A Safety Plan for Your Teen: What Parents Do, What the Teen Writes

This guide is for parents and caregivers of a teenager who has talked about suicide, hurt themselves, or come home from an emergency room or hospital with a safety plan in hand. Your teen should read it too. Where your child’s clinician has told you something different, go with the clinician.

In 2024, suicide was the second leading cause of death in the United States for people ages 10 to 44, according to the CDC’s National Center for Health Statistics. Many young people who die by suicide had a health care visit in the weeks or months before, and most young people do not bring up suicidal thoughts unless someone asks. That is why the American Academy of Pediatrics recommends screening every patient 12 and older for suicide risk, and safety planning for young people who are at risk.

What is different about a teen’s safety plan?

The structure is the same six or seven steps described in how to make a safety plan: warning signs, things to do alone, people and places, people to tell, professionals and crisis lines, making the space safer, and reasons to keep going. Three things change.

The teen writes it, in their words. A plan a parent writes for a teenager is a list of rules. A plan the teen writes, with a clinician and with the parent in the room for part of it, is something they might open at midnight. Let them choose the coping steps, even the ones that seem small, and the people they will reach out to, even if the parent is not first on the list.

It lives on the phone. Many teens will not carry a paper card. A photo of the plan saved as a favorite, a note on the phone, or the plan typed into the notes app works. Some clinics use a safety-plan app; ask what yours recommends. The printable safety plan template can be the draft they photograph.

The parent owns the safer-home step. A teenager cannot lock up the medicine cabinet or move a firearm. That part is the adult’s, and limiting access to lethal means is one of the suicide prevention strategies with the strongest research support.

The parent’s part: making the home safer

Suicidal crises in young people can escalate quickly and are often impulsive, so what is within reach during that window matters. Clinicians call this step lethal means counseling, and the American Academy of Pediatrics recommends it for young people with suicidal thoughts or behavior. If no one at the emergency room or clinic went over it with you, ask.

• Medications. Lock up all medications, prescription and over-the-counter, including pain relievers and the teen’s own prescriptions, and hand out doses as needed for a while. Keep only small amounts at home, and clear out old or unneeded medications.
• Firearms. If there is a gun in the home, the safest step during a crisis is to store it somewhere else: a relative’s house, a gun shop or range that offers temporary storage, or a police department that will hold firearms (not all do; call first, and do not bring a firearm in unless they tell you to). If it must stay, store it locked and unloaded with the ammunition locked separately, and make sure the teen does not know the combination or where the key is. Laws on transferring firearms vary by state; check before you move one.
• Other means. Alcohol, sharp objects, car keys at night, and anything the teen has mentioned or used before. Ask the clinician what to prioritize for your child.
• Supervision. In the first days after a crisis or a hospital stay, ask the clinician how much supervision is needed and for how long.

What to say, and what not to say

Ask the direct question: “Are you thinking about killing yourself?” Research on asking about suicide, including a large study of high school students, has found no evidence that asking puts the idea in someone’s head, and some evidence that it may help.

Listen more than you talk. Do not promise to keep it secret from their clinician, and do not promise it will never happen again. Promise the things you can keep: “I’m not angry,” “I’m staying with you,” “We’re going to get help with this together.”

Avoid lectures about how much they have to live for, comparisons with other kids, and threats about phones or privileges tied to how they are feeling. Those can make a teen less likely to keep telling you.

School, friends, and the plan

Decide together who at school will know. A school counselor can be on the plan as one of the people to tell, and you can ask the school whether it has a plan for a student returning after a hospital stay. The teen gets a say in what is shared and with whom.

Some teens tell a friend before they tell any adult. It is worth telling your teen plainly: if a friend tells you they are thinking about suicide, you are allowed to tell an adult, and it is not a betrayal.

After the emergency room or hospital

The months after self-harm or a psychiatric hospital stay are a time of higher suicide risk for teenagers, not only for adults. In a large U.S. study of young people ages 10 to 18 leaving a psychiatric hospital, those who had a mental health visit within 7 days of discharge had a lower risk of suicide over the next six months. Before leaving, have a follow-up appointment within a week, medications in hand with clear instructions, a written safety plan, and the safer-home steps done before the teen walks in the door. The guide on the first 30 days after a psychiatric hospital stay covers each item.

If your teen is prescribed an antidepressant, the prescriber should explain the FDA boxed warning. It says antidepressants increased the risk of suicidal thoughts and behavior in children, teenagers, and young adults through age 24 in short-term studies, and that families should watch closely, especially in the first few months and whenever the dose changes. Call the prescriber right away about new or sudden changes in mood or behavior; if your teen is in danger, use the steps at the top of this page. The same label says depression and other serious mental illnesses are the most important causes of suicidal thoughts, and that the medicine should not be stopped without talking to the prescriber first.

Looking after the parent

You can call 988 for yourself, too. The Lifeline takes calls from worried family members, not only from the person at risk. NAMI runs free classes and support groups for families, including NAMI Basics, for parents and family caregivers of young people 22 and younger, in person or online.

If you want more structure for the household, the household crisis plan is a one-page sheet for clinicians’ numbers, medications, hospital preference, and who covers what.