What is a Mental Health Safety Plan?

A mental health safety plan is a coping skills plan that walks you through what to do and what skills to use when you’re thinking about hurting yourself. If you feel like you cannot keep yourself or someone else safe, call 911 immediately.

Thinking about suicide or hurting yourself can be scary and lead to many other emotions, including sadness, anxiety, guilt, or shame. Suicidal thoughts can co-occur with many mental health concerns, including depression, anxiety, substance use, and bipolar disorder, just to name a few. Suicidal thoughts might come and go, varying in strength and how much they’re on your mind. Some days you may be able to ignore these thoughts. However, when these thoughts are more persistent, having a safety plan can be really helpful.

When to Make a Mental Health Safety Plan

If you begin to notice thoughts of suicide or self-harm that are distressing and feel out of your control, a great way to get started is to seek professional help by contacting a therapist, doctor, or mental health professional. Other signs that you need extra support include spending more time isolated or alone, not hanging out with friends or family, using substances, missing days of school or work, missing your extracurricular activities, or engaging in other behaviors that are not typical for you.

You can create a safety plan with your therapist, doctor, or mental health professional. You can also make one on your own or with your parents or other trusted adults. Safety plans are predominately used for thoughts of suicide. Still, they can also be used if you have thoughts of hurting yourself, hurting someone else, using substances, or engaging in other behaviors that have the potential to harm you and that you want to stop.

How to Make a Mental Health Safety Plan

It’s best to create a safety plan when you are clear-headed and not currently experiencing suicidal thoughts. You can then refer back to this plan when you’re feeling hopeless or depressed. Write out your plan on a notecard, in your phone’s notes app, or in any other place where you’ll regularly be able to see it and access it. 

1. Warning Signs

The first step in creating a safety plan is to identify your warning signs—indicators that your mood is changing or you’re likely to start having suicidal thoughts. These warning signs might include:

1. Emotions: Such as sadness, loneliness, depression, anxiety, or hopelessness.
2. Thoughts: Like “Things are never going to get better” or “I’m so overwhelmed.”
3. Behaviors: Isolating yourself from loved ones or not doing activities you usually enjoy.
4. Physical Sensations: Feeling on edge or antsy, pacing, feeling sick to your stomach, having difficulty breathing, or feeling disconnected from your body.
5. Specific Environments: You might notice different warning signs if you’re at school vs. home vs. work or doing extracurricular activities. You may need to modify your safety plan based on where you are at the time.
6. Overall Physical Health: Feeling sick, having increased fatigue, or not eating well may also impact your mood and are warning signs to consider.

2. Coping Skills

After identifying your warning signs, the next step is to name your coping skills. When you’re distressed, it can be hard to think of things that help. Listing out your coping strategies in advance helps your brain go directly to what helps you and can reduce the amount of time you feel distressed. Examples of coping skills might include:

1. Reaching out to friends and family: Spend time with your friends or family in person, if possible, or talk to people close to you about how you’re feeling.
2. Do an activity to distract yourself: You can change your thoughts by watching videos, playing games, doing a hobby you enjoy (like drawing or crocheting), or even running errands. You might also consider places you can go, like a coffee shop or bookstore, to distract yourself.
3. Use relaxation techniques: Mindfulness, deep breathing, or meditation are great for stress relief.
4. Exercise: Get active if you can. Go for a walk, lift weights, dance, practice yoga, or even walk up and down stairs. Getting your body moving can help improve your mood.

3. Reasons to Live

It can also be helpful to reflect on important things in your life and why you want to live. These reasons might include:

1. Family members
2. Friends
3. Pets
4. Dreams you have for the future
5. Things you’re looking forward to, like concerts, sporting events, trips, etc.
6. It can also be helpful to remind yourself of times you’ve felt this way before and the pain decreased, as well as hard times you’ve gotten through in the past.

4. Your Support System

Who can you turn to when you’re having these thoughts? Your support system might include: 

1. People you can talk to directly about how you’re feeling
2. People who can make you laugh
3. People who will do activities with you or hang out with you
4. People who will otherwise distract you, even if you don’t feel comfortable telling them how you’re feeling

5. Professional Resources

If you feel like you cannot keep yourself or someone else safe, call 911 immediately.

1. 988 - You can contact the Suicide and Crisis Lifeline, available 24/7. You can also chat with someone online at 988lifeline.org.
2. Crisis Text Line - If you’d prefer to text instead of talk on the phone, you can text “HOME” to 741741.
3. A therapist or mental health care provider - Reach out to your therapist or other mental health care provider to talk about what you’re thinking and feeling. They can also help you create a mental health safety plan. Consider starting therapy if you haven’t yet gotten help—not only with your suicidal thoughts but also with the underlying emotions, thoughts, and behaviors contributing to thoughts of hurting yourself.

6. Ways To Keep Yourself Safe

Consider how to make your environment safer. 

1. Do you have access to guns or other weapons? If so, how can you limit your access? Ideas might include locking the gun and ammo in separate places and giving the key to someone you trust, giving your gun or other weapons to someone you trust who does not live with you, storing them in a place you don’t have access to, or disposing of your weapons safely.
2. Do you have access to alcohol or other substances? If so, how can you limit your access? Ideas might include locking up these substances and giving someone you trust the key, giving them to someone you trust who does not live with you, storing them in a place you don’t have access to, or disposing of the substances safely.

Safety Plan Example

1. Warning signs

I feel sad and lonely, I have thoughts like “no one likes me” and “I can’t take this anymore,” and I just want to lay in bed all day.

2. Coping skills

1. Get out of bed and take a shower
2. Go downstairs and eat something
3. Text my friends to see if anyone can hangout
4. Play video games in the family room with my brother
5. Read a book in the kitchen while my mom makes dinner
6. Take the dog for a walk
7. Watch a movie with my family
8. Do a youtube yoga workout

3. Reasons to live

1. My mom, dad, and brother
2. My dog
3. My two best friends
4. Camping trip with my friends in two months

4. My support system

1. My mom and dad
2. My two best friends
3. My grandma

5. Professional resources

1. 911
2. 988
3. Crisis text line “Home” to 741741

6. Keeping myself safe

1. Taking a screenshot of my safety plan and setting it as the background of my phone when I notice my warning signs

Revisiting Your Safety Plan

You’ll know your safety plan works if you don’t act on your thoughts to hurt yourself. If you still feel pretty down after going through your safety plan steps, you might want to consider updating your plan. Talk to your therapist or a trusted adult to come up with other ideas to add to your plan. 

If you forgot you created a plan, brainstorm ways to make it more accessible. Consider sharing it with your family or friends who can remind you to use it, set it as the background of your phone, make multiple copies, or download a safety planning app to ensure you always have options available.

Treatment Options

It’s really important for anyone struggling with thoughts of suicide or of hurting themselves to get mental health support. If you’re experiencing suicidal thoughts, know that you are not alone, and help is available to you!

The fastest way to find relief is to connect to a licensed professional specializing in evidence-based care for teens and young adults, like the therapists at Joon Care.

If you’d like to explore therapy options and see how Joon Care can support you, you can get matched with a therapist or email us at [email protected]. You can also look at our Emergency Resources page and our round-up of Free Mental Health Resources for more ways to get support.