Why Does Safety Planning Prevent Suicidal Behavior?

Safety planning interventions have demonstrated efficacy in reducing suicidal ideation, suicide attempts, and death by suicide. Less is known, however, about potential mechanisms underlying the effectiveness of safety plans. The present manuscript provides an overview of the steps involved in safety planning, reviews literature demonstrating its efficacy, and proposes seven potential factors that may explain why safety planning works: providing distraction, increasing connection, promoting autonomy, building competence, reducing engagement in impulsive urges, hindering engagement in suicidal behavior, and reducing cognitive load. By improving our understanding of why safety planning is effective, future work may be able to enhance, or augment, safety planning to further increase its efficacy and, ultimately, to save lives. Public Significance Statement This manuscript provides an overview of two safety planning interventions-Crisis Response Planning and Safety Planning Intervention-and proposes seven potential reasons why these interventions may be effective in managing suicidal thoughts and urges and preventing suicidal behavior.