Make A Commitment
PERSONAL COMMITMENT SHEET -
My Personal Commitment to Myself:
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I agree to value every life, including my own.
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I commit to practicing health activities like:
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Getting consistent sleep
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Hanging out with positive people
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Eating a good balanced diet
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Getting some form of exercise
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Avoiding excessive alcohol use and the use of drugs
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Attending doctor’s appointments
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Taking my medication as directed
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I agree to make a list of 5 safe people and/or organizations (e.g. school counselors, church staff, etc.) that I can seek help from if I feel depressed or are considering taking my life.
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I understand that if I am having the following symptoms, I may be getting depressed:
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Excessive sleep/inability to sleep
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Reckless behavior
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Unusual irritability
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Wanting to be alone all or most of the time
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A loss of energy to do things I used to enjoy
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Feeling worthless or hopeless
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Excessive use of drugs or alcohol
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Increased or loss of appetite
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I commit to talk with my friends or family if I see these symptoms in them.
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I commit to listen to my friends or parents if they tell me that they see these symptoms in me.
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I understand that if I use Alcohol or illegal drugs, I may act in ways that are less rational and more impulsive.
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I recognize that if I or someone I know is thinking about suicide or taking their life, that this is a sign that professional help is needed.
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I understand that the national suicide hotline is 1.800.273.8255 or text “go” to 741-741.
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I understand that Tri-County’s 24/7 Crisis Hotline is 1.800.659.6994.
By signing this form, I am committing to choose life if I ever have thoughts of suicide.
SIGNED BY:_______________________________________________________
I will Choose Life, because Suicide is Never an Option!
CAREGIVER COMMITMENT SHEET -
1. I understand that I may be scared or uncertain of what to do if my child/family/friend tells me they are thinking about taking their life;
however I commit to taking these concerns very seriously and I will not wait to get them help.
2. I commit to reacting calmly, without judgment, and in a way that encourages my child/ family/friend to share their feelings.
3. I commit to seek immediate help from emergency response by calling 911 if someone is actively trying to hurt themselves.
4. I recognize that if I or someone I know is thinking about suicide or taking their life, that this I s a sign that professional help is needed.
5. I commit to assist my child/family/friend in seeking professional help if they are considering hurting themselves.
6. I will help my child/friend to remain safe while they are seeking help.
7. I understand that the national suicide hotline is 1.800.273.8255 or text “go” to 741-741.
8. I understand that Tri-County’s 24/7 Crisis Hotline is 1.800.659.6994.
By signing this form, I am committing to help them choose life if they tell me they are having thoughts of hurting themselves.
Signature:_____________________________________Date:_______________
I will help them Choose Life, because Suicide is Never an Option!
What Can Our Community Do?
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We can understand there is a problem.
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We can increase awareness of suicide prevention.
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We can share responsibility.
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We can come together to develop suicide prevention strategies.
HELPFUL PHONE NUMBERS:
Crisis Hotline
1-800-659-6994
Psychiatric Emergency
Treatment Center
936-538-1150