The above is an example of a highly inadequate safety/crisis plan. The one that Saagar was given. It does not mention the word ‘Suicide’.
A safety plan should include:
- Reasons for living and reasons not to harm themselves
- A plan to create a safe environment How they can remove or secure things they could use to harm themselves? Can they identify and avoid things that they know make them feel worse? These are called distress triggers
- Activities to lift mood, calm or distract
- People to talk to if distressed. Include contacts for general support (not necessarily confiding their suicidal thoughts) and specific suicide prevention support.
- Professional support such as 24 hour crisis telephone lines
- Emergency NHS contact details
- Personal agreement that Safety Plan was co-produced and a commitment to follow when required
Include names and all phone numbers for people to be contacted
Bank of Hope
A. Maximise the power of the individual not to act on their suicidal thoughts;
- Increase wellbeing and resilience – enhance protective factors
- Increase emotional resourcefulness and share simple problem solving techniques to better equip them to deal with their triggers for suicidal thoughts or adverse life events should they occur/continue;
- Increase internal locus of control – ‘do not be a passive victim of suicidal thoughts’
- Increase self-efficacy – uncover or learn the skills and techniques not to act on suicidal thoughts
B. Reduce the power of suicidal thoughts;
- Help patients see that suicidal thoughts don’t last forever;
- Intense suicidal feelings are often short lived (although acknowledge that individuals may have long lasting suicidal thoughts which can still be very distressing)
- Share examples of others who made serious and potentially lethal suicide attempts but who changed their mind immediately before or half way through and realised that they did not want to actually die, it was just that they felt so desperate and hopeless that they did not know what else to do to make those feelings go away. Their real wish was to feel better, not to actually die.
- Reduce ‘the power’ of their suicidal thoughts, whilst acknowledging and validating the distress they can cause to the individual experiencing them;
- Help the individual experiencing suicidal thoughts to view those thoughts as nothing more than ‘a symptom of distress’ (like having a temperature due to a viral illness), rather than some powerful magical impulse that they cannot resist.
Podcast: BMJ : https://soundcloud.com/bmjpodcasts/revisiting-the-bridge
(Source : Connecting with people: http://www.connectingwithpeople.org/)