How to Make a Mental Health Safety Plan

What is a safety plan, and what is it not?

A safety plan is a personal, written list of what to do when things start to get dangerous. It moves from the steps you can take alone to the steps that bring in other people, so you have somewhere to go next if one step does not work.

It is not a “no-suicide contract.” Those are agreements in which a person promises not to harm themselves, and suicide prevention guidance has moved away from them. A promise gives you nothing to do when the feeling arrives. A plan does.

The point of a safety plan is to lower the number of decisions you have to make when you are least able to make them. Who to call, where to go, and what has helped before are all written down already.

Does safety planning actually help?

The evidence is encouraging, and it is not a cure. The best-known version, the Safety Planning Intervention developed by psychologists Barbara Stanley and Gregory Brown, was tested in a 2018 study of about 1,600 patients, most of them veterans, seen in Veterans Health Administration emergency departments for suicide-related concerns. Patients who made a safety plan and got follow-up phone calls had 45% fewer suicidal behaviors over the next six months than patients who got usual care (3.0% compared with 5.3%), and they were more likely to attend at least one outpatient mental health visit. The study compared hospitals rather than assigning patients at random, and it was led by the intervention’s developers.

A 2021 meta-analysis that pooled six studies of safety planning-type interventions also found fewer suicidal behaviors among people who received them. It did not find a clear reduction in suicidal thoughts themselves. These studies mostly looked at plans built with a clinician, often in a hospital or clinic. A plan you make on your own is still useful. It is just not the version that was studied.

The seven parts of a safety plan

The order matters. Each part is a little more involved than the one before it, so you start with what you can do in the next five minutes and move outward only as needed. The printable worksheet follows this order.

1. Your warning signs

What tells you a crisis may be coming? Warning signs can be thoughts (“nothing is ever going to change”), feelings (numbness, panic, rage), behaviors (not eating, not answering texts, drinking more), or situations (an anniversary, a fight, a bill you cannot pay, a sleepless week).

Be specific and personal. “I start canceling plans and stop showering” is something you and the people around you can actually notice. “I feel bad” is not.

2. Things you can do on your own

These are small actions that have helped you get through a bad hour before, without needing anyone else. A walk, a cold shower, a specific playlist, a breathing exercise, writing it out, a game that takes your full attention.

Choose things you can actually do at 2 a.m. in the state you are likely to be in. A plan that says “go for a run” is not much help to someone who has not left bed in two days.

3. People and places that get you out of your own head

Sometimes the goal is not to talk about it. It is just to not be alone with it. List places where you can be around other people, such as a coffee shop, a library, a gym, a place of worship, or a support group, and people you can spend time with without having to explain anything.

4. People you can tell what is really going on

These are the people you trust enough to hear “I’m not okay and I need help.” Write their names and phone numbers on the plan itself. In a crisis, scrolling through contacts to decide who to call is one more decision you should not have to make.

Ask them first, if you can. A friend who knows they are on your plan is more likely to pick up, and to know what you want from them when they do.

5. Professionals and crisis lines

List your therapist, psychiatrist, or primary care doctor, and ask each office what you should do if you need them after hours. Add the crisis lines that work for you:

• 911 for immediate danger, an attempt in progress, or a medical emergency.
• 988, the Suicide & Crisis Lifeline, by call or text, or chat at 988lifeline.org. Veterans and service members can press 1 to reach the Veterans Crisis Line.
• Crisis Text Line: text HOME to 741741.
• The address of your nearest emergency room.

6. Making your space safer

This step is about putting time and distance between yourself and anything you could use to hurt yourself, before a crisis, not during one.

Why does that matter? Research on suicide prevention has found that many suicidal crises are short, and that making dangerous means harder to reach during that window saves lives. Some people who are kept from one method do not go on to find another. Distance buys time, and time is often what a crisis needs to pass.

What this looks like depends on your home. It often means asking someone else to hold or lock up medications, keeping only a small supply on hand, and, if there are firearms in the home, storing them locked and unloaded or with someone outside the home while things are hard. Some police departments, gun shops, and ranges offer temporary storage. Laws on transferring firearms vary by state, so check before you move one. A clinician or a 988 counselor can talk this step through with you.

7. What you are holding on for

Write down the people, pets, plans, beliefs, or small things that matter to you, even when they feel far away. On a hard day, this section can be the hardest to fill in. One honest line is enough to start: a niece’s birthday, a dog who needs feeding, a show you want to finish.

Should you make it alone or with someone?

With someone, if you can. In the research, safety plans were built in conversation with a clinician who asked follow-up questions, helped the person picture using each step, and checked whether the steps were realistic. That conversation was part of the intervention that was tested.

If you are in therapy, ask your therapist to build or review a safety plan with you. If you are not seeing anyone right now, you can start one on your own and bring it to the next appointment you have, including a primary care visit. You can also call or text 988 and ask the counselor to help you work through it.

Helping someone you care about make a plan

If you are a parent, partner, or friend, you can help someone make a plan, but it has to be theirs. Ask what their warning signs look like from the inside. Offer to be one of the people in step 4, and ask what they would want you to do if they called. Ask whether they want help with step 6 and, if they do, follow through that week.

What not to do: write the plan for them, use it to monitor them, or treat a plan as proof the danger has passed. If you are worried someone is in danger right now, the guide on helping someone in a mental health crisis covers what to say and who to call.