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Connect & Grow Magazine: Edition 12 August - September 2024
What is a mental health safety plan?
A mental health safety plan, sometimes referred to as a crisis plan, is an evidence-based and structured recovery support tool that can be used for people experiencing mental health crisis (MH Crisis) and suicidal ideation (SI) (Cassivi et al., 2023).
The purpose of the safety plan is to appropriately respond to MH crisis and SI in a timely manner, prevent further deterioration and worsening of symptoms and to promote personal recovery by fully involving the service user. Cassivi et al. (2023) report that the safety plan is a suicide prevention intervention that can be used in both the community and in the hospital setting.
Suicide prevention interventions that have been widely used in the past such as safety contracts, no harm contracts and no suicide contracts are coercive by nature and according to Rozek et al. (2022) are now considered contraindicated for suicide prevention. Safety plans are recognised as being effective at reducing coercive measures (Cassivi et al., 2023).
Why do we need them?
There is no one single agreed-upon definition for MH Crisis, and everyone who experiences a crisis can and will experience something different. Caplan (1992) describes a crisis as a subjective event. He goes on to explain that the person in crisis feels as though the situation is out of their control and that they lack the coping mechanisms required to deal with it. This contributes to the complexity of developing a safety plan.
Suicide Prevention Australia (2022) state that “suicide was the 15th leading cause of death, accounting for 1.8% of all deaths” in 2022. It is reported that 3,249 people died by suicide in 2022 which is an increase from the previous year.
In a scoping review, whilst acknowledging that further research is required to fully understand the subject, specifically with those with substance use disorder, Siria et al. (2022) suggest that suicidal behaviours can be conceptualised as a continuum which include “suicidal ideation, suicide attempts and completing suicide”.
It is hoped that by understanding this continuum and careful implementation of safety plans in early stages, suicide can be prevented.
What does the plan look like?
Beyond now is an application-based safety plan developed by Beyond Blue and is now used throughout Australia by organisations such as Lifeline (Beyond Blue, 2024). The plan is made during periods of stability or when not experiencing MH Crisis and SI and can be easily accessed and used when in need. It can be adjusted and modified and updated and can even be shared with other people involved such as friends, family, healthcare professionals and teachers.
The safety plan covers the following headings and if using the app some questions and prompts help the user think about each step in detail.
1 Early warning signs and triggers
2 Creating a safe environment
3 Identify reasons to live
4 Identifying things to do by myself
5 Connecting with people and places
6 Reaching out to others
7 Seeking professional help
References
Beyond Blue. (2024, May). Creating a safety plan. Beyou.edu.au. https://beyou.edu.au/resources/suicide-prevention-and-response/suicide-prevention/creating-a-safety-plan
Caplan, G. (1992). Principles of preventive psychiatry. Deakin University, Burwood Campus.
Cassivi, C., Sergerie‐Richard, S., Saint‐Pierre, B., & Goulet, M. (2023). Crisis plans in mental health: A scoping review. International Journal of Mental Health Nursing, 32(5). https://doi.org/10.1111/inm.13158
Rozek, D. C., Tyler, H., Fina, B. A., Baker, S. N., Moring, J. C., Smith, N. B., Baker, J. C., Bryan, A. O., Bryan, C. J., & Dondanville, K. A. (2022). Suicide Intervention Practices: What Is Being Used by Mental Health Clinicians and Mental Health Allies? Archives of Suicide Research, 27(3), 1–13. https://doi.org/10.1080/13811118.2022.2106923
Siria, S., Leza, L., López-Goñi, J. J., & Fernández-Montalvo, J. (2022). Lifetime suicidal-related behaviour among patients in treatment for substance use disorder: A cross-sectional study. Psychiatry Research, 317, 114921. https://doi.org/10.1016/j.psychres.2022.114921
Suicide Prevention Australia. (2022). Stats & Facts. Suicide Prevention Australia. https://www.suicidepreventionaust.org/news/statsandfactsIf
If you are someone that has an NDIS plan and are struggling with your mental health or addictions, know that you are not alone, reach
Written by Mark Bint
Mental Health
On Your Marks Care
(c) Break Free Consultancy 2024
Disclaimer: All information is accurate at the time of publication and subject to change