you can think more clearly.
• Global recognition: The World Health Organisation and healthcare systems worldwide recognise safety planning as an essential suicide prevention strategy.

Components of a Safety Plan

Step 1: Warning Signs

Personal warning signs that a crisis may be developing:

• Specific thoughts, feelings, or behaviours that happen before you feel suicidal
• Examples: "I start thinking I am a burden," "I feel completely hopeless," "I cannot sleep for several nights"

Step 2: Internal Coping Strategies

Things you can do on your own to help yourself feel better:

• Activities that distract you or improve your mood
• Examples: Listen to music, take a shower, go for a walk, practice breathing exercises, write in a journal

Step 3: People and Social Settings

People and places that can provide distraction and support:

• Friends or family members you can be around (even if you do not talk about the crisis)
• Public places where you feel safe and less alone
• Examples: Go to a coffee shop, visit a friend, go to the library

Step 4: People You Can Ask for Help

Specific people you can reach out to during a crisis:

• Friends, family members, or other support people
• Include their phone numbers and when they are available
• Have multiple people listed in case someone is not available

Step 5: Professional Contacts

Mental health professionals and crisis services:

• Your therapist, psychiatrist, or other healthcare providers
• Crisis hotlines and emergency services
• Include phone numbers and availability

Step 6: Making the Environment Safe

Removing or limiting access to means of self-harm:

• Removing or securing potentially harmful items
• Having someone else hold onto things temporarily
• Creating physical barriers to impulsive actions

Global Perspectives on Safety Planning

World Health Organisation (WHO): Includes safety planning as a key component of suicide prevention strategies and recommends it as part of comprehensive mental health care globally.

International research: Studies from countries including the United States, United Kingdom, Australia, and Canada show that safety planning:

• Reduces suicide attempts by up to 45%
• Decreases emergency department visits
• Improves treatment engagement
• Increases feelings of hope and control

Healthcare integration: Safety planning is now standard practice in:

• Emergency departments worldwide
• Mental health clinics and hospitals
• Primary care settings
• Crisis intervention services

Creating Your Safety Plan

• Work with a professional: While you can start thinking about your safety plan on your own, it is most effective when created with a trained mental health professional.
• Be specific: The more specific and detailed your plan, the more helpful it will be during a crisis.
• Make it personal: Your plan should reflect your unique situation, relationships, and preferences.
• Keep it accessible: Have copies in multiple places where you can easily find them during a crisis.
• Review and update: Your safety plan should be reviewed and updated regularly as your situation changes.

What to Expect When Creating a Safety Plan

• Collaborative process: You and your healthcare provider will work together to identify what works best for you.
• Takes time: Creating a thorough safety plan usually takes 30-60 minutes, but it is time well spent.
• No judgement: Healthcare providers are trained to discuss these topics without judgment and with understanding.
• Confidentiality: Your safety plan is confidential, though providers may need to take action if you are in immediate danger.

Using Your Safety Plan

During a crisis:

• Start with Step 1 and work through each step in order
• Do not skip steps even if they do not seem helpful at the moment
• Keep trying different strategies from your plan
• Remember that the crisis will pass

When you are feeling better:

• Review what worked and what did not
• Update your plan based on what you learned
• Share your experience with your healthcare provider
• Practice using coping strategies when you are not in crisis

For Family and Friends

How you can help:

• Learn about their safety plan (if they are comfortable sharing)
• Be available when they reach out
• Help remove means of self-harm when asked
• Encourage them to use their safety plan
• Know when to call for professional help

What not to do:

• Do not promise to keep suicidal thoughts secret
• Do not leave someone alone if they are in immediate danger
• Do not try to handle a serious crisis by yourself
• Do not judge or minimise their feelings

Cultural Considerations

• Family involvement: In some cultures, family plays a central role in mental health support and should be included in safety planning when appropriate.
• Religious and spiritual resources: Many people find strength in their faith community, and these resources can be included in safety plans.
• Cultural stigma: Safety planning should address cultural barriers to seeking help and include culturally appropriate resources.
• Language needs: Safety plans should be in the person's preferred language and may need professional translation.

Technology and Safety Planning

• Apps and digital tools: Some smartphone apps can store safety plans and provide quick access to crisis resources.
• Text-based support: Many crisis services now offer text-based support, which some people find easier to use.
• Online resources: Websites provide templates and guidance for creating safety plans.

Research and Evidence

Effectiveness:

Multiple international studies show that safety planning:

• Significantly reduces suicide attempts
• Improves treatment engagement
• Increases hope and sense of control
• Is cost-effective for healthcare systems

Ongoing research:

Scientists worldwide continue to study and improve safety planning methods to make them even more effective.

Key Takeaways

Safety planning is a collaborative, evidence-based suicide prevention tool that helps individuals stay safe during moments of crisis or emotional distress. By identifying warning signs, coping strategies, support systems, and emergency resources, a safety plan provides practical steps to reduce risk and increase hope.

Important points to remember:

• Safety planning is a proven intervention that can reduce suicide attempts and save lives
• A safety plan is personalised to each person’s needs, experiences, and support system
• It includes warning signs, coping strategies, supportive contacts, and professional resources
• Safety plans are most effective when created collaboratively with a trained mental health professional
• Keeping the plan accessible and regularly updated improves its usefulness during crises
• Family, friends, and trusted supports can play an important role in maintaining safety
• Safety planning is a key part of comprehensive suicide prevention and mental health care worldwide

Reaching out for help and using a safety plan are important acts of self-protection and strength.