A self-harm safety plan is a personalized tool with coping strategies and support contacts to help you manage self-harm urges or suicidal thoughts.

Self-harm and suicide pose significant public health challenges, impacting individuals, their families, and communities. Putting effective prevention strategies in place is vital.

One such strategy is a personalized self-harm safety plan, a practical tool to help during self-harm or suicidal thoughts.

A personalized plan provides immediate access to coping strategies, enhances decision making in crises, and empowers people to actively manage their mental health.

A safety plan for self-harm is a personalized, proactive strategy designed to help you cope with and prevent self-harming behaviors. It typically involves several key components:

  • Support network: listing trusted friends, family members, or professionals to reach out to when experiencing distress
  • Identifying triggers: recognizing the situations, thoughts, or emotions that lead to self-harm urges
  • Coping strategies: developing healthy coping mechanisms to manage triggers, such as relaxation techniques, mindfulness, or engaging in activities that provide comfort
  • Delayed response: committing to delaying self-harm for a specific period (e.g., 15 minutes) to allow intense emotions to subside
  • Distraction techniques: identifying activities or strategies — like reading, drawing, or exercise — that can divert attention from self-harm urges
  • Crisis helpline: including contact information for crisis helplines or mental health professionals who can provide immediate support
  • Removing harmful objects: ensuring that objects commonly used for self-harm are out of immediate reach. (This should be done before the episode.)

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

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Safety plans can be effective tools for managing and avoiding risks and hazards, but their effectiveness hinges on thorough planning, regular drills, and compliance.

According to a 2021 study, a safety planning intervention (SPI) was effective in the following ways:

A 2022 review of 22 studies suggests that suicide safety planning is effective in reducing suicidal behavior and ideation. Though some studies hint at potential benefits for reducing mental illness symptoms, enhancing resilience, and promoting the use of mental health services, the evidence for these benefits is less robust.

Overall, safety planning is considered a valuable tool for preventing suicide. It becomes even more effective when it’s developed through collaboration between professionals (service providers) and people at risk of suicide.

Though not an exhaustive list, here are some signs that someone could benefit from a safety plan:

  • Expressing suicidal thoughts: If someone talks about wanting to die, feeling hopeless, or having no reason to live, take such statements seriously.
  • Previous suicide attempts: People with a history of suicide attempts or self-harm are at higher risk and may need ongoing support and a safety plan.
  • Engaging in self-harming behaviors: Self-harm, such as cutting or burning, can indicate emotional distress and a need for help.
  • Drastic mood shifts: Frequent and extreme changes in mood, particularly if they involve severe sadness, hopelessness, or agitation, may signal a need for intervention.
  • Social withdrawal: Someone who suddenly isolates from friends and family, avoids social interactions, or loses interest in previously enjoyed activities may need support.
  • Sudden and severe changes in behavior: Significant changes in behavior, such as increased risk-taking, reckless behavior, or substance misuse, can be warning signs.
  • Giving away possessions: If someone starts giving away belongings or making final arrangements, it can be a sign of suicidal intent.
  • Experiencing major life stressors: Significant life events like a loss, relationship breakup, financial problems, or legal issues can trigger suicidal thoughts and may require a safety plan.
  • Verbal clues: Pay attention to subtle statements like feeling like a burden to others, having no reason to live, or feeling trapped with no way out.
  • Isolation and alienation: Feeling disconnected from loved ones, experiencing discrimination, or having feelings of not belonging can contribute to suicidal thoughts.
  • Sudden improvement: Paradoxically, if someone who has been depressed or withdrawn suddenly appears to be doing better, it can be a sign they’ve made a decision to end their life, and a safety plan may be needed.

A safety plan is a personalized and structured document designed to help people at risk of suicide or experiencing emotional distress. Though the exact content can vary depending on the person and the context, a typical safety plan generally includes the following components:

  • Emergency contacts: names and numbers of people you can call for support
  • Warning signs: signs that tell you when you might be feeling really bad
  • Coping strategies: healthy ways to manage tough emotions, like deep breathing or going for a walk
  • Who to talk to: people you can reach out to when you need to chat
  • Professional help: contacts for therapists or crisis services
  • Safe place: where to go when things get really tough
  • Removing access: if you have items that could be dangerous, a plan for keeping them safe
  • Reasons to stay: reminders of why life is worth living
  • Follow-up: a plan to check in with someone regularly
  • Crisis helplines: phone numbers for immediate help

Creating a safety plan involves these key steps:

  • Identify warning signs: Recognize what triggers your distress or suicidal thoughts.
  • List coping strategies: Identify healthy ways to cope when you feel overwhelmed.
  • Connect with support: Identify people you can turn to for help and communicate with them about your plan.
  • Seek professional help: Include contacts for mental health professionals and crisis hotlines.
  • Designate a safe place: Choose a safe location to go to when in crisis.
  • Limit access: If applicable, make a plan to restrict access to any means of self-harm.
  • Focus on reasons to live: List reasons why life is important to you.
  • Schedule follow-ups: Set up regular check-ins with someone you trust.
  • Include crisis helplines: Add phone numbers for immediate assistance.

What to do after you have created a safety plan

After creating a safety plan, it’s vital to:

  • Regularly review and update it.
  • Share it with trusted individuals in your support network.
  • Practice the coping strategies it includes.
  • Stay connected with your mental health professionals and support system.

Safety plans are critical tools in self-harm and suicide prevention. They can reduce suicidal thoughts and behaviors and provide guidance during tough times.

They’re most effective when personalized, regularly updated, and used alongside professional help. In short, they can save lives, but they’re just one part of a broader strategy to support mental health and well-being.