By Pam Dewey • mental health, mental health treatment, therapy, suicide, suicide prevention, safety plan, suicide safety plan, suicidal thoughts, suicidal intent, mental illness, treating severe depression, support for suicidal tendencies, preventing suicide, support for people with suicidal intent • September 29, 2022
A safety plan might sound like something you’d use in case of a fire. For people with severe depression, borderline personality disorder and other mental illnesses, a safety plan can be a life-saving tool that prevents them from following through on suicidal feelings.
Here’s what you need to know about safety plans.
What is a safety plan?
A safety plan is usually created with a therapist, a person with suicidal thoughts or intent and if that person is a minor, a parent. VeryWell Mind states, “It contains a series of gradually escalating steps that you follow, proceeding from one step to the next, until you are safe.” A safety plan is typically written down and shared with all of these parties. The plan should also be documented in a person’s health record.
Why is a safety plan particularly important for teenagers?
Teenagers are dealing with an influx of hormones and changing bodies. They are also generally more impulsive than adults. In a Child Mind Institute article, Dr. Joanna Stern states, “Adults tend to make a plan — they will often have left a note. But that’s usually not the case with teenagers. Making this safety plan for teens is to create more barriers, in that time when they’re at highest risk, to acting on those impulses.” A safety plan isn’t a guarantee, but it can encourage people to pause and think more about their decision.
What is included in a safety plan?
The first step of a safety plan is recognizing warning signs. This will be different for each individual, but some warning signs might include thoughts of dying, isolating themselves or thinking people would be better off without them. Some situations may also be triggers, like a breakup with a romantic partner or losing a friend or loved one.
The second step is coping or calming strategies, like journaling, exercising, listening to soothing music, cuddling with a pet, going for a hike, baking or painting. It’s helpful to pick a few things that work.
Naming reasons to stay alive is the next step. This may be particularly hard to get teens to do. In a Child Mind Institute article, Dr. Joanna Stern states, “Sometimes they say ‘Nothing. There’s nothing worth living for. It’s really on us as the clinicians to work with them and say, ‘Okay, is there something even short term?’” This could be something like a concert they’re looking forward to, or that their pet would miss them. It could also be bigger things like seeing their sister grow up or graduating from high school or college.
The next step is creating a list of contact information for trusted people, like a best friend, a teacher, loved ones, a significant other or perhaps a religious leader. They should include a few names and phone numbers, in case someone isn’t available when they reach out.
The plan should also include professional contacts, like a therapist, school counselor and national resources, like the National Suicide Prevention Lifeline — now known as the 988 Suicide & Crisis Lifeline. People can call or text 988 to be connected with a local crisis counselor. Individuals can also access an online chat feature here.
How can parents help?
Parents may find it difficult to face their child is feeling suicidal. The Child Mind Institute states, “Validating their feelings by listening to them calmly, without judgment, is crucial to enlisting the child in not acting on impulses to harm themselves.” So listening and paying attention is critical to getting your child help. It’s important for parents to know that asking about suicide doesn’t increase a person’s risk to act. Instead, the risk is much greater by not asking or making a plan.
Parents should also make some plans. The Child Mind Institute suggests, “parents identify the nearest emergency room and, if there are several, which has more expertise and resources for handling psychiatric emergencies in children and teenagers — such as a child psychiatry training program and an inpatient unit in case a child needs to be admitted.”
Remove unsafe objects
Parents should also ask about their child’s suicide plans, so they can make the environment safer. Perhaps they planned to take an overdose, so parents can place pills in a lockbox or safe. Remove guns from the home, or lock guns in a gun safe that only you know the combination for. However, teens are often savvier than parents anticipate, and gun removal is the best guarantee for your child’s safety. You should also limit access to sharp knives or razors. Anything you can do to stop, or slow down, access to these objects could prevent a person from moving forward with suicide.
Make sure the plan is still working and follow through
It’s important to check in and ensure the safety plan is still working. If the person is feeling unsafe, they should see their therapist sooner. A concerned parent can reach out to their child’s therapist or in the case of immediate risk or concern, take their child to an emergency room.
If a child expresses an immediate suicidal desire, parents must take their child to the emergency room. To reluctant parents, Dr. Joanna Stern says, “I understand you don’t want to do this, and you don’t want to take your child to the emergency room, because what if they’re bluffing? I hear you having the thought, ‘I don’t think my kid really means it.’ We have to err on the side of caution. Because what if they do? My priority is keeping them alive.”
A safety plan gives individuals who experience suicidal tendencies a concrete set of steps to use when they those feelings begin to arise. It also helps them identify what emotions and situations might trigger the impulse. A safety plan opens a discussion between children and parents, so a child knows they can talk to their parents about how they’re feeling. It also helps parents prepare for this worst-case scenario and have resources at their fingertips.