Suicide Safety Plan
The best suicide safety plan is to not think of suicide as an option but unfortunately some of amongst us are not able to avoid thoughts of suicide. When one is struck with darkness of severe depression, hopelessness creeps in, the emotional pain becomes intolerable and suicide seems like a way out of the misery. But in my work as a psychiatrist, I realized most suicidal patients don’t want to die, they just want to “not exist” during those moments of deep despair. It's a transitional and temporary state of mind, an existential (but not permanent) crisis that can be safely managed. And that’s where a practical, easily accessible and reliable preemptive safety plan can help.
Thoughts of suicide can induce a sense of helplessness, not only in the person afflicted by it, but in others who care about the person and want to help him/her but don’t know how. Developing a Suicide Safety Plan converts this sense of helplessness into an actionable plan to work with.
The Center for Suicide Prevention has an excellent article about Suicide Safety Plans (click here). I have summarized some of the salient points from that article here:
A safety plan is a document that supports and guides someone when they are experiencing thoughts of suicide, to help them avoid a state of intense suicidal crisis. Anyone in a trusting relationship with the person at risk can help draft the plan; they do not need to be a professional.
A safety plan is written when a person is not experiencing intense suicidal thoughts
A safety plan is an assets-based approach designed to focus on a person’s strengths. Their unique abilities are identified and emphasized so they can draw on them when their suicidal thoughts become intense
The safety plan is organized in stages.
Step 1: List warning signs that indicate a suicidal crisis may be developing
Step 2: List the coping strategies that can be used to divert thoughts, including suicidal thoughts.
Step 3: List the places and people that can be used as a distraction from thoughts of suicide.
Step 4: List all the people that can be contacted in a crisis, along with their contact information.
Step 5: List mental health providers and the hours they can be reached, as well as 24/7 emergency contact numbers that can be accessed in a crisis.
Step 6: List the steps to be taken to remove access to means of suicide from the environment.
Step 7: List important reasons to live, or how/why that person is still alive.
Here is a comprehensive safety plan template, if you want to get started. Better now than never.
Another good resource: National Suicide Prevention Lifeline- 800-273-8255 (available 24/7).
If you want to go one more step further and be prepared for any Mental Health Crisis, here is an app developed by the American Psychiatric Association named “my Mental Health Crisis Plan”. It is available in the Apple App store and Google Play store. Essentially it helps an individual develop a Psychiatric Advance Directive (PAD) before a crisis happens.
A Psychiatric Advance Directive (PAD) is a written document that has two parts. The first part is called an ‘instructional directive.’ It is a list of instructions and information that you wish to be followed if in a mental health crisis. For example, you might request admission to a certain hospital or refuse admission to another. The second part of a PAD is a choice of a trusted person to make decisions for you if you are in crisis. A PAD is official once it has been signed by witnesses in from of a notary public and given to the patient’s doctors, providers and hospitals.
Stay safe you all.