How to Create a Suicide Safety Plan
We’ve recently been sharing the stories of people with firsthand experiences of suicide; whether they’ve lost someone to suicide, helped someone navigate that dark period, or have struggled with suicidal thoughts themselves.
Through all those stories, you might be left wondering, What can I do about it? How can I help?
The short answer is; there are plenty of ways you can help make a difference to someone who might be struggling with suicidal ideation.
Perhaps one of the most important things we can all do is to start by understanding a bit more about suicide – what is it, why might people consider it, and what are some warning signs to look out for that might indicate someone is thinking about suicide? We’ll break down those three questions in this blog post.
Then, once we’ve got more of an understanding of how to notice someone who might be suicidal, we’ll talk about what we can do; from questions we can ask a person, how to support in the immediate aftermath of an attempt, and ongoing preventative measures we can help that person take, especially in the form of a Safety Plan.
Let’s dive in.
What Is Suicide, and Why Do People Consider It?
Let’s start with the definition. The word ‘suicide’ comes from the latin words “sui” (meaning “of oneself”) and “cidium” (meaning “a killing”); so suicide is “the deliberate killing of oneself”.
There are three components that must be fulfilled in order for something to be considered a suicide.
It’s a self-inflicted injury
There needs to be an intent to die
It results in death
There are many different reasons why a person may choose to end their life. The three most common reasons for suicide are:
Mental illness; it could be severe depression which leads to the suicidal thoughts, or it could be another disorder such as schizophrenia or bipolar affective disorder, which both have a higher incidence of suicide that we know of.
Physical illness; many people don’t realise the impact that a physical illness, disability or chronic pain can have on a person’s mental health, leading them to take their life.
Relationship breakdown; it could be the breakdown of a marriage or a rupture in family relationships or friendships that causes a person to feel that there is no longer a reason for them to live.
Some other reasons a person may take their life include:
Financial problems such as bankruptcy or losing your home
Social isolation
Being elderly; when someone has lost their loved one and is now on their own, possibly feeling neglected and lonely
Alcohol and drug problems
Childhood abuse which leads to post-traumatic stress disorder (PTSD)
Losses & failures, such as the loss of a loved one or the loss of reputation and status
A common theme you may notice in all of these is that people experiencing these situations are in a vulnerable emotional state and can’t see a way out of their pain.
So, How Can We Help?
Identifying Warning Signs
There’s a common misconception that someone who’s feeling suicidal will be easy to spot. But a lot of the time, it’s not so obvious. So an important step we can take to help prevent suicide is to be well-versed in recognising the warning signs of someone who may be struggling with suicidal thoughts.
Some of these signs include:
Existing mental health struggles that appear to be getting worse; especially depression
Expressing feelings of shame or hopelessness
Loss of energy, feeling tired all the time
Changes in appetite and eating habits
No longer putting in effort towards school, work, or hobbies
Talking or writing about death or dying
Reckless behaviour (more spontaneous than usual, spending money, doing things on impulse, etc.)
A recent loss or form of grief (losing a friend or family member, going through a breakup, etc.)
Talking about or showing signs of self-harm
Having means of self-harm, such as excess medication, a gun, or poisonous substances
Feelings of hopelessness
Increased alcohol intake or substance abuse
Social isolation and withdrawal from family, friends or community
Someone who has recently started taking antidepressants
This is an important point to be aware of, because the side effects of going antidepressants can often include a higher risk of suicide. This is because when someone is severely depressed, they’re lethargic and lacking in motivation; so even though they might think they want to end their life, they don’t necessarily have the energy to carry that out. Once they start taking antidepressants, however, their energy levels begin to improve and they now have the capacity to follow through on their thoughts of suicide. So if you’re a relative or friend of someone who has recently started on antidepressants, be on the lookout.
Questions To Ask
When we suspect someone might be struggling with suicidal thoughts, there are a few questions we can ask to gauge the seriousness of their intent.
Even though it may feel uncomfortable, asking someone directly if they’ve felt suicidal can give them permission to share what they’re going through. While it might feel counterintuitive to bring up the topic, research shows that someone who can speak about their suicidal thoughts is less likely to take their own life. In short; asking a person whether they’re struggling with suicidal ideation won’t put the idea in their head or make it worse, it’ll give them the opportunity to feel seen and understood.
And, if you don’t ask the question, you might miss someone who is suicidal. You’re not going to make it worse by asking.
Here are some questions we can ask:
Have you been feeling depressed?
When you feel this way, have you thoughts of harming or killing yourself?
When and how often did you have these thoughts?
What did you think of doing? When and where?
When was the last time you had these thoughts?
Have you acted on these thoughts in any way (like accumulating medication, buying poison, ropes, a gun, etc.)?
Have your thoughts ever included harming someone else as well as yourself?
We increasingly hear of suicide and homicide together – for example, someone who wants to end their life but also kills their partner or children because they think there’s no point in leaving them behind.
Have you made plans for your possessions or left a will or instructions?
