Safety Plan for Suicide Ideations: Tips from Experts

A suicide safety plan is a personalized action plan designed to help individuals when they are at risk of acting on suicidal thoughts. The plan provides a structured series of steps to follow when suicidal ideation becomes overwhelming, guiding the individual by offering ways to cope and connect with supportive resources.

Bace explains, “The elements of a safety plan include warning signs, coping strategies, supportive contacts, emergency resources, and ways to maintain a safe environment.” These elements can be helpful in managing moments of emotional distress. A safety plan for suicidal thoughts ensures the person at risk has a ready-to-use guide when they need it most.

In addition to offering guidance, the suicide safety plan provides individuals with a sense of control during moments of irrational thinking. Dr. Cobbs emphasizes this point: “A safety plan is a step-by-step guide on what to do when I don’t know what else to do. More importantly, it serves as a reminder that there is help and hope—even when it feels like there isn’t.”

A safety plan is a step-by-step guide on what to do when I don’t know what else to do. More importantly, it serves as a reminder that there is help and hope—even when it feels like there isn’t

— Dr. Melissa Cobbs

A suicide safety plan for suicide ideation is essential for anyone at risk of suicidal thoughts or behavior. Individuals who have experienced trauma, chronic mental or physical illness, or significant life changes may be more at risk. Melling explains, “Clients that feel isolated, lack a support system, or have experienced a recent traumatic or stressful situation are prone to suicidal ideation.”

People with a history of trauma, grief/loss, or strained relationships may also benefit from a suicide safety plan. According to Bace, “A recent stressor, coupled with a lack of social support and/or coping skills, hopelessness, and access to a means of suicide all increase risk.” A well-developed suicide safety plan provides a practical way for these individuals to manage their feelings and avoid impulsive decisions.

It is important to note that suicide safety plans are not only for those currently experiencing suicidal thoughts. Dr. Cobbs stresses that it’s never too early to create one. “There is no wrong time to tell someone you are worried about them,” she says. A proactive suicide safety plan can address suicidal thoughts before they escalate into a crisis.

There is no wrong time to tell someone you are worried about them

— Dr. Melissa Cobbs

A suicide safety plan consists of several key components that can help individuals recognize their risk factors and take steps to protect themselves during moments of distress. According to Dr. Cobbs, “In times of severe depression, isolation, loneliness, it’s difficult for an individual to think critically. When a safety plan is in place, it can be utilized as the guide of ‘what to do when I don’t know what to do’.” There’s no perfect safety plan format, but it can be helpful to include these elements:

1. Warning Signs: These are thoughts, moods, or situations that indicate a crisis is imminent. Bace explains that identifying these signs is a critical first step: “Warning signs may include feelings of hopelessness, isolation, or physical symptoms like insomnia or agitation.” Dr. Cobbs says, “Knowing the warning signs of worsening symptoms is the key. Some questions to consider include: ‘How do my symptoms show up? What happens in my body and mind that tells me things are getting worse? How do other people notice things are getting worse for me? Do I act differently, isolate, look different?’”
2. Support Network: This is a list of contacts—family, friends, or professionals—whom the individual can turn to in a crisis. Dr. Cobbs highlights the importance of having this information readily available: “It may sound elementary and basic to have someone write down their support people and phone numbers—but an individual’s ability to reason is diminished in a mental health crisis and it may feel like they have no one and nowhere to turn—this gives someone who is deeply struggling a starting point, a memory of what they believed, who they believed would support them, and when they believed in their future.”
3. Emergency Resources (Crisis Plan): This includes a list of hotlines, crisis centers, or other emergency resources and a section entitled, “How do you want others to help you in a crisis?” Dr. Cobbs says, “Every person is different, some may want to just have someone come over to sit with them and say nothing, while others may want to process through their thoughts. Some may want you to remind them they are loved, some may want you to take charge because they don’t trust themselves when they’ve reached their dark place.” Coming up with a buzzword or phrase (code word) people in your network will recognize as ‘I am struggling right now’ can be a good idea as sometimes it is hard to say ‘I need help’ directly to others.
4. Safe Environment: Ensuring a safe environment is another key element of the suicide safety plan. This could involve removing or locking away potential means of suicide. Melling emphasizes that creating a safe environment helps minimize the risk of impulsive actions.
5. Reasons for Living: This is a list of reminders of what the individual has to live for—whether it’s relationships, goals, or personal beliefs. This provides a grounding point during times of distress, helping to shift focus away from immediate pain. For some people, a reason for living to include in the plan can be as simple as the name of a pet who needs them, a favorite food they enjoy, or a bucket list of travel destinations. Other reasons to include might be someone’s faith, or their desire to see their grandchildren grow up.

