I’ve been writing about the Safety Plan as a brief suicide intervention, Tear up that no-harm/no-suicide contract and The Safety Plan Initiative, and how it is an improvement over the no-harm/no-suicide contract.
The first step in the Safety Plan is recognition of warning signs. Within the field of suicidology, we distinguish between warning signs and risk factors. Warning signs apply only to individuals, and indicate an immediate risk for suicide. Risk factors may apply to individuals or groups, and indicate a heightened risk for suicidal behaviors.
Think of what you’ve learned about heart attacks, perhaps thru public service announcements. Risk factors for heart attacks include physical inactivity, obesity, high LDL cholesterol, and tobacco use. For people who have these risk factors, their overall risk for a heart attack is higher, but not necessarily imminent. Similarly, with suicide, risk factors include substance abuse, mood disorders, access to lethal means and prior attempt(s). These signs mean the risk for suicidal behaviors is higher, but not necessarily imminent.
Warning signs, however, do indicate immediate risk. In heart attacks, we’ve learned that chest pain, shortness of breath, nausea, and lightheadedness indicate a heart attack may be imminent. Urgent action is highly recommended. Likewise, in suicide, feelings of hopelessness, increased substance abuse, threats of self-harm, and seeking lethal means indicate suicidal behaviors may be imminent.
One of the things I have always emphasized in my writings and trainings is to please take both warning signs and risk factors seriously. I believe we always want to err on the side of caution.
Next time, we’ll talk more about warning signs, and I’ll share an acronym to help remind you of the most important signs.