In my last post, Tear up that no-harm/no-suicide contract, I discussed contracts as a suicide prevention tool and recommended the Safety Planning Initiative (SPI) approach. Developed by Stanley & Brown, the SPI process prompts the individual to develop an escalating series of self-care steps.
The Safety Plan has a distinct advantage over the no-harm/no-suicide contract because the Safety Plan helps patients develop a plan for how to care for themselves while the no-harm/no-suicide contract is a “promise” not to try to end their life.
The Safety Plan is often a collaborative effort between the healthcare professional and the patient or client, developing the lists of options for each step. One method is to encourage the patient/client to write on paper what they intend to do at each step, using their own words (download a Patient Safety Plan Template). There are also apps for smartphones that can be used to develop the plan digitally. We’ll talk about the digital option further into this topic.
One of the aspects of SPI that I really like is that the plan is developed when the patient is not in acute crisis. When someone is in acute crisis and actively contemplating suicide, the individual is often not thinking clearly. In that state of mind, often referred to as “tunnel vision,” thinking of options regarding who to talk with or what to do to take care of myself can be very difficult. Developing the strategy or plan before you need it makes a lot more sense.
Next, we’ll look at the first step of the SPI, recognition of warning signs.