Safety Planning: Creating Your Crisis Prevention Plan

When you’re in the middle of a mental health crisis, thinking clearly feels impossible. The very cognitive abilities you need—problem-solving, perspective-taking, remembering what helps—are exactly what gets compromised when you’re overwhelmed. That’s why the best time to plan for a crisis is before one happens.

A safety plan is a written, prioritized list of coping strategies and support resources that you create when you’re feeling stable, so it’s ready when you’re not. It’s not just for people who are suicidal—anyone who experiences intense emotions, self-harm urges, or mental health crises can benefit from having a plan.

Understanding Safety Plans

What Is a Safety Plan?

A safety plan is a personalized document that helps you navigate mental health crises. It’s different from a no-suicide contract (which research shows doesn’t work). A safety plan is a practical tool with specific steps to take when warning signs emerge.

Key Features:
– Created collaboratively (with a therapist or on your own)
– Personalized to your specific triggers and resources
– Written down and accessible
– Graduated steps from self-help to professional help
– Reviewed and updated regularly

Why Safety Plans Work

Practical Benefits:
– Reduces need for decision-making during crisis
– Provides concrete steps when thinking is foggy
– Reminds you of resources you might forget
– Creates time between urge and action
– Connects you to support

Psychological Benefits:
– Builds sense of control
– Reduces hopelessness
– Creates commitment to use strategies
– Validates that crises are manageable
– Reinforces that you have options

When to Create One

Good Times to Make a Safety Plan:
– When you’re feeling relatively stable
– After a crisis (to prepare for future ones)
– When starting therapy
– When recovering from suicidal thoughts
– When managing chronic mental health conditions
– Anytime you recognize potential for future crises

The Six Steps of a Safety Plan

Step 1: Recognizing Warning Signs

What These Are:
– Personal indicators that a crisis may be developing
– Thoughts, feelings, sensations, situations that precede crises
– Early warning signs that tell you to start using the plan

Examples:
– Thoughts: “Nobody cares,” “I can’t do this anymore,” “What’s the point?”
– Feelings: Hopelessness, intense anxiety, numbness, overwhelming sadness
– Physical: Sleep changes, appetite loss, chest tightness, fatigue
– Behaviors: Isolating, drinking more, not responding to messages
– Situations: Conflict with family, work stress, anniversary dates

To Identify Yours:
– Think about past crises—what happened before?
– What do you notice first when things start to go downhill?
– What do others notice about you before crises?

Write Down:
– List 3-5 specific warning signs personal to you
– Be specific enough to recognize them
– Include different types (thoughts, feelings, behaviors)

Step 2: Internal Coping Strategies

What These Are:
– Things you can do on your own to calm down or distract yourself
– No other people needed
– First line of intervention

Examples:
– Physical: Exercise, walking, cold shower, stretching, deep breathing
– Distraction: Watching a favorite show, playing a game, reading, cleaning
– Soothing: Hot bath, music, comfortable clothes, favorite scent
– Creative: Drawing, writing, playing music, crafts
– Cognitive: Mindfulness exercises, grounding techniques, challenging thoughts

Choosing Effective Strategies:
– What has helped before?
– What do you enjoy even when feeling bad?
– What absorbs your attention?
– What shifts your physical state?

Write Down:
– List 5-10 strategies you can do alone
– Make them specific and actionable
– Include variety (physical, mental, creative)

Step 3: Social Situations and People for Distraction

What This Is:
– People and places that provide healthy distraction
– Social contact that takes your mind off things
– Not for talking about problems—just for not being alone

Examples:
– Going to a coffee shop
– Calling a friend to chat about their day
– Visiting family
– Going to a public place (library, mall)
– Attending a class or group activity
– Walking in a busy area

Identifying Options:
– Where can you go to be around people?
– Who can you call for light conversation?
– What public places help you feel better?
– What regular activities connect you with others?

Write Down:
– List specific places you can go
– List specific people you can contact
– Focus on distraction, not crisis support

Step 4: People to Ask for Help

What This Is:
– Trusted individuals who know about your struggles
– People who can provide support during difficult times
– Those who can help you stay safe

Who to Include:
– Close friends who understand your situation
– Family members you trust
– People who have supported you before
– People who have agreed to be contacts

Important Considerations:
– Have their contact information ready
– Let them know in advance that they’re on your plan
– Have multiple people (in case one isn’t available)
– Include people available at different times

What to Tell Them:
– “I might contact you when I’m struggling”
– “Here’s what helps me…”
– “Here’s what to watch for…”
– “Thank you for being someone I can call”

Write Down:
– Name, phone number, and when they’re typically available
– At least 2-3 people
– Notes about how they can help

Step 5: Professionals and Agencies to Contact

What This Is:
– Mental health professionals and crisis resources
– For when personal resources aren’t enough
– Bridge to professional crisis intervention

Include:
– Your therapist (if you have one) – name and number
– Your psychiatrist (if applicable)
– Local crisis line number
– 988 (Suicide and Crisis Lifeline)
– Local emergency room address
– Mobile crisis team if available in your area

Considerations:
– Know your therapist’s after-hours policy
– Know the process for reaching your psychiatrist
– Have local crisis line memorized or easily accessible
– Know the location of nearest ER

Write Down:
– Name, phone number, and hours for each resource
– Backup options for after-hours
– Address of nearest emergency room

