Table 6. Safety Planning Intervention Steps Step Goals
Communication
1. Recognizing the warning signs of an impending suicidal crisis:
• Identify warning signs that may indicate the beginning of worsening of a crisis. • Understand how identifying warning signs provides an opportunity to cope before acting on suicidal urges.
• Ask, “What were the warning signs that you experienced during the crisis?” or “How will you know you are in a crisis and the safety plan should be used?” • If the warning signs are vague, ask the patient to be more specific so they are more likely to recognize the beginning signs of a crisis. • Ask, “What have you done in the past to take your mind off your suicidal thoughts without contacting another person? What activities could you do by yourself to help take your mind off of your problems, even if it is for a brief period of time?” • If the individual cannot think of any distracting activities, provide suggestions. • Ask, “How likely do you think it is that you would be able to do this during a time of crisis?” or “Is it feasible?” If there is doubt, ask, “What might stand in the way of you thinking of these activities or doing them if you think of them?” • Ask, “Who can you contact who helps you take your mind off your problems or helps you feel better? You don’t need to tell these people that you are feeling suicidal. We just want to identify people who can take your mind off your problems, even for a brief time.” • Ask, “What public places, groups, or social events help you to take your mind off your problems or help you feel better?” • Ask, “Sometimes when people are feeling really upset, they don’t want to talk to other people. However, sometimes just getting out and being in a place around other people can help. Can you think of places you could go where you wouldn’t have to be alone?” • For each response, ask, “How likely do you think it is that you would be able to talk with someone/go somewhere during a time of crisis?” “Is it feasible and safe?” • 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 or feeling suicidal?” • Ask, “How likely do you think it is that you would be able to reach out to each person?” • If doubt is expressed about contacting others, ask, “What might get in the way of reaching out to this person? • Ask, “Who are the professionals and community workers that we should identify to be on your safety plan? • Ask, “What is the likelihood that you would contact these professionals or agencies?”
2. Using your own
• Explain that the purpose of coping strategies is to (1) help take the individual’s mind off of their problems to prevent worsening of suicidal thoughts and (2) prevent the individual from making a suicide attempt without contacting other people. • Help the individual recognize internal coping strategies. • Identify barriers and ways to overcome them.
coping strategies:
3. Contacting others in order to distract from suicidal thoughts:
• Instruct the individual to use step 3 if step 2 does not lower risk. • Identify other people and social settings that provide distraction. • Obtain feedback from the individual about the likelihood of doing these activities. • Identify barriers and problem-solve ways to overcome them.
4. Contacting family members or friends who may help to resolve the crisis:
• Instruct the individual to use step 4 if step 3 does not resolve the crisis or lower risk. • Explain that this step involves contacting a trusted family member or friend for support. • Obtain feedback from the individual about the likelihood of doing these activities. • Identify barriers and problem-solve ways to overcome them.
5. Contacting
• Instruct the individual to use step 5 if step 4 does not resolve the crisis or lower risk. • Explain that step 5 involves of professionals who can provide assistance to the individual during a crisis.
mental health professionals or agencies:
Page 61
Book Code: SWPA1525
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