Myth: No-Suicide Contracts Work
No-suicide contracts are a written agreement between the provider and the patient that states the patient will speak to the provider before attempting suicide. No-suicide contracts create a great deal of internal stress on the part of the patient, but the evidence doesn’t support their use. The contract statement creates a false sense of safety.
Fact: Safety Plans Work
Helping patients understand what they can do when they’re feeling suicidal can help them make better choices in a moment of crisis.
Learn More
Coming soon.
Evidence
Contracting for safety (a no-suicide contract) inhibits free and open communication, which results in poorer outcomes. Alternatives, like crisis response plans (CRPs) and the Stanley-Brown Safety Plan are research based alternatives.
In Support of the Myth
None identified.
To Refute the Myth
“Such a contract may limit open and honest communication because patients have nothing additional to gain by signing a contract.”
“Consistent with our expectations, Soldiers who received a crisis response plan were significantly less likely to make a suicide attempt during follow-up than Soldiers who received the contract for safety.”
“Results of this study indicate that soldiers who received either version of the CRP (standard or enhanced) showed significantly larger reductions in negative emotional states from pre- to postintervention than did those who received the CFS, but the two CRP groups did not differ from each other.” CFS = Contract for Safety
“Both CRPs have high acceptability ratings. The effect of both CRPs on reduced suicide ideation is associated with patient recall of components. More frequent use of the E-CRP is associated with larger reductions in suicide ideation.” E-CRP = CRP + Reasons for Living
Unclear or Mixed Support
None identified.
Learn more about suicide myths – and the truths behind them – by following the links below.