================================================================== MY SAFETY PLAN ================================================================== This is yours. Fill it in when you are feeling steady — not in a crisis — and keep it somewhere you will find it. A photo of it on your phone works. It is best written WITH your practitioner. If you do not have one yet, fill in what you can; the numbers at the bottom are already there. If you are in danger right now, skip to step 6. Name: ______________________________ Date: ____________________ ================================================================== 1. THE WARNING SIGNS ================================================================== What tells me things are getting worse — thoughts, feelings, situations, or something I notice in my body. ______________________________________________________ ______________________________________________________ ______________________________________________________ ================================================================== 2. WHAT I CAN DO ON MY OWN ================================================================== Things that have helped before, that do not need anybody else. Small and specific works better than big and vague. ______________________________________________________ ______________________________________________________ ______________________________________________________ ================================================================== 3. PEOPLE AND PLACES THAT TAKE MY MIND OFF IT ================================================================== Not people to talk to about it — people and places that are simply a distraction. A cousin who makes me laugh. A tea shop. A park. ______________________________________________________ ______________________________________________________ ______________________________________________________ ================================================================== 4. PEOPLE I CAN ASK FOR HELP ================================================================== Name and number. Two or three, so it does not rest on one person being free. Name: __________________________ Phone: __________________________ Name: __________________________ Phone: __________________________ Name: __________________________ Phone: __________________________ ================================================================== 5. PROFESSIONALS AND SERVICES ================================================================== My practitioner: ________________________________________________ Their Mannvartan page / how I book: ____________________________ My doctor: ______________________________________________________ Nearest hospital emergency department: __________________________ ================================================================== 6. IF I AM NOT SAFE — CALL NOW ================================================================== TELE-MANAS 14416 or 1800-891-4416 Free. 24 hours. Many languages. Government of India national mental health line. EMERGENCY SERVICES 112 Nearest hospital emergency department — write it in step 5 now, so it is already here when you need it. These lines will also talk to you if you are worried about somebody else. ================================================================== MAKING IT HARDER TO ACT ON ================================================================== If there is something specific I would use to hurt myself, what can I do to put distance between me and it — give it to somebody, lock it away, change where it is kept. ______________________________________________________ ______________________________________________________ ______________________________________________________ ================================================================== THE ONE REASON ================================================================== One thing worth staying for. It can be very small. ______________________________________________________ ______________________________________________________ ================================================================== Mannvartan is not an emergency service. We do not monitor messages or bookings around the clock, and a booking request will not reach anybody immediately. For help now, use the numbers in step 6. This template follows the Stanley–Brown Safety Planning Intervention, the form most widely used in clinical practice. It is a structure to fill in, not advice — the words in it should be yours.