How to Create a Mental Health Safety Plan: Step by Step

What Is a Safety Plan?

A safety plan is a written, personalized document that outlines specific steps you'll take when you notice yourself moving toward a mental health crisis — whether that involves suicidal thoughts, self-harm urges, panic, or overwhelming emotional distress.

Think of it as a fire escape plan for your mental health. You create it when you're calm and thinking clearly, so it's ready when you're in crisis and your brain's problem-solving ability is compromised.

A safety plan is not a contract or promise not to hurt yourself. Research shows that "no-harm contracts" are largely ineffective. A safety plan is different — it's a practical, step-by-step guide that gives you actions to take, people to contact, and strategies to use, arranged in a specific order from least to most intensive.

The Stanley-Brown Safety Planning Intervention, developed by Dr. Barbara Stanley and Dr. Gregory K. Brown, is the most widely used and researched safety planning model. A landmark 2018 study published in JAMA Psychiatry found that veterans who received safety planning plus structured follow-up had 43% fewer suicidal behaviors than those who received care as usual. The plan works.

If you're creating a safety plan, it's recommended to do so with a therapist, counselor, or trusted person who can help you think through each step. But if you don't have access to a professional right now, creating one on your own is still valuable.

Why Safety Plans Work

In a crisis, your brain shifts into survival mode. The prefrontal cortex — responsible for rational thinking, planning, and problem-solving — becomes less active, while the amygdala (threat response) takes over. This means that during the exact moments when you most need a plan, you're least equipped to create one.

A safety plan works because:

• It's made in advance — clear thinking creates the plan; the crisis just executes it
• It's concrete and specific — "call Sarah at 555-1234" is easier to follow than "reach out to someone" when you're in distress
• It creates a sequence — each step is a checkpoint that may resolve the crisis before you need the next step
• It buys time — suicidal crises are often temporary, lasting minutes to hours. A safety plan creates barriers and delays that allow the intensity to pass
• It reminds you of resources — in a crisis, people often forget what help is available to them

The simple act of pulling out your plan and reading step one can itself be a grounding intervention.

Step 1: Recognize Your Warning Signs

The first section of your safety plan identifies the thoughts, feelings, behaviors, or situations that signal you're heading toward a crisis. These are your personal early warnings — the signs that tell you to pull out the plan.

Examples:

• Thoughts: "Nobody cares," "I can't do this anymore," "Everyone would be better off without me," "Nothing will ever change"
• Feelings: Intense hopelessness, sudden calm after a period of distress (this can signal a dangerous shift), overwhelming anger, numbness, crushing loneliness
• Behaviors: Withdrawing from everyone, stopping eating or sleeping, giving away possessions, increasing alcohol or drug use, researching methods of self-harm
• Situations: Being alone for extended periods, anniversaries of losses, conflict with a specific person, specific times of day (late night is common)
• Physical sensations: Chest tightness, nausea, the feeling of being hollow, agitation you can't sit still through

Write yours down now. Be specific to your experience. The more personalized your warning signs, the earlier you'll recognize them.

My warning signs:

1. ---

2. ---

3. ---

Step 2: Internal Coping Strategies

Once you notice a warning sign, the first step is to try strategies you can do on your own, without contacting anyone else. These are things that help reduce distress or interrupt the escalation.

The key: these need to be strategies you've actually found helpful before, not generic advice. What works for someone else might not work for you.

Examples to consider:

• Physical: Take a cold shower, hold ice cubes, go for a walk or run, do 20 push-ups, splash cold water on your face
• Sensory: Listen to a specific calming playlist, pet your dog or cat, light a scented candle, wrap yourself in a heavy blanket
• Cognitive: Practice the 5-4-3-2-1 grounding technique, do a crossword puzzle, name every state capital, count backward from 100 by 7s
• Creative: Draw how you feel, play an instrument, write in a journal (even just "I'm having a hard time right now")
• Movement: Yoga, stretching, dancing to loud music, cleaning the house
• Distraction: Watch a familiar, comforting show, play a game that requires focus, organize something (drawers, photos, files)

Write down 3-5 strategies that have helped you:

1. ---

2. ---

3. ---

Step 3: People and Places That Provide Distraction

If internal coping strategies aren't enough, the next step is to seek out social contact or a change of environment — not necessarily to talk about how you're feeling, but to be around others and break the isolation.

People you can reach out to for casual contact:

• A friend you can text or call about everyday things
• A family member you enjoy spending time with
• An acquaintance you could suggest coffee or a walk with

Places you can go:

• A coffee shop where there are other people around
• A library or bookstore
• A park or walking trail
• A gym or community center
• A place of worship or community gathering

The goal here isn't deep conversation or crisis disclosure. It's interrupting isolation and reconnecting with the world outside your head.

