When you or a friend are thinking of suicide, fear is a natural reaction. The fear makes it difficult to think of a good approach. As a result, people often rely on 911 and emergency rooms to help. This isn’t always the best response though. This post will help you figure out when to create a safety plan, how to create one, and when it is more prudent to access emergency services.
Why Safety Plan
When you notice warning signs that someone is considering suicide, consider safety planning. Safety planning helps those thinking about suicide get support. It avoids expensive emergency room visits or risky police interactions. In other words, a safety plan seeks to avoid engaging emergency services unless absolutely necessary. Remember, a safety plan is not appropriate for people who have already injured themselves or people who are not able or willing to stay safe.
Key Parts of a Safety Plan
While you can create a safety plan any way you’d like, it’s helpful to include a few key “ingredients.” These parts help increase the efficacy of your plan and set you up for success.
Names and Contact Info
Your safety plan needs to include names and phone numbers for people you can ask for help. These contacts should include both personal and professional contacts. Your personal contacts help you with emotional support and should be your first point of contact. Professional contacts can offer more therapeutic or medical support.
When listing your personal contacts, consider family or friends who may be more likely to answer the phone when you call. You might consider having a conversation with these people ahead of time to let them know how they can support you. You may need to have different people for different time periods. Therefore, it’s important to have multiple personal supports to ensure someone is available.
Your list should also include professional supports. These contacts consist of your therapist, your primary care doctor, and a crisis hotline. Consider these your second line of defense. If your personal supports can’t answer or you don’t feel relief after talking to them, contact your professional supports.
Coping Skills to Use
A safety plan will not be complete without a list of coping skills. This list should include things you can do both when you’re thinking of suicide and when you notice warning signs. Consider including a variety of different coping skills to allow for choices.
For example, you might include some things you can do quietly inside and alone. For me, these include coloring, building Lego, and video games. It also helps to include things you can do outside and with other people. This might include going for a hike, going to eat with a friend, or just going for a car ride. Build your list from things that you find helpful or things you’d like to try.
Your safety plan should also include warning signs that you might start thinking of suicide. This section might include signs that your depression is getting worse. Or it might include other signs you’ve noticed that specifically indicate thoughts of suicide are coming. Be sure to list things that you can observe yourself as well as signs that other people might notice.
As an example, you might have found that when things with your significant other are not going well, your thoughts of suicide follow. Other people might notice that your outlook seems more negative or you’re talking more about death in general.
Of course, a safety plan needs to actually address the safety aspects. You can tailor this section to a specific suicide plan. When you don’t have a specific plan for suicide in mind, keep it more general.
For a more generalized safety plan, consider anything you might use to hurt yourself. These include knives, medications, firearms, cords, and anything similar to these things. Removing these things or making it harder to access them helps reduce the ability to use them for suicide. Even when they cannot be removed completely, consider locking them up or otherwise doing things to put more time between having a thought of suicide and taking action.
Reasons for Living
Finally, include your reasons for living in your safety plan. You can choose to only use words, but adding images, such as photos, can be a more powerful reminder. For example, if your kids or pets are part of your reason for living, consider including a picture of them.
Don’t think you only need to include present things. Things you want in the future can be pretty powerful as well. You can include things like completing a degree, buying a house, or anything else that you’re looking forward to. These don’t need to be huge things; small things can be just as effective. For example, if you know there’s a video game coming out next year that you really want to play, include that too!
Putting Your Plan Together
Once you have all the necessary parts, it’s time to put your plan together. If you choose to hand write everything, be sure to take a photo with your phone so you always have your plan accessible. Give important people in your life, such as those on your safety plan, a copy of your plan.
Be sure to also review your safety plan periodically. Update the things that need to be updated. Sometimes, you’ll find little ways to tweak your safety plan to keep it relevant. For example, you might find that you no longer talk to someone you put on your supports or you changed therapists. Updating those contacts is important.
When to Contact Emergency Services
While safety planning helps keep people out of hospitals, it’s not always the best choice. You should contact emergency services (911) if anyone has actively made a suicide attempt. For example, if someone has overdosed, someone is bleeding, or someone has any other injuries requiring emergency medical treatment.
Additionally, contacting 911 may be best when the suicidal person refuses to do anything to stay safe. Situations like this include times when someone has a firearm but will not hand it over and times when someone is adamant that they’re going to die today. These situations constitute a true emergency and you need help asap.
Safety planning serves as an alternative for emergency services for people with thoughts of suicide who have not yet decided they HAVE to die. It includes a list of contacts, coping skills, warning signs, and reasons for living in addition to specific safety actions. As always, be sure to go to the ER or contact emergency services in the event of a life threatening emergency.