Thursday, December 5, 2013

Creating a Safety Plan

Having a safety plan in place is vitally important when you are dealing with a child who struggles with mental illness, whether it is a threat of suicide, manic or aggressive/threatening behavior, knowing what to do when in the midst of crisis needs to be second nature to ensure everyone's safety.

When developing the safety plan it is important to have input not only from any family members or caregivers who it may effect, but also additional third parties such as counselors, therapists, first responders, etc.  It is important to know what your options are and what supports are available to you before a crisis occurs.  Having input from other trained professionals can help you find other available supports you may not know about as well as determining the best course of action for your particular child.  Involving others also protects you in the future and helps you to explain to first responders/hospitals/treatment centers the actions you took before contacting them and how the family has gotten to this point in the safety plan. Most importantly don't forget to include your child in this process.  Keeping the discussion open may help them recognize their own warning signs for crisis and respond better. asking your child about what would help them in crisis is a great place to start.

Having a written safety plan is only helpful if everyone in the family knows their role and what to do in an emergency.  It is extremely important that all family members participate in "practice" runs much like a fire drill.  In our house we have a code word we use to indicate that they are to go to the play room, lock the door, and pick a TV show to watch.  I use the code word every once in awhile when they least expect it and give out treats for good listeners.  By making it fun and non threatening I think it reduces any stress or fear when an actual need arises. 

Our safety plan includes a page (front and back) of basic/background/summary information including:

Child’s information

Family information 

Common Behaviors including known triggers/antecedents, things that can escalate/calm the behavior, strategies that may work.

Medications both current and past

Treatment and Interventions

Professional Team

Other Outside Supports/Resources

Safety Concerns


The second page includes the actual plan "If child is doing X, then you do Y."  This will be very child-specific, but here is a copy of ours so you can get an idea.

So now that you have your safety plan, you can just stick it on a shelf and forget about it right?  NO, the safety plan will have to constantly be amended and changed based on your families current needs and support systems.  It is also important to reflect on the safety plan and any changes that need to be made following a crisis.  You may want to ask What situations or triggers led to the crisis? What worked and didn't work?  What can we do differently to keep everyone safe and calm?
I like to make notes right on my safety plan and then develop a revised version based on my notes for the next crisis.


If any of you have ever sat in a psychiatric emergency room for hours on end, you know how boring, stressful and unproductive you can feel.  Creating a bag that can be left in the car or near the door is a great idea to prepare for a crisis.  Things are happening so fast when you reach the point of transporting or having your child transported to a hospital or emergency unit.  The last time we were in crisis the first responders wouldn't even give me the time to find my youngest kids shoes!!

This bag should include your crisis plan, documentation binder and some snacks, games, music or books for both yourself, the child in crisis, and any others who may be waiting for long periods of time.

You may also want to pack an emergency bag that includes a change of clothes and basic hygiene supplies in case it is determined the child in crisis will be admitted or transferred to another unit.


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