Have you thought about how your actions will affect your loved ones?
What has stopped you from acting on your thoughts so far?
What do you think might help you cope with the way you’re feeling?
How does talking about all this make you feel?
A common worry we might have is feeling ill-equipped to deal with the answers a person might give us. What if they are suicidal, what then?
This brings us to the best thing we can do: refer. There’s only so much you can do on your own for someone who’s struggling with suicidal ideation, so encourage that person to also seek professional help.
They may feel unsure of where to go or nervous about speaking to a professional, so “referring” might look like doing a quick Google search for organisations or clinics in your area who this person can see, helping them make that phone call, or even offering to take them to their first appointment; whatever support that person needs to go and seek professional help.
Most countries have a 24-hour crisis helpline that you can call for support or advice on how to help your friend, and if you’re in Australia or New Zealand, you can visit this page of helplines.
Don’t carry the burden of your friend alone, but find support for yourself, too – a mental health professional, your pastor, family, or trusted friends.
How to Respond in the Aftermath of an Attempted Suicide
Firstly, if we come across somebody who has attempted to take their life, our immediate actions should be to:
Remove the person from that environment (wherever they attempted);
Take away whatever they used to attempt (whether that’s medication, rope, a weapon etc.);
Be with them, and don’t leave them by themselves.
After taking these actions, the most important thing we can do is to refer the person, as we’ve already mentioned above. Rather than trying to help them all by ourselves, the person needs professional help.
It’s important to note that a person who is struggling with thoughts of suicide might not be willing to be referred, and you can’t force that. However, if the person has made an attempt or you know that they have taken actions in this direction (e.g. they’ve stored up medicine, purchased a gun, changed their will, etc.) then we have the responsibility to alert the authorities and refer them for help, because they’re not in the right mind to make that decision for themselves.
Regardless of whether the person wants this help at the time, if we think they’re a danger to themselves or others, it’s important we take action. If you’re in Australia or New Zealand, visit our Helplines page to view a list of helplines you can call. If you’re outside of this area, a quick Google search for ‘suicide helpline’ should help you find an organisation you can call.
What’s a ‘Safety Plan’ and How Do We Create One?
A Safety Plan prepares a person to cope with suicidal thoughts when they come. It’s an agreement beteween the suicidal person and you as the close friend or relative, and it’s created while the person is feeling calm and safe (i.e. not in the moment they’re experiencing suicidal thoughts or contemplating acting on them).
More than just being helpful in an emergency situation, a Safety Plan can proactively help a suicidal person start to work through their feelings. It’s reminding them that they have reasons to live, and you’re helping them consider how they can get help for themselves.
These are some of the questions and things to talk about with that person to create the plan. You can either have that person write down their answers, write it out for them with their permission, or create a digital plan, whether that’s in a note on your phone or in an app (e.g. Beyond Blue has an app called Beyond Now that you can use to set up a digital Safety Plan).
Questions/topics to work through together:
How can I identify warning signs in myself before heading into an emotional crisis?
How can I make my environment safe now when I’m not thinking about suicide? (E.g. do I have tablets I need to throw away, a gun I’m not safe with, razors I don’t need, etc.?)
Identify reasons to live. Everybody has reasons to live; family, loved ones, things they find purpose in. Encourage the person to write them down and place them in an easily visible spot so that any time they experience suicidal thoughts, they can remember their reasons to live. When they’re not feeling in their right mind, having these tangible reasons easily visible and accessible could help them to reconsider.
What actions can I take when I’m feeling suicidal? Can I remove myself from the environment I’m in and call someone I trust?
Who are some people I can connect with?
Who are the people I can talk to in a crisis? Write down the phone number of yourself or someone else they trust who can agree to respond at any time when the person is feeling this way.
How can I get professional assistance when required? Gather a list of phone numbers for helplines you can call or the contact information of organisations and clinics in your area.
Once you’ve helped this person create their Safety Plan, make sure it’s on hand and that you each have a copy, whether that’s physical or digital. You may want to revisit the plan every now and then to make sure it’s up to date and accurately reflects what would best help that person.
Although a Safety Plan by itself won’t guarantee to keep the person safe, it’s a helpful tool we can use to get the person engaged in thinking about their decision and its implications, and feeling empowered that they know what they can do or who they can turn to for help when suicidal thoughts arise.
We hope you’ve found this post helpful. For more information on suicide, including where we see it in the Bible and stories of people who’ve been affected by suicide–whether through their own mental illness struggle or the loss of a loved one–head to our Suicide Resources page. And, if you’re looking for some more general ways to offer support, check out 6 Ways to Support Someone Struggling With Suicidal Ideation.
If you yourself are struggling, we’d strongly encourage you to reach out to someone, whether that’s a family member, trusted friend, your pastor, doctor or psychologist. If you aren’t sure who to speak with, you can find a list of Australian and New Zealand helplines here, or a quick Google search should find you an organisation you can call in your own country.
