A nurse is collaborating with a patient who screened positive for suicidal ideation but has no immediate plan. The patient is stable and being discharged today with a follow-up appointment. The nurse uses the Stanley-Brown Safety Plan. Which elements should be included? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
The Stanley-Brown Safety Plan is a brief, evidence-based intervention used at discharge or in clinic visits for individuals at risk of suicide. It has six elements: (1) warning signs; (2) internal coping strategies; (3) social contacts and settings for distraction; (4) family or friends who can help (different from #3 — these are people the patient can ask for direct support); (5) professionals and agencies (including 988); (6) means safety counseling — restricting access to lethal means at home (firearms, medications). The classic "no-suicide contract" (choice 1) is NOT evidence-based, has not been shown to reduce suicide, and may give a false sense of security; safety planning has replaced contracts.
The Stanley-Brown Safety Plan is a brief, evidence-based intervention used at discharge or in clinic visits for individuals at risk of suicide. It is collaboratively developed and consists of six elements: warning signs that signal a developing crisis (mood, thoughts, situations, behaviors); internal coping strategies the patient can use alone; social contacts and settings useful for distraction and connection; trusted family or friends to ask for direct support; professional and agency resources, including the 988 Suicide and Crisis Lifeline; and means safety counseling — practical steps to restrict access to lethal means at home such as firearms or medications. "No-suicide contracts" are not evidence-based, have not been shown to reduce suicide, and have been replaced by safety planning. Means restriction is one of the most effective single interventions to reduce suicide deaths.
A nurse is collaborating with a patient who screened positive for suicidal ideation but has no immediate plan. The patient is stable and being discharged today with a follow-up appointment. The nurse uses the Stanley-Brown Safety Plan.
Stanley-Brown Safety Plan — Brief, evidence-based suicide-prevention tool used at discharge or in clinic. Six collaboratively developed elements: warning signs, internal coping, social contacts/settings for distraction, trusted contacts for support, professional/crisis resources, means safety counseling.
Means Safety Counseling — Practical restriction of access to lethal means in the home — firearms (lock, store off-site), medications (lock box, dispose of unused), alcohol, sharp objects. One of the most effective single interventions to reduce suicide deaths because attempts are often impulsive and method-substitution does not always occur.
Why Not "No-Suicide Contracts" — Older practice. Not evidence-based. Have not been shown to reduce suicide and may give clinician and patient a false sense of safety. Safety planning collaborative documents have replaced contracts in current standards of suicide-prevention care.