Client Safety Plan

Step 1 — My warning signs

I will identify thoughts, feelings, situations, behaviors, physical sensations, or other warning signs that may indicate that I am becoming overwhelmed or that a crisis may be developing.

• Examples may include significant changes in mood, increasing hopelessness, withdrawing from others, severe anxiety or agitation, increased substance use, thoughts of self-harm or suicide, feeling trapped, inability to sleep, or other changes that are personally meaningful to me.

Step 2 — Internal coping strategies

Before the situation becomes more severe, I can try activities that may help me manage distress without immediately needing another person.

• Examples may include taking a walk, listening to music, breathing or grounding exercises, engaging in a safe activity, prayer or meditation if personally meaningful, exercise, journaling, spending time with a pet, or another healthy coping strategy that has helped me.

Step 3 — People and places that can provide distraction or support

When coping on my own is not enough, I can connect with safe people or go to safe places that may help me feel less isolated or distressed.

Step 4 — People I can ask for help during a crisis

If my distress increases or I am concerned about my ability to remain safe, I can contact someone I trust and tell them that I need help.

I may give permission for my healthcare provider to involve a named support person in implementing this Safety Plan when clinically appropriate and permitted by law. This selection does not replace a separate Authorization for Release of Information when one is legally required.

Step 5 — Professional and crisis resources

If the strategies above are not sufficient, if my symptoms are worsening, or if I am concerned about my safety, I can contact professional help.

Luminox Healthcare Services LLC — Phone: (240) 753-7276 · Fax: (240) 753-7279 · Email: contact@luminoxmentalhealth.com

Important: routine calls, emails, portal messages, and appointment requests to Luminox Healthcare Services LLC are not emergency services and may not be reviewed immediately.

• Maryland: 16701 Melford Blvd, Suite 400, Bowie, MD 20715
• District of Columbia: 2001 L St NW, Suite 500, Washington, DC 20036
• Virginia: 3900 Westerre Pkwy, Suite 300, Richmond, VA 23233
• 988 Suicide & Crisis Lifeline — call or text 988 for 24/7 crisis support for suicidal thoughts, emotional distress, mental health concerns, or substance-use concerns.
• Veterans, service members, and their loved ones: call 988 and press 1, or text 838255.
• Spanish: call 988 and press 2, or text AYUDA to 988.

Step 6 — Emergency care

If I believe I am in immediate danger, have made a suicide attempt, have seriously injured myself, have an overdose or other medical emergency, am at imminent risk of harming myself or someone else, or cannot maintain my safety, I will call 911 or go to the nearest emergency department.

If possible and safe, I may ask a trusted person to stay with me or assist me in obtaining emergency care. I am not required to use any hospital listed in this plan; in an emergency, I should use the nearest or most appropriate emergency service available.

Step 7 — Making my environment safer

An important part of my Safety Plan is reducing access to things I could use to seriously harm myself during a crisis. Together with my provider and a trusted support person when appropriate, I will identify reasonable steps that can make my environment safer.

This may include developing an individualized plan for safely securing or temporarily limiting access to medications, firearms, weapons, toxic substances, or other potentially dangerous items when clinically indicated. Lethal-means safety creates time and distance between a person experiencing an acute suicidal crisis and potentially lethal methods.

Step 8 — Reasons for living and what is important to me

People, responsibilities, beliefs, goals, relationships, experiences, or other things that are important to me may help me remain connected to life.

What I will do if my safety worsens

If I notice my warning signs, I will use this Safety Plan beginning with coping strategies and available supports.

If these steps are not helping, my symptoms are rapidly worsening, I develop suicidal thoughts or urges that I am concerned I may act upon, or I am otherwise unable to maintain my safety, I will seek additional professional or crisis assistance. I may call or text 988, contact an appropriate crisis service, seek assistance from a trusted support person, go to the nearest emergency department, or call 911 when there is immediate danger or a life-threatening emergency.

I do not need to wait until I have tried every step of this Safety Plan before seeking emergency assistance.

Important information about this Safety Plan

• This is a Safety Plan, not a promise or “no-suicide contract.”
• Completing or signing this plan does not guarantee that a crisis will not occur.
• This plan does not replace clinical suicide-risk assessment, psychiatric treatment, therapy, medication management, emergency evaluation, or hospitalization when clinically indicated.
• I may seek emergency or crisis services at any time if I believe they are needed.
• I am encouraged to keep this plan somewhere readily accessible during a crisis.
• I am encouraged to review the plan periodically with my healthcare provider and update it when my circumstances, supports, treatment, or risk factors change.
• I may share this Safety Plan with trusted individuals who can help support my safety.
• My healthcare provider may take appropriate actions when there is a serious or imminent safety concern, consistent with applicable law and professional responsibilities.

Patient acknowledgment

I participated in developing this Safety Plan to the extent clinically appropriate. I understand the steps and resources identified in this plan and have had an opportunity to ask questions. I understand how to contact 988, when to call 911, and when to seek emergency medical or psychiatric care.

My signature acknowledges my participation in and receipt or review of this Safety Plan. My signature is not a promise that I will never experience suicidal thoughts, self-harm thoughts, or a mental health crisis, and it does not waive any of my legal rights.