Suicide / Self-Harm Safety Plan

Have you ever noticed how when you’re stressed, depressed, anxious, overwhelmed, or experiencing any other negatively-charged feeling (or sometimes even strong positive feelings), it’s increasingly hard to develop new patterns of responding or to make healthy choices if different than your norm? It may be especially difficult to consider later consequences of your actions or to self-soothe in ways that serve your greatest good. You may automatically fall into repeating old, less adaptive patterns of behaving. This is particularly true if you have a history of addictions or difficult with impulse control. It takes extra focus and discipline to suspend old patterns of responding and to establish new habits.

Historically in mental health treatment providers guide patients through completion of safety plans. Sometimes these are referred to as “suicide safety plans,” but truly these can be helpful in managing and even preventing any escalation of negative affect. They are especially helpful though in diverting/managing suicidal thoughts as one starts sinking into a dark hole, struggling to see see a way out. A safety plan is a document that proactively walks you through identifying triggers to negative feelings. It prompts you to proactively identify steps that help redirect focus, reminds you of more positive choices, reminds you of who you might surround yourself to promote more positive feelings, and ultimately helps you prevent/combat de-escalation of feelings. While the safety plan is often used in suicide prevention, it can be very effective too in managing or challenging depression, stress, anxiety, and unhealthy impulses and in developing healthier patterns of coping and self-soothing.

Consider going through the safety plan below and ask yourself  how you might adapt this to bettering your life. I’ve also linked a self-care worksheet to help prompt ideas of strategies you might try in replacing old patterns. It doesn’t help to say “I’ll STOP doing X” or “I won’t do X anymore.” Say what you’ll do INSTEAD!  “Next time I feel an urge to X, I will do Y!”

The safety plan and self-care documents can be found here and under the tab for Investing in Yourself and Emotional Health. Use the SAFE Self-Care worksheet to help brainstorm activities/hobbies/pleasurable activities you might too to Steps 2 and 3 of the Safety Plan for internal coping strategies and people/places that can help you feel better. Consider what actions you might take to challenge/redirect negative thoughts while focusing on feeling better. After all, “pain forgotten, pain gone.” Instead of turning to that drink, cigarette, cutting, social withdrawal, junk food, argument with your mom, etc., consider something off your self-care list instead. The average life of a craving or urge is usually about 20 minutes, so consider behavioral substitution (doing something else, e.g, a walk, working on art, watching a funny yet informative show, reading a poem, listening to a favorite upbeat song, journaling, taking a bath, brushing your teeth) or thought substitution (thinking something else, e.g., imagining a favorite memory or a trip you look forward to going on, visualizing the life you will have created in a year, praying, sending positive thoughts to someone — all the better, someone you have issue with — forgiveness of an apology you do or do not receive is an amazing gift to yourself and peace of mind).

There are many versions of safety plans you might find online and/or adapt. One of my favorites was previously distributed through the VA system and is a wonderful, clearly laid out document to walk a person through the critical steps for prevention/intervention. The crisis hotline number indicated on the document is for Veteran’s, but additional crisis support is available through 1-800-Suicide. See the Suicide Prevention section of the Invest In Emotional Health tab for additional prevention/intervention hotline information.

Safety Plan

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