A safety plan can be effective if completed correctly. The best practice is to complete this form when not in a crisis. This will allow you to think clearly when completing this form. Once completed, keep a copy for yourself and provide a copy to those that you can trust so they can help you in your time of need. Keep the contract in a visible space where you can easily find it. The safety plan will hopefully provide an increased sense of control during a time when you feel most out of control.
The safety plan should not take the place of an actual mental health assessment. For further assistance, contact your local community mental health center to schedule an appointment. Here is a list of community mental health centers.
Below are questions and examples to consider when completing this form. The examples do not cover all options available to you. Please individualize this form to meet your needs.
Step one: Warning signs (thoughts, images, mood, situation, behavior) that a crisis may be developing:
- Was there a negative change in a personal relationship such as with a parent, another family member, or significant other?
- Did something happen at work or at school that is affecting how you feel about yourself?
- Are you sleeping too much or not at all?
- Are you seeing/hearing things that others can’t see/hear?
- Is there increased stress in your community or living situation?
- Have you had financial or medical changes?
Step two: Internal coping strategies – Things I can do to take my mind off my problems without contacting another person (relaxation technique, physical activity):
- Draw
- Paint
- Calming music
- Deep, slow breathing
- Stretching
- Go for a walk
- Exercise
- Watch a favorite movie/TV show
- Praying
- Take a shower
- Eat a snack
- Take a nap
Step three: People and social settings that provide distraction:
- Places
- Park
- Walk in the local mall
- Volunteer at an animal shelter
- Church
- People
- Friend
- Case worker
- Spiritual advisor
- Family
Step four: People whom I can contact for help:
This section would include names and phone numbers from individuals from step three or anyone else that you can think of that could help you.
Step five: Professionals or agencies I can contact during a crisis:
- Clinician/therapist
- Local Community Mental Health Center
- Local hospitals
- 9-1-1
Step 6: Making the environment safe:
What needs to be removed/secured in your home to make it safer?
- Weapons
- Medications
- Vehicle keys
- Alcohol/drugs
- Chemicals/cleaners
- Sharp objects
- Ensure the safety of pets
- Robes, belts, neckties