Step 6: Making the Environment Safe

What This Is:
– Reducing access to things you might use to hurt yourself
– Creating physical barriers between urge and action
– Asking others for help with this

Common Steps:
– Storing firearms outside the home or locked
– Having someone else hold medications
– Removing or securing sharp objects
– Creating physical distance from means
– Limiting alcohol access

Why This Matters:
– Most suicide attempts are impulsive
– If the method isn’t readily available, many don’t substitute
– Creating barriers gives time for crisis to pass
– It’s a concrete protective action

Write Down:
– Specific items that need to be secured or removed
– Who can help with this
– What steps you’ve taken or will take

Bonus: Reasons for Living

What This Is:
– A reminder of what matters to you
– What keeps you going
– Who and what you live for

Examples:
– People who love you and would be affected
– Goals and dreams for the future
– Pets who depend on you
– Things you want to experience
– Values that matter to you
– Curiosity about what’s ahead

Write Down:
– Personal, specific reasons that matter to YOU
– Update these as life changes
– Make them concrete and meaningful

Using Your Safety Plan

How to Use It

When Warning Signs Appear:
1. Recognize that you’re moving toward crisis
2. Pull out your safety plan
3. Start with Step 1 (recognize what’s happening)
4. Try strategies from Step 2 (internal coping)
5. If Step 2 isn’t enough, move to Step 3 (distraction through social contact)
6. If still struggling, move to Step 4 (ask for help from trusted people)
7. If more is needed, move to Step 5 (professional help)
8. Throughout, ensure Step 6 is in place (environment is safe)

Keep It Accessible:
– Save it in your phone
– Keep a paper copy in your wallet
– Post it somewhere at home
– Share it with trusted people
– Know where it is without having to search

Use It Before Crisis Peaks:
– The earlier you start using it, the better it works
– Don’t wait until you’re in severe crisis
– Using it at first warning signs is most effective

When to Call for Help

Move to Professional Help (Step 5) If:
– Internal coping strategies aren’t working
– Support from others isn’t enough
– Urges are intensifying
– You don’t feel safe
– You’ve made this far through the plan and still need help

Go to Emergency Room or Call 911 If:
– You’ve attempted to harm yourself
– You have a plan and feel unable to resist
– You’re in immediate danger
– You need a higher level of care

Reviewing and Updating Your Plan

Regular Review

Why Review:
– Your life changes
– What helps may change
– Contacts may change
– New strategies may be discovered

When to Review:
– After a crisis (what worked? what didn’t?)
– Every few months
– When major life changes happen
– When your treatment changes

Questions for Review

• Did my warning signs accurately predict crisis?
• Which coping strategies actually helped?
• Were my contacts available and helpful?
• What was missing from my plan?
• What would I do differently?

Creating Your Plan with a Therapist

Benefits of Collaborative Creation

• Therapist can help identify warning signs
• Professional input on effective strategies
• Accountability for completing the plan
• Opportunity to discuss and practice using it
• Integration with overall treatment

What to Bring to the Session

• Ideas about your warning signs
• List of strategies that have helped before
• Names of potential support contacts
• Questions about crisis resources

Special Considerations

For Parents Creating Plans with Teens

• Involve the teen in creating it
• Respect their input while ensuring safety
• Include parents as contacts
• Balance independence with support
• Regularly review together

For Those with Chronic Suicidal Thoughts

• Safety plan becomes ongoing tool, not one-time creation
• May need more detailed strategies
• Regular review especially important
• Integration with treatment essential

For Self-Harm

• Include specific alternatives to self-harm
• Ice cube, rubber band, and other sensation-based alternatives
• Address underlying emotions
• Include wound care information if needed

For Substance Use Crises

• Include sponsors or recovery contacts
• Address relapse warning signs
• Have sober support options
• Know location of nearest meeting

Sample Safety Plan Template

My Warning Signs:
1. ___
2. ___
3. _____

Internal Coping Strategies (things I can do alone):
1. ___
2. ___
3. ___
4. ___
5. _____

People and Places for Distraction:
1. Name: ___ Phone: __
2. Place: ____
3. Name: __ Phone: ____

People I Can Ask for Help:
1. Name: ___ Phone: __
2. Name: _ Phone: _
3. Name: _ Phone: ____

Professionals and Crisis Lines:
1. Therapist: ___ Phone: __
2. Psychiatrist: _ Phone: _
3. Crisis Line: 988
4. Local Crisis Line: _
5. Emergency Room: ____

Making My Environment Safe:
– Items to secure: ___
– Who can help: ___
– Steps I’ve taken: _____

My Reasons for Living:
1. ___
2. ___
3. _____

Moving Forward

A safety plan is a gift you give yourself during stable times, to be opened when you need it most. It doesn’t guarantee crises won’t happen, but it ensures you won’t have to figure out what to do in your most vulnerable moments.

Take time to create your plan. Share it with people who matter. Keep it accessible. And know that having a plan is itself an act of hope—a belief that you will face difficult moments and that you can get through them.

This article is for educational purposes only. If you are currently in crisis, please reach out immediately to 988 (Suicide and Crisis Lifeline), call 911, or go to your nearest emergency room. Arise Counseling Services offers compassionate, professional support for individuals and families throughout Pennsylvania.