How to prepare ahead of time for thoughts of suicide
“Getting my feelings out on paper and reminding myself of the good things that I had in my life gave me a different perspective from what my mind would see when I felt down.” – Justin’s Story
These steps can be followed in order to help overcome a suicidal crisis.
It can be hard to think clearly when having suicidal thoughts, leading to a sense of feeling overwhelmed and forgetting all the reasons we have to live.
One way to help manage suicidal thoughts and prevent acting on them is to create a Crisis Game Plan (or Suicide Safety Plan), which has been shown to reduce the risk of suicide.[1]
The process of creating a Crisis Game Plan can itself be helpful as it reminds us of important people we have in our lives and that we have multiple resources available to us. We recommend having both a printed (e.g., on a piece of paper in your wallet) and digital copy (accessible both on- and off-line) that you can quickly and easily access.
A Crisis Game Plan consists of six steps:
- Listing our personal triggers for suicidal thoughts
- Writing out coping strategies that work for us
- Listing people and social settings that could be used as distractions
- Contact info for family members and friends who we can reach out to in a crisis
- Contact info or resources for accessing professional support
- How to make our environment safe
We’ll go through each part in detail below, and also provide an example of a guy’s Crisis Game Plan.
CREATING A PLAN
We can use the original template for the Stanley-Brown Safety Plan, developed and studied by Barbara Stanley and Gregory Brown, or we can also simply use a piece of paper, or make notes on our phones or computer following the steps below.
Steps can be followed in order to help overcome a suicidal crisis. If the current step doesn’t help to ease stress and tension to the point where we feel safe and out of a crisis, we can move on to the next one.
Though it may feel awkward at first, it can help to complete our game plans with a trusted friend/family member or professional. This can also help to reassure the people who care about us, by showing that we are taking active steps to address suicidal thoughts or urges.
Step 1. WARNING SIGNS
Ask yourself if there are certain situations or events that trigger negative emotional spirals that tend to lead to suicidal thoughts.
These will be your warning signs, and they can vary a lot from guy to guy. Here are some examples to help get you thinking about your own warning signs:
- Getting little or no quality sleep for several nights in a row
- Feeling rejected in some way
- Experiencing some type of failure
- Feeling shamed
- Doing something you feel immensely guilty about
Whenever we notice ourselves thinking about suicide, we can try to slow down and ask ourselves what set the thoughts off – if we can identify a cause, we can add this sign to our game plan. Sometimes it may be hard to determine what triggered the thoughts, but simply noticing these thoughts and slowing down to think about them can help.
Once you get better at noticing your triggers, you will be able to anticipate when you may be more susceptible to suicidal thinking, and avoid things that may set these thoughts off.
Step 2. PERSONAL COPING STRATEGIES
In this section, we’d list our strategies for managing suicidal thoughts that we can do on our own.
For example:
- Deep breathing with visualizations
- Going for a walk or jog
- Playing an easy, stress-free video game
Another approach we can try is to create a list of “reasons to live” with all the things we care about (people, places, hobbies) or have enjoyed before (happy memories, positive experiences, or simple pleasures). When we are spiraling it can be hard to think rationally or remember times when we were happy as our thoughts are contaminated by how shitty we feel. So, if we sit down and write out what we have to live for at a time when we are feeling O.K., it’s almost like having a conversation with a different, more rational version of ourselves when we read it back later.
Step 3. PEOPLE AND SOCIAL SETTINGS FOR DISTRACTION
Rather than shutting down and isolating, surrounding ourselves with people we care about or moving ourselves to a more public setting can help distract you from intrusive suicidal thoughts and offer some relief from the crisis.
Think about the people and places in your life that make you feel good or that you have enjoyed in the past and write them down.
For example:
- Go to your favourite coffee shop
- Visit a friend
- Sit outside in a park you like
- Meet your friends/family at a restaurant
Try to have a few different options listed in case one isn’t available when you need it. For example, if you find suicidal thoughts come on more strongly late at night, make sure to include someone who is comfortable messaging or talking with you in later hours of the evening, or a social setting that will be open, like a 24-hour cafe.
Step 4. CONTACTING FAMILY MEMBERS OR FRIENDS FOR MORE DIRECT SUPPORT
Suicidal thoughts can be so overpowering that we forget about the people who care about us and want to help. Having their contact information on hand makes it easy to reach out during a crisis. Create a list of people you are comfortable talking with about your suicidal thoughts and who are comfortable helping you out if a crisis occurs.
Our How to Manage Suicide Risk page can provide them with direction on what they can do to help.
Try to list at least three support persons who are able to provide support, aware of existing resources you can access, and know that they are part of your crisis plan. This way, you have a few options in case you can’t reach your first or second contact.
Step 5. CONTACTING MENTAL HEALTH PROFESSIONALS OR RESOURCES
If the crisis continues, the next step is to contact mental health professionals or resources who can help us through suicidal crises.
If you have a therapist or mental health professional who is comfortable with you reaching out to them, you can include them in your list. Otherwise, you can add your local crisis phone or chat line, as well as the nearest hospital emergency room departments.
Step 6. MAKING YOUR ENVIRONMENT SAFE
The final step of the crisis plan is to make our immediate environment safe and have a plan to avoid any situations or objects that could be used to end your life. This is a good step to ask someone for help with, so they can put things away and help make our environment safer.
For example:
- Removing knives or firearms from your household
- Limiting access to prescription or non-prescription drugs
- Limiting access to alcohol, drugs, and other substances that could lower your inhibitions or affect your mood negatively
MAKING USE OF YOUR GAME PLAN
The process of creating a plan can help to lessen suicidal thoughts. In the future when we’re feeling suicidal or hopeless we can refer back to our plan and walk through each step to help calm ourselves down.
If reviewing the plan doesn’t help to reduce suicidal thoughts, see our guide on what to do In a Crisis for the next steps to take.
TIPS TO KEEP IN MIND
Review and make sure you are comfortable with everything in your plan:
- Practice the strategies you’ve written down under Step 2, so you know what works best for you.
- Imagine yourself calling each person you listed for Step 4. Is this someone you feel comfortable talking to about suicidal thoughts? If not, replace them with someone else.
Make sure you and others know your plan:
- Share your plan with a trusted friend and/or mental health professional.
Keep your Crisis Game Plan up to date
- Your plan can be a living document, so you don’t have to think of everything at once. You can add or update notes over time.
References
- Stanley, B., Brown, G. K., Brenner, L. A., Galfalvy, H. C., Currier, G. W., Knox, K. L., Chaudhury, S. R., Bush, A. L., & Green, K. L. (2018). Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA psychiatry, 75(9), 894-900. https://doi.org/10.1001/jamapsychiatry.2018.1776