When the antidote is the poison: Rethinking suicide prevention

Suicide is a leading cause of premature death worldwide and, despite significant investment, the prevalence rate has remained relatively stable for more than a decade. Cognitive theories suggest that the widespread use of ‘safety planning’ as a response to suicidality likely maintains suicide as a potential solution for vulnerable people. This paper describes a theoretically-supported paradigm shift from safety planning to ‘coping planning’ to improve patient outcomes and improve the confidence and competence of clinicians working with people experiencing suicidality. Coping planning is a suicide prevention strategy used to support people with acute distress. The components of ‘caring’, ‘collaborating’ and ‘connecting’ reinforce existing strengths, promote self-efficacy, and link people with more intensive support, as needed. Coping planning broadens suicide prevention beyond simply managing people with explicit suicidality to supporting those people who are acutely distressed and ensuring they have minimally sufficient temporary support—including health professionals—to help them cope effectively. Early intervention has the potential to promote coping self-efficacy and prevent stigma and suicide.