Safety Planning for Suicidal Thoughts and Self-Harm: A Guide to Staying Safe During a Crisis
Safety planning is a brief, structured intervention used to help someone recognize warning signs, reduce immediate risk, and identify concrete steps for staying safe during a crisis. It is most often used when someone is experiencing suicidal thoughts, urges to self-harm, or periods of high emotional danger. A safety plan is different from a “no-suicide contract.” Instead of asking someone to promise not to act, safety planning helps them name what tends to happen before risk increases, what they can do first, who they can contact, and how to make the environment safer. Peer-reviewed research has found that safety planning-type interventions can reduce suicidal behavior, increase treatment engagement, and support crisis coping, especially when paired with follow-up support.
Guided Practice
(optional)
To create a safety plan, begin by identifying early warning signs that risk may be increasing. These may include thoughts, feelings, body sensations, urges, behaviors, situations, substance use, conflict, isolation, hopelessness, or changes in sleep. Next, list internal coping strategies that can be tried before reaching out to others, such as grounding, distraction, cold water, breathing, leaving an unsafe location, or reducing access to lethal means. Then identify people and places that can provide connection, support, or distraction. Include trusted contacts, professional supports, crisis lines, emergency services, and steps for making the environment safer. The plan should be specific enough to use when thinking is narrowed by distress. Keep the plan somewhere easy to find, such as your phone, wallet, journal, or therapy folder. A safety plan is most useful when it is reviewed before crisis moments and updated when circumstances change.
Important Reminder
Safety planning is a support tool, not a substitute for emergency care. If you may act on suicidal thoughts, cannot stay safe, have already harmed yourself, or are in immediate danger, contact emergency services, call or text a crisis line, go to the nearest emergency room, or reach out to a trusted person who can stay with you. Safety plans work best when they are collaborative, realistic, and connected to real support. You do not need to wait until things are “bad enough” to use the plan.
References
Albaum, C., Hesson, J., Munce, S., Thabane, L., Cohen, E., Toulany, A., & Saunders, N. R. (2025). Safety planning interventions for suicide prevention in children and adolescents: A systematic review and meta-analysis. JAMA Pediatrics, 179(8), 886-895. https://doi.org/10.1001/jamapediatrics.2025.1012
Bryan, C. J., Mintz, J., Clemans, T. A., Leeson, B., Burch, T. S., Williams, S. R., Maney, E., & Rudd, M. D. (2017). Effect of crisis response planning vs. contracts for safety on suicide risk in U.S. Army Soldiers: A randomized clinical trial. Journal of Affective Disorders, 212, 64-72. https://doi.org/10.1016/j.jad.2017.01.028
Nuij, C., van Ballegooijen, W., de Beurs, D., Juniar, D., Erlangsen, A., Portzky, G., O’Connor, R. C., Smit, J. H., Kerkhof, A. J. F. M., & Riper, H. (2021). Safety planning-type interventions for suicide prevention: Meta-analysis. The British Journal of Psychiatry, 219(2), 419-426. https://doi.org/10.1192/bjp.2021.50
Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256-264. https://doi.org/10.1016/j.cbpra.2011.01.001
Stanley, B., Brown, G. K., Brenner, L. A., Galfalvy, H. C., Currier, G. W., Knox, K. L., Chaudhury, S. R., Bush, A. L., & Green, K. L. (2018). Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry, 75(9), 894-900. https://doi.org/10.1001/jamapsychiatry.2018.1776
