61 SUICIDE PREVENTION AWARENESS Safety plans to prevent suicide Expert Reviewer: Dr.Yvonne Bergmans PhD, RSW While some people who consider suicide do so fleetingly or only once in their lives, others experience these thoughts ongoing or off and on over time. Suicidal thoughts can burden people and hold them hostage. Experiencing these thoughts is to experience “absolute darkness, hopelessness, pain,” and nothing matters but stopping that pain.As friends and caregivers, we may feel at a loss to help or support people with these thoughts; we may feel that taking our loved one to the emergency room is our only option, that crisis medical support is necessary. If the person considering of suicide is in immediate crisis, the emergency room is an appropriate level of care. Otherwise, co-developing a safety plan is the best way forward. What is a safety plan? A safety plan is a document that supports and guides someone when they are experiencing thoughts of suicide, to help them avoid a state of intense suicidal crisis. Anyone in a trusting relationship with the person considering suicide can help draft the plan; they do not need to be a professional. When developing the plan, the person experiencing thoughts of suicide identifies: • their personal warning signs, • coping strategies that have worked for them in the past, and/or strategies they think may work in the future, • people who are sources of support in their lives (friends, family, professionals, crisis supports), • how means of suicide can be removed from their environment, and • their personal reasons for living, or what has helped them stay alive. When is a safety plan written? A safety plan is written when a person is not experiencing intense suicidal thoughts. It may be written after a suicidal crisis, but not during, as at this time an individual can become overwhelmed with suicidal thoughts and confusion and may not be able to think clearly.A safety plan is written when a person has hope for life, or even can consider the possibility of life, so that they can identify their reasons for living, and positive actions they can take to prevent their thoughts from becoming intense and overwhelming.A safety plan can be developed in one sitting by the person with thoughts of suicide together with you, their caregiver or friend, or over time.The plan can change as the circumstances for the individual change and can be revised accordingly. Why does it work? A safety plan is an assets-based approach designed to focus on a person’s strengths.Their unique abilities are identified and emphasized so they can draw on them when their suicidal thoughts become intense. The goal is to draw upon their strengths during subsequent recovery and healing processes (Xie, 2013). Personal resources are another integral safety plan component. Drawing on strengths is the entry-level activity; reaching out for help may also become necessary (Xie, 2013; Bergmans, personal communication, 2019). The safety plan is organized in stages. It starts with strategies the individual can implement by themselves at home and ends with 24/7 emergency contact numbers that can be used when there is imminent danger or crisis. The person with thoughts of suicide can verify, along with their caregiver or friend, whether coping skills are feasible, as well as whether or not the chosen contact people are appropriate (Bergmans, personal communication, 2019). When implemented, safety plans become self-strengthening. For people who experience recurring suicidal thoughts or crises, one strength becomes knowing they have weathered the storm before and have navigated their way out. (continued) A suicidal crisis refers to “a suicide attempt or an incident in which an emotionally distraught person seriously considers or plans to imminently attempt to take his or her own life” (Suicide Prevention Resource Center, n.d.).