Violence and Safety Plans

Family Care

child proofing Crisis danger Family Members harm home safety homicide Legal risk suicidal suicide threat

Learn the basics for making a living environment safer for someone who is suicidal or experiencing psychosis. Learn also about filing an order of protection in your local court if your loved one with severe mental illness becomes violent or threatening toward you. Statistics shared are a harsh reminder that family members must not take safety and well-being lightly.

Is my loved one with SMI at higher risk for suicide?

More than 100 Americans die by suicide every day, and more than 1 million attempt suicide annually. Suicide is a significant contributor to the early mortality of individuals with schizophrenia and bipolar disorder, whose life expectancy in the United States is approximately 25 years shorter on average than the general public. The lifetime risk for suicide among those diagnosed with bipolar disorder is 10-15 percent. For those diagnosed with schizophrenia, the lifetime risk is about 5 percent.

Adequate and consistent treatment lowers the risk. The American Foundation for Suicide Prevention (AFSP) provides a website page about mental health conditions and suicide that includes guidance and links to videos specific to a few diagnoses associated with suicide.

Take any suicide threat seriously, and ask direct questions:

Are you thinking of suicide?
Do you have a plan?

If the answers are yes, call 988 or your local crisis response service for immediate on-site assistance or (if feasible) drive your loved one to the nearest crisis center or hospital emergency department. If your area has Right Response, you might call 911, 211, or a specific local number to request that service.

If a suicide risk is not imminent but is an ongoing fear because your loved one resists treatment for their severe mental illness (SMI), learn all you can about tips for communicating and motivating someone to engage in treatment, even if they experience the common neurological symptom known as anosognosia, which disables a person’s ability to see that they are ill or needing care. Plan for a possible emergency, which may be the next best opportunity to help someone stabilize enough to access treatment.

In the meantime, you may need to take steps to protect the safety of your loved one, yourself, and others in your household. This resource includes a few options. Please note that fully safety-proofing your home is impossible, but small changes and preventive steps can make a difference.

What should I do if my loved one becomes violent?

When a loved one has a poorly managed SMI, maintaining healthy and safe boundaries is critically important. If your loved one’s behavior becomes violent, the priority is safety and protection. When untreated, and particularly when SMI is combined with alcohol use or other substances, the risk of violence is higher. SMI is a factor in approximately 29 percent of family homicides despite those with SMI making up only three percent of the population.

Do not take personal safety lightly.

Call 911 if someone is at risk of harm because of current, active violence or a threat that involves a weapon. Ask for a CIT trained officer, if available.
Call 988 if there is a mental health emergency, such as someone talking about their wanting to die by suicide, but no immediate sign of violence. 
Lock up firearms! If a loved one has access to firearms that you cannot secure, research whether there is a “red flag law” in your state to have those weapons removed. Ask how law enforcement takes measures to utilize the law.

If a family member or intimate partner develops a pattern of causing physical or psychological harm, it’s considered domestic violence or domestic abuse. You can call the National domestic violence hotline: 800-799-7233 (SAFE) or TTY 800-787-3224. 

What is an order of protection?

If a loved one becomes threatening or abusive, you may need to consider filing an order of protection to prevent them from coming to your home or having contact with you.  

Note: If your loved one has injured you and been accused of a crime for the assault, a judge may issue a no contact order. Families may not have a choice about whether criminal charges are filed. A victim advocate may be available to help you express your wishes to the prosecutor. See TAC’s article on criminal legal topics.

The court for your county/area will have paperwork for filing a protection order, or you may be able to download the paperwork online to fill out before taking it to the courthouse. Here are a few things to consider: 

Orders of protection operate similarly throughout the country, but your state or local area may have a specific process and there may be specific elements you must satisfy to have the order granted. The degree to which the order is enforced varies widely depending on location. 
Getting an order of protection may require a lower threshold of threat than your state’s involuntary treatment laws. If you are afraid for your safety, consider filing even if you have concern that your order might be rejected. 
If the threat of harm is immediate, seek safety and call 911. Once safe, you can request an emergency petition. A judge can grant an ex parte (without the other party present) order of protection if there is immediate or present danger of abuse to you. The temporary order is in place until a hearing is held for a full order of protection. 
Consider if you want zero contact or limited contact. You may have the option to file an order of protection that prohibits the person to come to your home but does not prohibit you from communicating in public places or by phone, mail, or electronic means.  
Ask court staff for information about options for serving the paperwork; Sometimes law enforcement will help. 
Consult an attorney if you want help filing the paperwork and understanding your rights. 
Be kind to yourself if you are facing these difficult decisions. You deserve safety and protection.

What can I do to make the home safer when my loved one is suicidal or psychotic?

If your loved one with SMI experiences psychotic delusions, they may be linked to specifically dangerous things, such as fire, sharp objects, medication, or something else. Listen to clues from your loved one about specific things that might create a danger and do your best to get them out of the house or at least out of reach. Here are a few general ideas for making the home safer:

Lock up or remove firearms.
Knife drawers can be locked, and you can store the scissors, razers, and other sharps there or in another locked space. A hardware store or online retailer is a place to look for an option that might utilize a key or a fingerprint opener.
Medication that isn’t being used can be delivered to a local law enforcement office for proper disposal.
Prescription and over-the counter medication should be secured. Note that liver damage and death from acetaminophen is common.
Consider if you want to lock the room where you sleep and consider packing a suitcase with essentials for a prompt escape from the home if necessary.
Consider hiding or locking up the car keys.
Get rid of or lock up alcoholic beverages.
Remove or lock up other objects that could be used harmfully: toxic cleaning chemicals, ties, belts, ropes, extension and charging chords, lighters…

Please keep in mind that your home cannot be expected to be as secure as a locked psychiatric facility. If your loved one has reached a stage of illness that is causing an imminent threat of harm, your state’s criteria for involuntary hospitalization may be met. Visit TAC’s U.S. map to look up the criteria in your state for an emergency evaluation and/or a civil commitment. On the page about your state, you will also find family resources to help you navigate the treatment system.

For individualized support, fill out a Get Help request form and someone from our Helpline Team will assist you.

Additional Resources