While there is no standard format for a suicide safety plan, we’ve created a template that anyone can use as a starting point, but we highly recommend working with a licensed mental health professional to help ensure that the plan you create has the best chance of helping to guide you or a loved one through difficult moments. Download a Suicide Safety Plan PDF here.

A suicide safety plan must be tailored to meet the unique needs of the individual, particularly when working with specific populations such as LGBTQ+ individuals, veterans, or people with chronic illnesses. Bace explains that safety plans for these populations may require additional considerations. “For LGBTQ+ individuals, for example, there may be people in their support network who are not aware of their identity, which may affect who they can turn to for help,” she says.

Veterans may need their suicide safety plan for to include resources for managing PTSD, while individuals with chronic illnesses might need coping strategies that consider their physical limitations. Melling adds, “A good safety plan incorporates an individual’s physical, social, and cultural needs, ensuring that the person can access the resources and support they need.”

Dr. Cobbs points out that the plan should consider every aspect of the individual’s life, not just their suicidal thoughts. “Cultural impacts, gender identity, social fears or anxiety, physical health conditions, and employment implications can all be contributing factors to one’s wishes in a crisis,” she explains. The more personalized the safety plan for suicidal thoughts is, the more effective it can be.

Per Melling, “Children in therapy who may be experiencing suicidal ideation should be active participants in safety planning with adult support. Children are excellent identifiers of support persons and tools/strategies that can bring comfort and increase safety in times of stress, but parents/guardians/trusted adults should be incorporated into the process of safety plan development to ensure that vulnerable children can be kept safe. Therapists often work with children to find the best ways to incorporate trusted adults into this process while also following ethical guidelines and state laws.”

A good safety plan incorporates an individual’s physical, social, and cultural needs, ensuring that the person can access the resources and support they need

— Corinne Melling, LMFT

Therapy and medication are critical elements of a suicide safety plan. Bace highlights the importance of evidence-based therapies such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Cognitive Therapy for Suicide Prevention (CT-SP). These therapies are directed at helping individuals identify and challenge negative thought patterns, develop healthier coping mechanisms, and build resilience against suicidal ideation.

Melling advises that therapists and clients should work together to form a suicide safety plan, ensuring it is both practical and accessible. “Clients should continue taking their medications as prescribed and reach out to their psychiatric provider if their symptoms persist.” Medication management is often a critical piece in stabilizing mood and preventing suicidal crises.

Dr. Cobbs also notes that a suicide safety plan should include specific actions to take when symptoms worsen, such as contacting a licensed mental health clinician. “The more support a person has, the higher the chance of healing,” she says.

A suicide safety plan is a living document and should be regularly reviewed and updated to give it the best chance of being effective. Bace emphasizes that a plan should be reassessed after any episode of suicidal ideation or if the individual’s circumstances change significantly. “Safety plans should be reviewed and updated as necessary,” Bace says. This ensures the plan remains relevant and has the best chance of being useful.

Dr. Cobbs also encourages individuals to share their suicide safety plan with trusted members of their support network, so others know how to help during a crisis. “It’s important to store a copy with mental health professionals and update it regularly,” she adds.

Safety plans can be stored in the person’s medical record. It is most beneficial if the person also has a readily accessible copy of their safety plan, either in digital or paper format. Many people also make a copy accessible to included members of their support system. There are some mobile apps that might help an individual create a safety plan and can keep it readily accessible, like the app created by the U.S. Department of Veteran Affairs.

If you or someone you know is struggling with suicidal thoughts, please consider calling the national helpline right away. If you are looking for help with a suicide safety plan and/or want to schedule a time to speak to a therapist, you can find one near you here.

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