Hi Prickly Pam,

Thanks for your message. You bring up a really valuable point which is important to remember: no one technique will work for everyone. That’s true with respect to anti-biotics for infection, it’s true with respect to anti-depressants for depression, and it’s certainly true with respect to strategies that mitigate suicide risk.

We’re all different, so we may respond to different things.

I think there is enough evidence for the effectiveness of safety planning that it’s worth making people aware of it and encouraging them to try it, as we have done in our article. Here’s a very brief summary of that evidence:

  • This study found that safety planning reduced psychiatric emergency room visits, inpatient hospitalization days, and suicide attempts.
  • Another study reviewed a number of brief interventions for suicide. It found that interventions that include safety planning “appear to be effective in reducing suicide and suicide attempts”.
  • Also, safety planning has been “determined to be a best practice by the Suicide Prevention Resource Center / American Foundation for Suicide Prevention Best Practices Registry for Suicide Prevention.”

The Department of Veterans Affairs also uses it and finds it useful in that context; here’s what they have said about it:

The risk of suicide is elevated for people with serious mental illness, that is, a mental illness that interferes with the ability to carry out one or more major life activities. Serious mental illness makes it difficult to think clearly, make decisions, and take positive action. In other words, it impairs executive functioning. A wide variety of diagnoses, including depression (unipolar or bipolar), borderline personality disorder, post-traumatic stress disorder, and schizophrenia, are associated with this kind of impairment.

A Safety Plan in easy reach reduces the burden of problem-solving when a crisis is looming and the ability to think clearly is impaired. There is no need to figure out what to do to interrupt a darkening mood, because strategies that may help are already written out. There is no need to look up emergency contact information, because it has already been compiled.

Essential as this information can be, a well-constructed Safety Plan is more than just a list of strategies and contacts. When the items are individualized and described in detail, they can be potent reminders of cherished memories, simple pleasures that give comfort, and people who care who are in reach and can be counted on to respond when needed. In other words, a well-constructed Safety Plan can reassure its owner that s/he is neither helpless nor alone.”

All that is to say that safety planning is likely useful for at least some people. I think that, together, the evidence points towards it being a useful strategy to recommend people who may be going through a period of more intense emotional distress.

But that doesn’t mean you should use it!

It sounds like you’re very self-aware and have a very good idea about what is useful for you — and what isn’t. There might be lots of people out there that are in the same position and for whom this won’t be effective.

I am glad to have had your comment and I think the perspective you’ve shared here and in your articles is a really valuable one. In one of your articles, you quoted the Western Massachusetts Recovery Learning Community, “The goal is not to simply force someone to stay alive from moment to moment. Rather, it is to support them to create meaning and a life that they want to live.”

I think we have to remember that. Safety planning can be (but, as you have pointed out, isn’t always) useful for people to help them go through moments of particularly intense distress. But it’s not a long-term strategy. The long game needs to be helping people create meaning and a life they want to live.

I love that.

Thanks again Pam! I look forward to reading more of your stuff.

Written by

Ramsay is a researcher, educator, and writer (crisptext.ca) based in Brazil. When not writing, you can find him cycling or looking for his keys.

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