Mental Health Safety Plan
Create your personalized safety plan to help manage mental health crises and support your well-being.
Full Name
*
First Name
Last Name
Best Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
What are your personal warning signs that indicate you may be struggling?
*
Feeling anxious or panicked
Withdrawing from others
Changes in sleep or appetite
Feeling hopeless or helpless
Difficulty concentrating
Other (please specify)
What are your effective coping strategies? (Select all that apply)
*
Listening to music
Going for a walk
Deep breathing or meditation
Talking to a friend or family member
Writing in a journal
Other (please specify)
Who are the people you can contact for support? (List names and relationship)
Professional resources you can reach out to (e.g., therapist, counselor, hotline):
What are some places where you feel safe or comfortable?
What steps can you take to make your environment safer during a crisis?
What should others do to support you during a crisis?
Signature (please sign to acknowledge this plan)
*
Submit Safety Plan
Submit Safety Plan
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