Suicide Awareness

Completing a Brown Stanley Safety Plan with a Patient

What is a Safety Plan?

A Safety Plan is a prioritized written list of coping strategies and sources of support patients can use who have been deemed to be at high risk for suicide. Patients can use these strategies before or during a suicidal crisis. The plan is brief, is in the patient’s own words, and is easy to read.

Who should have a Safety Plan?

Any patient who has a suicidal crisis should have a comprehensive suicide risk assessment. Clinicians should then collaborate with the patient on developing a safety plan.

How should a Safety Plan be done?

Safety Planning is a clinical process. Listening to, empathizing with, and engaging the patient in the process can promote the development of the Safety Plan and the likelihood of its use.

What are the steps after the Safety Plan is Developed?

  • ASSESS the likelihood that the overall safety plan will be used and problem solve with the patient to identify barriers or obstacles to using the plan.
  • DISCUSS where the patient will keep the safety plan and how it will be located during a crisis.
  • EVALUATE if the format is appropriate for patient’s capacity and circumstances.

Implementing the Safety Plan

There are 6 Steps involved in the development of a Safety Plan.

Step 1: Warning Signs

  • Ask: “How will you know when the safety plan should be used?”

  • Ask: “What do you experience when you start to think about suicide or feel extremely depressed?”

  • List warning signs (thoughts, images, thinking processes, mood, and/or behaviors) using the patient’s own words.

Step 2: Internal Coping Strategies

  • Ask: “What can you do, on your own, if you become suicidal again, to help yourself not to act on your thoughts or urges?”

Step 3: Social Contacts Who May Distract from the Crisis

  • Ask: “Who or what social settings help you take your mind off your problems at least for a little while?” “Who helps you feel better when you socialize with them?”

  • Ask for safe places they can go to be around people (i.e. coffee shop).

  • Ask patient to list several people and social settings in case the first option is unavailable.

Step 4: Family Members or Friends Who May Offer Help

  • Review safety plan with family member or friend that will hold the patient accountable for following the plan. If alone, request patient informs a relative or friend about the plan.  

  • Ask: “Among your family or friends, who do you think you could contact for help during a crisis?” or “Who is supportive of you and who do you feel that you can talk with when you’re under stress?” 

Step 5: Professionals and Agencies to Contact for Help

  • Ask: “Who are the mental health professionals that we should identify to be on your safety plan?” and “Are there other health care providers?”

  • List names, numbers and/or locations of clinicians, local urgent care services.

Step 6: Making the Environment Safe

  • Ask patients which means they would consider using during a suicidal crisis. For methods with low lethality, clinicians may ask patients to remove or limit their access to these methods themselves. Restricting the patient’s access to a highly lethal method, such as a firearm, should be done by a designated, responsible person – usually a family member or close friend, or the police.

  • Ask: “Do you own a firearm, such as a gun or rifle??” and “What other means do you have access to and may use to attempt to kill yourself?”

  • Collaboratively identify ways to secure or limit access to lethal means:

    • Ask: “How can we go about developing a plan to limit your access to these means?”