If you could write something down that might one day save your life, would you?
In 2016, 9.8 million American adults seriously thought about suicide, according to the Centers for Disease Control and Prevention. To reduce the risk of making an attempt, suicide experts said, people who struggle with suicidal thoughts should create a personalized suicide safety plan, which outlines warning signs of a suicidal crisis, coping strategies and people to reach out to for support.
“When you’re in a crisis situation, it’s not the time to figure out how you’re going to handle it,” said Jill Harkavy-Friedman, a clinical psychologist and vice president of research for the American Foundation for Suicide Prevention. “What a safety plan does is it helps you figure out beforehand a strategy for handling distress.”
Shelby Rowe developed a safety plan after her suicide attempt and said it’s an important part of keeping herself healthy.
“They help us to get our brains out of the tunnel vision that can set in when we are swept up in a mental health crisis,” she said.
A study published in JAMA Psychiatry in September found that when patients who visited the emergency department for suicide-related concerns were given a safety plan at discharge as well as follow-up phone calls, it reduced the odds of suicidal behavior by half.
Stories of hope:
- Stepping back from the ledge
- Suicide never entered his mind. Then 9/11 happened.
- Young, transgender and fighting a years-long battle against suicidal thoughts
- She worked in suicide prevention. Then one day she had to save herself.
“Suicidal feelings come and go,” Barbara Stanley, lead author of the study, said in a video for the American Foundation for Suicide Prevention. “We also know that if somebody resists making a suicide attempt that they don’t necessarily have to go on and make a suicide attempt later – that the urges can dissipate.”
Sit down with someone you trust
It’s ideal to create your safety plan with a mental health professional, but if you’re not under the care of a clinician, you can turn to a trusted friend or family member.
“The reason why it helps to have a clinician or another person … is sometimes if you’re in a distressed place, your thinking about these things isn’t always 100 percent. You may feel like you don’t have anyone to call. Or you don’t know what to do to distract yourself,” Harkavy-Friedman said. “You may feel you’re a burden … but that’s not accurate, and that’s part of the reason you want to fill it out with someone.”
Identify your personal warning signs
The warning signs listed on your safety plan should be specific to you. They are the thoughts, feelings and behaviors that may lead to you feeling suicidal. According to the Suicide Prevention Resource Center, they can include:
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden
- Increasing use of alcohol or drugs
- Acting anxious or agitated, behaving recklessly
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Extreme mood swings
Find ways to distract yourself
Since thoughts of suicide typically come and go, it’s important to find ways to distract yourself when they emerge. This could include:
- Listening to music
- Reading a book
- Watching a movie
- Calling a friend
Make your environment safe
It’s important that if you have thoughts of suicide, you reduce access to lethal means. Ask a family member to safely store medications, or have a friend hold the key to your firearm box.
Turn to people you trust
Who do you call when you want to laugh? Who do you call when you want to vent? Who do you call when you want someone to come over and just sit quietly? It’s important to identify people in your life who can help keep you safe. Maybe it’s a best friend, maybe it’s your pastor. Write their names and contact information down on your plan, so you can easily reach them when you need to.
Make more than one copy
You shouldn’t be the only one with access to your safety plan. Give copies to everyone you list on your plan, so they can be proactive. Someone on your call list may want to keep their ringer on late at night. A loved one may be able to spot a warning sign before you do. Let people know you may need to reach them, and don’t be afraid to be explicit about the specific things they can do to help you.
Include the professionals
Your friends and family are important supports, but you should include emergency contacts on your plan who can help if your feelings escalate. This can include your therapist, primary care physician, local mobile crisis line, 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.
Keep updating it
As things in your life change, your safety plan should, too. If you’ve lost touch with one of the people on your call list, make sure to add another trusted support. If you’ve found a new reason to stay alive, include it.
“It’s a living document,” Harkavy-Friedman said. “Revisit it, rework it, keep it up to date with things that make you feel better.”
Remember, you’re not alone
When you’re in crisis, it can feel like there’s nowhere to turn. A safety plan can be a lifesaving reminder that there are people you can reach out to for support.
“The more you engage people in helping you, the more effective [a safety plan] will be,” Harkavy-Friedman said.
Suicide Lifeline: If you or someone you know may be struggling with suicidal thoughts, you can call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) any time of day or night or chat online.
Alia E. Dastagir, USA TODAY