Making A Safety Plan

Personal Information

This section collects essential personal details needed to identify you and ensure that your care preferences are linked to the correct individual. It's also vital for contacting someone on your behalf if the need arises.

Please enter your full name.

What is your date of birth?

Type or select your date of birth.

Could you provide an emergency contact? (Name, relationship, phone number)

Warning Signs

This section is crucial for early identification of emotional distress. It involves recognizing personal signs that indicate you might be entering a mental health crisis. These can be changes in thoughts, feelings, behavior, or physical sensations.

What specific thoughts or feelings indicate that you're becoming distressed?

How does your behavior change when you start feeling overwhelmed or distressed?

Are there any physical sensations that serve as warning signs?

Internal Coping Strategies

Here, the focus is on methods you can use independently to manage distress. These are personal strategies that don't require external intervention but rely on your own skills and resilience.

What calming techniques have worked for you in the past during high-stress moments?

Can you list any hobbies or activities that engage your mind and provide relief?

Are there particular music, books, or movies that help you feel better?

Socialization and Support Network

This part centers on identifying a support network of people and social settings that offer comfort and assistance. It's about recognizing the role of interpersonal relationships and community in your mental health.

Who are your 'go-to' people when you need support, and how can you contact them?

Are there specific social settings or communities (like support groups) where you feel most understood?

How have these people or settings provided support in the past?

Professional Help and Resources

This section involves listing mental health professionals and emergency contacts. It includes knowing when and how to seek professional help, and having key contact information readily available.

Which mental health professionals or therapists have you found helpful, and how can you contact them?

What are your local emergency services or mental health crisis hotlines?

Are there specific instructions or information that emergency personnel should know about you?

Making the Environment Safe

Safety in your immediate environment is crucial. This involves proactively identifying and mitigating potential physical hazards or unsafe conditions in your surroundings.

What steps can you take today to make your living space safer?

If you need to leave your current environment, where can you go that you know will be safe?

How can you ensure that someone checks on you if your environment becomes unsafe?

Symptom Management Plan

Tailors strategies for managing specific mental health symptoms. This includes understanding how different symptoms manifest and what actions can be taken to alleviate them.

What symptoms of your mental health condition do you find most challenging, and what helps in managing them?

How can you track these symptoms to recognize a developing crisis?

Are there lifestyle changes (like sleep, exercise, diet) that help manage these symptoms?

Emergency Contacts and Consents

Specifies who can make decisions on your behalf in a crisis and ensures that key contacts are informed and accessible.

Besides your primary emergency contact, who else can be contacted in a crisis?

What are your preferences regarding hospitalization or medical treatment in an emergency?

Do you have any legal documents (like a living will or healthcare proxy) that outline your care preferences?

Review and Update

Regular reviews are essential to ensure the plan remains relevant. Life changes, treatment adjustments, and new insights into your mental health can all prompt updates.

When will you next review and potentially update this safety plan?

Select or type the next planned review date.

Have there been any changes in your life, health, or mental health treatment that should be reflected in this plan?

How will you remind yourself to review the plan regularly?

Personal Commitment Statement

This final section is a personal affirmation, a commitment to follow the safety plan. It's a powerful tool for self-empowerment and serves as a reminder of your reasons for working towards safety and well-being.

Can you write a statement that reflects your commitment to your own safety and well-being?

What are the key reasons or motivations that inspire you to stay safe and follow this plan?

How does following this plan align with your overall life goals or values?

Review and Confirmation

This final section is for you to review all the information provided and make any necessary changes before confirming your advance decision plan. It's important to ensure all details are accurate and reflect your current preferences.

Below is a summary of all the information you've provided. Please review each response carefully. You'll have the opportunity to make any changes before finalising your safety plan.