Suicide Assessment and Prevention in Early Psychosis-Handout: Patient Safety Plan Template

Handout: Patient Safety Plan Template

Pdf Summary

This document is a patient safety plan template that individuals can use to create a plan to support their mental and emotional well-being. It includes several steps and prompts for the individual to fill in. <br /><br />Step 1 asks the individual to identify triggers and stressors that put them at emotional risk. They can list specific behaviors, situations, and circumstances that have a negative impact on their emotional state.<br /><br />Step 2 focuses on warning signs that may indicate a crisis is developing. The individual is prompted to identify thoughts, images, moods, situations, or behaviors that signal a potential crisis.<br /><br />Step 3 involves listing internal coping strategies that the individual can use to distract themselves from their problems without contacting another person. This could include relaxation techniques or engaging in physical activity.<br /><br />Step 4 encourages the individual to reflect on their strengths and list things they are good at or qualities that others appreciate about them.<br /><br />Step 5 asks the individual to identify people and social settings that provide distractions. They can include names and contact information for individuals or specific places.<br /><br />Step 6 prompts the individual to list people they can ask for help during a crisis, providing names and contact information.<br /><br />Step 7 involves identifying professionals or agencies that the individual can contact during a crisis, including their names, phone numbers, and any pager or emergency contact information.<br /><br />Step 8 focuses on making the environment safe and asks the individual to fill in any specific measures they can take to ensure safety.<br /><br />The document concludes with a space for the individual to reflect on what is most important to them and worth living for. <br /><br />This template can be used by clinicians, individuals, and their families to create a personalized patient safety plan to support the individual's mental and emotional well-being.

Keywords

Patient safety plan template

Mental well-being

Emotional well-being

Triggers and stressors

Warning signs

Coping strategies

Strengths

Social support

Crisis intervention

Environment safety