People I can contact for social distraction:

1. Name: ___________ Phone: ___________
2. Name: ___________ Phone: ___________

Places I can go:

1. ---

2. ---

Step 4: People to Ask for Help

If distraction hasn't been enough, this step involves reaching out to someone you trust and telling them you're struggling. This is different from step 3 — here, you're explicitly asking for support.

Choose people who:

• You trust not to judge or dismiss you
• Can remain calm in difficult conversations
• Will take you seriously without panicking
• Are generally available (not someone who rarely answers their phone)

Write down 2-3 people and how to reach them:

1. Name: ___________ Phone: ___________ When available: ___________
2. Name: ___________ Phone: ___________ When available: ___________
3. Name: ___________ Phone: ___________ When available: ___________

What to say (having a script helps):

• "I'm having a really hard time right now and I need to talk."
• "I'm not okay and I could use some company."
• "I'm struggling with some dark thoughts. Can you stay on the phone with me for a bit?"

You don't need to explain everything. You just need to let someone in.

Step 5: Professional and Crisis Contacts

If personal contacts aren't available or the distress is escalating, this step involves professional support.

Your personal providers:

• Therapist: Name ___________ Phone: ___________
• Psychiatrist: Name ___________ Phone: ___________
• Primary care doctor: Name ___________ Phone: ___________

Crisis resources (available 24/7):

• 988 Suicide & Crisis Lifeline: Call or text 988
• Crisis Text Line: Text HOME to 741741
• SAMHSA Helpline: 1-800-662-4357
• Trevor Project (LGBTQ+ youth): 1-866-488-7386
• Veterans Crisis Line: Call 988, then press 1
• Your local emergency room: Address: _______________

When to go to the ER:

• You have a specific plan to harm yourself and access to means
• You've already harmed yourself
• You don't trust yourself to stay safe
• No other intervention has reduced the crisis

Going to the emergency room is always an appropriate response to a genuine safety crisis. You will not be wasting their time.

Step 6: Making Your Environment Safer

This step involves reducing access to lethal means during a crisis. Research consistently shows that restricting access to means during a suicidal crisis saves lives — because most crises are temporary, and most people who survive a suicide attempt do not go on to die by suicide.

Actions to consider:

• Firearms: Store guns outside the home (at a friend's, a gun range, or law enforcement) during vulnerable periods. Use a gun lock or safe with the key held by someone else. Research shows that the presence of a firearm in the home is the single strongest environmental risk factor for suicide completion.
• Medications: Have a trusted person hold medications that could be dangerous in large quantities. Ask your pharmacy to dispense in smaller amounts.
• Sharp objects: Remove or secure items that could be used for self-harm.
• Alcohol: Remove alcohol from your home during crisis periods, as intoxication increases impulsivity and disinhibition.

This isn't about permanent changes — it's about temporary environmental adjustments during your most vulnerable times. Tell a trusted person about this step so they can help.

Steps I'll take to make my environment safer:

1. ---

2. ---

Step 7: Your Reasons for Living

This step asks you to identify what matters to you — what tethers you to life even in the darkest moments. Writing these down when you're not in crisis ensures they're accessible when your depression or despair tells you nothing matters.

Your reasons might include:

• Specific people (children, partner, friends, pets)
• Goals or dreams you haven't accomplished yet
• Things you're curious about or looking forward to
• Values that matter to you (leaving the world better, creating something, caring for others)
• Simple pleasures (the smell of coffee in the morning, your favorite song, the feeling of sun on your face)

No reason is too small. If your reason for living tonight is "I want to see what happens next on that show" — that's a valid reason. Any anchor is an anchor.

My reasons for living:

1. ---

2. ---

3. ---

Using Your Safety Plan in a Crisis

Keep your plan accessible. Print it and keep it in your wallet, save it in your phone's notes, photograph it, email it to yourself, or use a safety planning app like My3 or Safety Plan (both free).

When you notice a warning sign:

1. Start at Step 1. Acknowledge: "I'm seeing my warning signs."
2. Move to Step 2. Try your internal coping strategies for at least 10-15 minutes.
3. If the crisis isn't resolving, move to Step 3. Reach out to someone or go somewhere social.
4. If you're still in distress, move to Step 4. Tell someone you trust that you need help.
5. If you need more support, move to Step 5. Call your therapist or a crisis line.
6. At any point, if you feel unsafe, go to the emergency room or call 988 immediately.

The plan is sequential — but you can skip ahead at any time. If you're in immediate danger, go straight to Step 5 or call 911.

Review and update your plan regularly — at least every few months, or after any crisis. Plans work best when they're current.

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A safety plan won't take away your pain. But it can give you a path through the worst moments — a set of handrails to hold when everything feels like it's falling apart. The fact that you're reading this, preparing for the possibility, is a profound act of self-care. You're worth the plan you're about to create.

If you are currently in crisis: Please call or text 988 right now. Someone is there for you, 24 hours a day, 7 days a week. You don't have to face this alone.