Safety Plan

• Marcus Vance (DOB: 14/08/1989, MRN: 492-817-33)
• 24/10/2023 14:30 CST

Current Situation

• 34 y/o M w/ MDD and GAD presenting w/ worsening depressive sx and passive SI over the past 2 wks following job loss. Denies active intent or plan today, but reports intermittent urges to overdose when isolated at night. Safety plan created to manage acute distress spikes and maintain outpatient safety while initiating sertraline (Zoloft®) 50 mg PO daily.

Step 1: Identify Warning Signs

• Triggers: Checking bank account balances, receiving rejection emails, being alone in apartment after 20:00.
• Warning signs: Pacing, chest tightness, ruminating on "being a failure," ignoring texts/calls, insomnia (> 24 hrs awake).

Step 2: Coping Skills to Try

• Take a brisk 20-minute walk outside w/ dog (Buster), listen to loud rock music, play video games, take a cold shower.
• Therapist/Psychiatrist recommended: TIPP skills (specifically ice dive/cold water on face for acute panic), box breathing (4-4-4-4), and 5-4-3-2-1 grounding exercises.

Step 3: People and Places That Offer Distraction

• Elena Vance (Sister) - (312) 555-0148; David Miller (College friend) - (312) 555-0192.
• Montrose Dog Beach, local public library, Cornerstone Coffee Shop on Clark St.

Step 4: People That Can Assist in a Crisis

• Elena Vance (Sister, lives 10 mins away) - (312) 555-0148.
• Arthur Vance (Father) - (773) 555-0115.

Step 5: Reach out to Professionals

Professional Contacts

• Dr. Sarah Jenkins (Psychiatrist) - (312) 555-0100 (Mon-Fri 08:00-17:00 CST).
• Mark Torres, LCSW (Therapist) - (312) 555-0122.
• Northwestern Memorial Hospital ED - 251 E Huron St, Chicago, IL 60611 - (312) 926-2000.
• Suicide & Crisis Lifeline - Call or text 988 (24/7).

Step 6: Make Your Environment Safe Until Help Arrives

• Sister (Elena) will hold all OTC medications (paracetamol, ibuprofen) and dispense a 7-day supply of Rx meds (sertraline) in a pill organizer.
• Dispose of all alcohol currently in the apartment today; remove utility knives from kitchen counter and lock in basement storage unit.

Step 7: Remember the Things That Are Worth Living For

• "My dog Buster—nobody else knows how to take care of him like I do."
• "Seeing my niece Maya grow up and start school."
• "Getting back into woodworking and finishing my shop."

Additional Notes

• Pt agreed to share a copy of this plan w/ sister Elena tonight.
• F/u appt scheduled in 1 wk (31/10/2023 at 10:00 CST) to assess med tolerability and SI. Call clinic earlier if sx worsen.