Depression Domain: Basic Safety Plan Example #1: What Happens: What To Do: Who Will Do It? By When: Passive Express empathy/sympathy partner/spouse/support 1. immediately Feeling overwhelmed regarding the feelings/ person Sleeps too much/too little experience-continue the conversation set up appointment with Mom 2. immediately if agreeable provider person Warning call friend/family/support Mom or spouse/partner etc 3. immediately if agreeable Thoughts of harming self person Thoughts of harming baby Find a babysitter/respite Mom/caregiver/partner 4. as needed Delusions/Hallucinations Set up or participate in Mom or spouse/partner etc 5. as needed Mood swings support group Set up or participate in Mom or partner/spouse etc 6. immediately or as needed Actions counseling options Harming or attempting to harm Make contact with CMH Mom or spouse/partner etc 7. immediately or as warranted self or baby Call CPS partner/spouse/support 8. immediately or as warranted person Call law enforcement spouse/partner/support 9. immediately or as warranted person Depression Domain: Safety Plan Example #2 Personalized to strengths/interest/learning style of individual/family: – What Happens: What To Do: Who Will Do It? By When: It is noted by dad that mom 1. express support for the mom’s 1. dad, partner, support person 1. immediately rarely holds the child and willingness to share her feelings eventually mom admits that and experience sometimes she thinks it 2. call medical provider and make 2. spouse/partner/support person 2. immediately would be easier if she just appointment or mom didn’t wake up in the 3. call friend/family/support 3. spouse/partner/support person 3. immediately morning and had a dream person to help with baby or mom about putting her hand over 4. call and make counseling 4. spouse/partner/support person 4. immediately the baby’s mouth. appointment or mom
Depression Domain: Basic Safety Plan Example #1: What Happens: What To Do: Who Will Do It? By When: Passive Feeling overwhelmed Sleeps too much/too little Warning Thoughts of harming self Thoughts of harming baby Delusions/Hallucinations Mood swings Actions Harming or attempting to harm self or baby Express empathy/sympathy regarding the feelings/ experience-continue the conversation set up appointment with provider call friend/family/support person Find a babysitter/respite Set up or participate in support group Set up or participate in counseling options Make contact with CMH Call CPS Call law enforcement partner/spouse/support person Mom person Mom or spouse/partner etc Mom/caregiver/partner Mom or spouse/partner etc Mom or partner/spouse etc Mom or spouse/partner etc partner/spouse/support person spouse/partner/support person 1. immediately 2. immediately if agreeable 3. immediately if agreeable 4. as needed 5. as needed 6. immediately or as needed 7. immediately or as warranted 8. immediately or as warranted 9. immediately or as warranted Depression Domain: Safety Plan Example #2 – Personalized to strengths/interest/learning style of individual/family: What Happens: What To Do: Who Will Do It? By When: It is noted by dad that mom rarely holds the child and eventually mom admits that sometimes she thinks it would be easier if she just didn’t wake up in the morning and had a dream about putting her hand over the baby’s mouth. 1. express support for the mom’s willingness to share her feelings and experience 2. call medical provider and make appointment 3. call friend/family/support person to help with baby 4. call and make counseling appointment 1. dad, partner, support person 2. spouse/partner/support person or mom 3. spouse/partner/support person or mom 4. spouse/partner/support person or mom 1. immediately 2. immediately 3. immediately 4. immediately
Depression_safety_plan_477912_7.docx