Information for health professionals

Safety planning helps people reduce their immediate risk of suicidal behaviour. It involves the person – ideally with support from a health professional – identifying coping and help-seeking strategies that are tailored for their needs, situation and personal relationships.

Together, the client and health professional develop a list of strategies that gradually progress from things the person can do by themselves through to social and external ways of coping. The resulting safety plan is then used during times of distress and crisis. 

Why use safety planning?

Around 200 Australians attempt suicide every day, while many more think about it. Research suggests that most people who think about or attempt suicide don’t actually want to die – they just want their psychological pain and distress to stop. Safety planning provides a structured approach to help people manage psychological distress and suicidal thoughts, which can reduce their immediate risk of engaging in suicidal behaviour.

Who can benefit from safety planning?

Safety planning can be beneficial for anyone experiencing, or who has recently experienced, suicidal thoughts or behaviour.

What’s involved in safety planning?

Many clinicians use some form of safety planning with their suicidal clients. However, until recently there has been little formal structure to guide the process, with even less empirical research to support interventions. The Safety Planning Intervention (SPI) developed by Professor Barbara Stanley and Professor Gregory Brown (2012) brings much needed structure to this area of clinical practice.

The SPI model involves identifying actions within each of the steps below, which are reflected in the BeyondNow app: 

  • Recognising warning signs
  • Creating a safe environment
  • Identifying reasons to live
  • Internal coping strategies
  • Socialisation strategies for distraction and support 
  • Trusted contacts for assisting with a crisis 
  • Professional contacts for assisting with a crisis 

Using BeyondNow with ​your client

Start by downloading the app from the App Store or Google Play and familiarising yourself with it. You can also check out our quick introduction to the different features, including editing and sharing a plan. If your client prefers, you can use the online version together and print or email them a copy.

When you're supporting your client to create their plan, asking questions can help them think about what might work for their situation and ensure any strategies meet their individual needs. We’ve developed a few prompts for each step below, or you could use the suggestions within the app to guide discussion and get ideas going.

Some people may not wish to complete a particular step or steps in the safety plan. Their plan is unique to them and is all about keeping safe, so if certain steps aren’t helpful or create an additional source of burden, stress or conflict, these can be left out. 

Safety plans are designed to be followed step by step. However, it’s important to reinforce with your client that if they feel at imminent risk and are unable to remain safe – even for a short period of time – they should phone or present to an emergency service.

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My warning signs

One of the most effective ways of averting a suicidal crisis is to address difficulties before they fully emerge. The first step of a safety plan involves identifying the warning signs that immediately precede a suicidal crisis. Being aware of changes in thoughts, moods and behaviour that may signal a developing crisis allows the person to act earlier, helping to reduce further risk.

Questions to ask might include:

  • How will you know when your safety plan should be used?
  • What are some of the difficult thoughts, feelings or behaviours that you experience leading up to a crisis?

Warning signs might include:

  • Moods such as sadness, anxiety or irritability.
  • Thoughts involving hopelessness, helplessness, or self-criticism.
  • Behaviours such as drinking more alcohol than usual, avoiding social situations, or arguing more often with friends or loved ones.

Creating a safe environment

The next step involves identifying ways of keeping the person’s immediate environment safe by reducing or eliminating their access to potentially lethal means. This step can also include being aware of and avoiding stressful or upsetting situations.

Questions to ask might include:

  • Are there any specific situations or people that you find stressful or triggering, or that contribute to your suicidal thoughts? 
  • What things do you have access to that are likely to be used in a suicide attempt?
  • How can we develop a plan to limit your access to these means and avoid these situations?

Restricting access to lethal means might include:

  • Asking someone else to manage access to medication
  • Reducing access to firearms or improving safety procedures. This step should always involve having a support person remove any firearms.
  • Getting rid of glass or blades that might be used to cause harm.

My reasons to live

Experiencing suicidal ideation is often mentally consuming, and it can be hard to see the positive things in life that bring joy and meaning. The next step of a safety plan involves having a pre-written list of reasons to live. These help the person remember things they enjoy or can look forward to.

Questions to ask might include:

  • What’s the best thing about living?
  • What’s the most important thing in your life?
  • What things in your future do you look forward to?

Reasons to live might include:

  • family, friends or pets
  • spiritual or religious beliefs
  • everyday pleasures such as walking on the beach or enjoying nature
  • life experiences such as having children or travelling.

Things I can do by myself

Suicidal thoughts can make it hard to focus on anything else. Activities and internal coping strategies help the person distract themselves from suicidal ideation, potentially preventing a further escalation into crisis. Identifying internal strategies as a first-line response improves the person’s ability and self-confidence in managing warning signs or suicidal thoughts.

Questions to ask might include:

  • What can you do on your own if you have suicidal thoughts in the future, to avoid acting on those thoughts?
  • What can you do to help take your mind off your problems, even for a short amount of time?

Internal coping strategies might include:

  • breathing or relaxation exercises
  • going for a walk, doing yoga or other exercise
  • watching a favourite movie or listening to a favourite band
  • playing or cuddling with a pet.

Connect with people and places 

If the person isn’t able to reduce their distress or suicidal ideation using internal coping strategies, the next step is to try some passive socialisation strategies.

Just being around other people can help provide distraction from suicidal thoughts – this can include spending time with family and friends, or going to a busy park or shopping centre. This step is really about spending time in a social setting, rather than reaching out and discussing their thoughts and feelings – that comes next. You should also remind your client about avoiding social environments where alcohol or other drugs might be involved.

Questions to ask might include:

  • Who helps you to feel good when you socialise with them?
  • Where can you go and be around other people in a safe environment?

Socialisation strategies might include:

  • Spending time with friends and family, remembering that socialising can include activities that don’t require much talking or engagement, such as watching TV.   
  • A coffee shop, park, place of worship or meeting group.

Friends and family I can talk to 

If the person is still in crisis after working through their internal coping and socialisation strategies, the next step in their plan involves sharing their thoughts and feelings with a trusted friend or family member. This differs from the previous step in that people are encouraged to explicitly reveal that they’re struggling with suicidal ideation and need support in coping with the crisis. For this step, the person should think carefully about who would be helpful in a crisis, and avoid listing people who could possibly exacerbate the situation.

Questions to ask might include:

  • Among your friends and family, who do you feel you could talk to when you’re having suicidal thoughts?
  • Who do you feel you could contact to support you during a suicidal crisis?

Professional contacts 

The final step involves listing professional support services the person can contact when they need to.

Questions to ask might include:

  • Which services could you turn to for support?