If you have depression, there is a very real risk that at some point in the course of the illness you may experience thoughts of suicide. While the emotional pain that has triggered these thoughts may feel overwhelming, it does not mean that you will lose control or act on your thoughts. In fact, having a suicide safety plan in place is one method you can use to cope with your bad feelings until circumstances change.
What Is a Suicide Safety Plan?
A suicide safety plan is a written set of instructions that you create for yourself as a contingency plan should you begin to experience thoughts about harming yourself. It will contain a series of gradually escalating steps that you will follow, proceeding from one step to the next, until you are safe.
How to Create Your Suicide Safety Plan
You should work together with someone you trust -- such as your best friend, a close family member or your doctor or therapist -- to develop your suicide safety plan. It is best to get these people involved, since you will most likely need to call on them if you decide to execute your plan. It is best to create the plan while you are feeling well and can think clearly rather than waiting until you are actively suicidal. Put your suicide safety plan in writing and keep it in a place where you can easily find it should the need arise.
Information to Include in Your Suicide Safety Plan
Your suicide safety plan should include the following elements, in the same order as presented below:
- When the Plan Should Be Used: This step will involve making yourself familiar with what types of situations, images, thoughts, feelings and behaviors might precede or accompany suicidal urges for you. List these warnings signs so that you can refer back to them when deciding whether to activate your plan.
Examples: "When I feel suicidal, I tend to isolate myself and not take good care of my health." Or: "Suicidal thoughts are often triggered for me when I am reminded of my childhood abuse."
- What I Can Do to Calm/Comfort Myself If I Am Feeling Suicidal: Create a list for yourself of activities that are soothing to you when you are upset.
Examples: Taking a hot bath, listening to music, exercising
- What Are My Reasons for Living? Create a list of your reasons for living. When you are feeling suicidal, it is very easy to get caught up in the pain you are feeling and forget the positives in your life. Your list will help you refocus your attention on the reasons to keep going until your suicidal thoughts and feelings pass.
Examples: My children, my spouse, my faith in God
- Who Can I Talk To? Keep a list of contacts you can talk to if you are unable to distract yourself with self-help measures. List names, phone numbers or other contact information and be sure to have backups in case your first choice is unavailable.
Examples: Your significant other, friends, relatives, pastor
- Who Can I Talk To If I Need Professional Assistance? Create a list of all professional resources available to you, along with their phone numbers, email addresses and other pertinent contact information.
Examples: Your psychiatrist, your therapist, a crisis hotline
- How Can I Make My Environment Safe? Plan what steps you can take to make yourself safe. This may involve removing or securing any items that you are likely to use to hurt yourself, or going to another location until the urges have passed. It may also involve getting another person involved to help you.
Examples: "When I am feeling suicidal, I will ask my brother to keep my guns at his house." Or: "When I feel like hurting myself, I will go to a public place, like a mall, restaurant or library to distract myself."
- What To Do If I Am Still Not Feeling Safe: If all other steps have failed to keep you feeling safe, go to your nearest hospital emergency room and ask for assistance. Keep the name, address and directions to the hospital listed in your plan for easy access or save it in your GPS. If you do not feel that you can get to the hospital safely on your own, call 911 or the emergency contact number appropriate for where you live and ask for transport to the hospital.
How to Use Your Suicide Safety Plan
If you begin to experience any of the warning signs of suicide listed in your suicide safety plan, proceed through the steps you have previously outlined for yourself, one by one, until you are feeling safe again.
Samra, Joti and Dan Bilsker. "Coping with Suicidal Thoughts." Consortium for Organizational Mental Health (COMH). 2007. Accessed: April 21, 2010.
Stanley, Barbara et. al. "Safety Plan Treatment Manual to Reduce Suicide Risk: Veteran Version." U.S. Department of Veterans Affairs. August 20, 2008. Accessed: April 21, 2010.