Safety Planning at the Emergency Room

When a young person visits the Emergency Room because of suicidal thoughts or actions, a safety plan must be created before they leave the hospital. A safety plan is a written guide that helps youth, family, and care team know what to do to stay safe and what to expect if another crisis occurs. 

1. Purpose of a Safety Plan

A safety plan:

  • Helps your youth and family recognize when risk is increasing.
  • Lists practical steps and supports to reduce danger.
  • Provides phone numbers, coping ideas, and people to call.
  • Ensure everyone understands how to respond if warning signs return.

This plan is personal—it should use your youth’s own words and be simple enough for anyone involved to understand. 

2. Who Participates

The plan is created together by:

  • Your youth (their voice leads the plan).
  • Parents or caregivers.
  • A crisis worker, nurse, or therapist.
  • Anyone else who will help at home (family, close friends, babysitters, etc.).

Make sure every person who helps your youth knows their role and has a copy of the plan. Keep one posted in an easy-to-find place, such as on the refrigerator. 

3. What the Plan Should Include

Below are the main steps most safety plans follow. The crisis worker can help your youth fill them in:

1. Warning Signs

  • What thoughts, feelings, or behaviors show that a crisis may be coming?
  • (Example: not sleeping, feeling hopeless, avoiding friends).

2. Coping Strategies

  • What can your youth do on their own to feel calmer?
  • (Example: listen to music, walk outside, use deep breathing, write in a journal).

3. Social Distractions and Supports

  • Who or what helps take their mind off unsafe thoughts?
  • (Example: spending time with a friend, playing with a pet, visiting a favorite place).

4. People to Contact for Help

  • Family or friends your youth trusts and can reach anytime. 
  • Include names and phone numbers.

5. Professional and Crisis Contacts

  • Therapist, doctor, or local crisis team.
  • Call or text 988 for the Suicide & Crisis Lifeline (24/7).
  • Oregon YouthLine: 877-968-8491 | Text “teen2teen” to 839863.

6. Making the Home Safe

  • Remove or lock up anything that could be used in a suicide attempt: firearms, medications, alcohol, sharp objects, ropes, cleaning chemicals, and cords. 
  • If your youth has used something before, make sure it is no longer accessible.

4. Adding Family and Caregivers

A complete plan also lists:

  • How parents or family will recognize warning signs that the youth may not notice.
  • What kinds of words, gestures, or support help your youth most. 
  • What is not helpful or could make things worse (for example, yelling, blaming, or pressuring).
  • Who will call 988, a doctor, or emergency services if your youth cannot do it themselves. 
  • How the household will stay safe—including plans for siblings, pets, and caregivers.

5. After the Hospital

Safety planning does not end when you leave the Emergency Room. The plan should:

  • Be reviewed often and updated with your youth’s therapist or doctor. 
  • Change as your youth’s recovery progresses.
  • Be revisited whenever stress increases or new triggers appear. 

Encourage your child to help revise it—this builds confidence and ownership over their safety and wellbeing.

6. Remember

  • A safety plan is not just paperwork — it’s a living agreement that everyone uses.
  • Keep extra copies in your phone, care, or wallet.
  • If you ever feel unsure, call 988 or your local crisis line immediately.