My Safety Plan

My Safety Plan

Bright Start Bright Future Counselling Center
Email:info@bsbf.ca

Web: www.bsbf.ca

Phone: 647-284-2248

Fax: 647-498-1110
Name

First NameLast Name
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This is your personal safety plan. It will support you when you have thoughts of suicide or self-harm. Whenever you have these negative thoughts, start to review the plan and complete each step of the plan until you feel safer.

Thoughts of suicide may seem very strong and never-ending, but suicidal thoughts are actually symptoms of problems that are bothering you, just like pain. You can make these symptoms go away with different coping resources. Then, you will have a chance to focus on what your problems really are and sort them out.

Make sure you ask for help and support from others whenever you are having these thoughts. Being alone and isolating yourself can only make suicidal thoughts worse. When you’re feeling this way, you might be unable to think clearly and make good decisions. So keep a copy of this safety plan close to you and use it anytime you need it.
Step 1
What warning signs (feelings, thoughts & behaviors) suggest I may be a danger to myself?
Step 2
What strategies or activities can help me take care of myself and calm myself down?
Please list at least 4 strategies or activities.
Step 3
Who are some people and places that can help me feel connected and/or distract me?
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First NameLast Name
Phone Number
Name

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Phone Number
Place
Place
Step 4
Who are some people that I can call and ask for help?
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First NameLast Name
Phone Number
Name

First NameLast Name
Phone Number
Name

First NameLast Name
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First NameLast Name
Phone Number
Step 5
Who are some professionals or agencies that I can contact when nothing else seems to help?
Name
Phone Number
Name
Phone Number
Step 6
What are some things that I can do to make my environment safer?
Please list 4 things at least
Nearest Hospital
Phone Number
If you don’t think you can reach the hospital safely, call 911 and request transportation to the nearest hospital.
Your Signature

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Witness Signature

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Should be Empty:

My Safety Plan

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