Mental Health Crisis Prevention Planning: How to Build a Safety Plan That Works

How to Create a Safety Plan

While having a mental health crisis prevention plan in place can be undeniably valuable, when it comes down to creating one, many people feel stuck. The following steps can guide you when creating a mental health crisis toolkit for either yourself or someone else – and can give you a sense of comfort that you don’t have to face these moments alone.

It’s important to note that if you notice signs of suicidal ideation in yourself or someone you care about, reaching out to immediate support services is essential. Call 988 (Suicide and Crisis Lifeline) or 911 for emergency support.  

Step 1: Identify Warning Signs

We mentioned earlier how there are often warning signs before a crisis. So try to think about what typically happens to you, or someone you care about, before emotions become intense or unmanageable. For instance, you might notice shifts in behavior, mood swings, physical tension, and so on. 

Here are some common warning signs a crisis in mental health might be impending: 

• Changes in sleep patterns: Tossing and turning, waking up suddenly during the night, nightmares, lack of restful sleep, and so on. 
• Increased anxiety, agitation, or irritability: Being short-tempered, snappy, or quick to anger. 
• Social withdrawal or isolation: Pulling back from social engagements, not seeing friends or family, feeling fearful of judgment. 
• Loss of motivation or interest: Reduced engagement in previously enjoyed hobbies or interests.
• Persistent negative thinking: Ruminating and feeling trapped in negative automatic thoughts.
• Hopelessness: Talking or thinking about how a situation will never improve.   

The above signs can be linked with mental health conditions like anxiety or depression. And the more frequent or intense these signs and symptoms are, the greater the risk of a mental health crisis.^[3][6] 

Being mindful of ourselves and those we care about when it comes to emotional or behavioral changes can be a vital means of offering support early and curbing any potential crises. 

Step 2: Develop Internal Coping Strategies

You might notice some warning signs. But now what do you do about them? The next step is to engage in some healthy coping strategies – activities that help us see through the fog. The following are some evidence-based coping strategies for crisis prevention: 

• Breathing and grounding exercises: These help to plant us in the here and now. When it feels like our thoughts are spiralling, slow, deep, and controlled breathing can do wonders. For example, box breathing is a simple method that can calm the nervous system. 

“Grounding” basically means to take note of bodily sensations that help connect us with reality. For instance, planting our feet on the ground, or focusing on the sensations of our hands holding a cup. Research shows that exercises like this can reduce anxiety symptoms.^[7] 

• Physical activity: Exercise doesn’t have to mean joining a gym or running a marathon. Simple, consistent activity like a daily walk can make all the difference. Exercise is linked to improved mood and reduced depressive symptoms.^[8]
  
  
• Mindfulness practices: Being mindful just requires finding moments throughout the day in which to allow the hum of our thoughts to pass through our minds, without assigning any strong emotions or judgments to them. Studies have shown mindfulness to be effective in regulating our emotional responses.^[9]
  
  
• Journaling or expressive writing: The act of putting our thoughts on paper can do wonders during times of distress. Plus, the research confirms it, as journaling is associated with reduced distress.^[10]

The goal is to choose strategies that are simple and accessible. During high stress, people are more likely to use tools that are familiar and easy.^[4]

Step 3: Identify Supportive People and Social Settings

It might sound obvious, but it can’t be understated how valuable friends and family are in times of crisis. The research confirms it too: Studies show that people with stronger support networks are less likely to experience severe crises.^[11] 

Even a short conversation can make an impact and reduce feelings of isolation or distress.^[11] It’s worth taking note of a few names and numbers of people you trust and feel safe with. For instance, who is most likely to be available and answer their phone?

Additionally, is there a specific place that helps you or someone else feel more safe and grounded? Making note of where this place is and how to get there easily during an impending crisis can offer a mental safety net. 

Step 4: Add Professional and Emergency Resources

In an ideal world, a quick chat with a loved one would be all we need to help us regain clarity and avoid episodes of crisis. But some things might feel a bit too complex or distressing to share with our friends and family. 

Confiding in a healthcare professional might feel like there’s less risk of judgment, and importantly, they’re certainly qualified and trained for mental health crisis scenarios. 

Important contacts may include:

• Your primary care provider or mental health professional: They can assess your mental state, adjust medications if needed, provide therapeutic support, and help determine whether a higher level of care is appropriate. 
• Local crisis response or mobile crisis teams: These teams are based locally and can assess your safety and provide immediate emotional support. Research confirms that mobile crisis teams can reduce unnecessary hospitalizations and improve outcomes when dealing with a crisis.^[12]
• The 988 Suicide & Crisis Lifeline (call or text 988, available 24/7): The 988 Lifeline connects you with trained counselors who provide confidential support during emotional distress, suicidal thoughts, or mental health crises. They can talk you through what you’re experiencing, identify coping strategies, and guide you toward next steps.
• Crisis Text Line (text HOME to 741741): The Crisis Text Line offers support via text messaging, which can feel more accessible for people who find phone calls overwhelming. 
• Emergency services (911): If there is an immediate risk of harm to yourself or others, calling 911 ensures rapid intervention. Emergency responders can provide urgent assistance and transport you to a hospital if needed.

Step 5: Make Your Environment Safer

When making a mental health safety plan for adults, it’s important not to rule out the risk of self-harm or suicide. 

As part of your emergency mental health plan, you can prepare for possible vulnerable periods by limiting access to anything potentially harmful in the environment. In fact, research shows that doing so can be one of the most effective suicide prevention safety planning strategies.^[13] This might mean: 

• Securing medications by locking away high-risk medicines.
• Reducing access to alcohol or substances.
• Ensuring that there is no access to sharp items or firearms. 

While taking these actions might seem like a lot, keep in mind that these steps to prevent self-harm are only temporary and focused on safety during high-risk periods.

Step 6: Include Personal Reasons for Staying Safe

When we’re feeling at our worst, sometimes the negativity cycle can feel all-consuming. So it’s easy to forget about all the good things in our lives, or simply, our reasons for living. 

When we, or someone we care about, is showing signs of an emotional crisis, it’s important to reinforce the positives where possible. What’s more, the research shows that shifting the focus to the things in life that bring us meaning and connection can significantly reduce suicide risk.^[14] 

It’s good to jot these positives or reasons for gratitude down in your mental health crisis management plan. These might include:

• Relationships: It’s very likely that you or the other person are a cherished partner, friend, brother, sister, daughter, son, mother, father, uncle, aunt, and so on. You matter to someone. 
• Personal goals: Writing down your hopes and dreams might sound cliché, but it’s a good way to remind yourself what you can still achieve. It’s also good to note down where achievements have already been made, no matter how small. 
• Responsibilities: Maybe there are people in life – or even pets – that depend on you. 

Step 7: Keep the Plan Accessible

Accessibility is essential – so keep your mental health safety plan for adults handy for when you or someone close to you needs it most. Consider keeping your plan:

• On your phone.
• In a little notebook, in your pocket.
• Printed in a visible place.
• Shared with someone you trust.