Clinician tool
Safety planning quick guide
AI-assisted — clinician review required.Prompts, checklists, and any suggested language here are a scaffold, not clinical advice. Confirm accuracy, apply your professional judgment, and follow your agency's policies and NH statute before anything enters the record.
A quick reference for delivering the Stanley-Brown Safety Planning Intervention (SPI) collaboratively. A safety plan is a prioritized, client-authored list of coping strategies and supports — it is not a “no-suicide contract,” which is not evidence-based and should not be used. Build the plan with the client, in their words, and give them a copy they’ll actually carry.
Before you begin
- Complete a suicide risk assessment first — the safety plan follows from it, and both are documented.
- Frame it collaboratively: “Let’s make a plan together for getting through the hardest moments.”
- Keep it concrete and brief. A plan the client helped write and can access quickly beats an exhaustive one they never open.
- Assess likelihood of use at each step, and troubleshoot barriers.
The six steps — facilitation prompts
1Warning signs
Goal: Personal signs that a crisis may be developing — the cue to start using the plan.
Facilitation: Collaboratively identify thoughts, images, moods, situations, and behaviors that preceded past crises. Use the client’s own words.
“How will you know the plan should be used? What do you notice first?”
“What were you thinking and feeling in the hours before things got worst last time?”
2Internal coping strategies
Goal: Things the client can do on their own to take their mind off the crisis, without contacting another person.
Facilitation: Emphasize self-soothing and distraction the client can do alone. Ask about likelihood of use and problem-solve obstacles.
“What can you do, on your own, to take your mind off things — even for a little while?”
“If that felt hard to do in the moment, what might get in the way, and how could we make it easier?”
3Social contacts & settings that distract
Goal: People and social settings that provide distraction and a sense of connection (not yet asking for help).
Facilitation: Identify healthy people and public places. The purpose here is distraction and connection, not disclosure of the crisis.
“Who or where helps you feel more like yourself — even without talking about what’s going on?”
“What places can you go where you feel steadier around other people?”
4People to ask for help
Goal: Family or friends the client can turn to explicitly for help during a crisis.
Facilitation: List trusted individuals with contact info. Discuss what the client would say and how much to disclose.
“Among the people in your life, who could you tell that you’re struggling and might harm yourself?”
“What would you want them to do — just listen, come over, help you get to care?”
5Professionals & agencies
Goal: Clinicians, urgent care, and crisis services to contact during a crisis.
Facilitation: Include names, numbers, and after-hours options. Pre-populate 988, local crisis lines, and the nearest ED.
“Who on your care team can you reach, and how do you reach them after hours?”
“Let’s write in 988, the NH Rapid Response line, and your nearest emergency room together.”
6Making the environment safer
Goal: Reduce access to lethal means so the plan can work in the window of highest risk.
Facilitation: Discuss means restriction directly and specifically (see the counseling module below). Agree on concrete steps and who will help.
“What do you have access to that you might use to hurt yourself?”
“What would help put time and distance between you and that, at least for now?”
Lethal means counseling (CALM)
Reducing access to lethal means during a high-risk period is one of the most effective things you can do. Approach it directly, matter-of-factly, and non-judgmentally.
Firearms
Ask directly about access. Recommend temporary, voluntary off-site storage (with a trusted person, a gun shop, or a range) during the high-risk period; if stored at home, locked and unloaded with ammunition stored separately. Involve a support person in the plan.
“Would you be willing to let someone you trust hold your firearm for a while, just until things feel steadier?”
Medications
Limit quantities on hand, switch to blister packs, have a support person store or dispense, and safely dispose of unneeded or high-lethality medications.
Other means
Address alcohol/substance access (disinhibition), and any other method the client has considered or has access to. Specificity matters more than completeness.
Means restriction is offered collaboratively and framed as putting time and distance between the person and a method — not as confiscation. Autonomy and a trusted support person make it far more likely to stick.
Documentation requirements
- The risk assessment that preceded and justifies the plan (risk & protective factors, level of risk, clinical judgment).
- That the safety plan was developed collaboratively, and that a copy was given to the client (paper, photo, or app).
- Each step as completed, including specific names/numbers and the means-restriction steps agreed to.
- Lethal means counseling offered and the client’s response.
- Any consultation obtained and the disposition / level of care decision.
- Warm hand-off or referrals made, and the scheduled follow-up.
- Client’s stated willingness and any barriers to using the plan.
Update the plan at subsequent visits and re-document. A safety plan is a living document, not a one-time form.
Follow-up protocol
- Caring contact within 24–72 hours of a high-risk visit (call or secure message) is associated with reduced risk.
- Shorten the interval to the next appointment; consider a bridge or same-week visit.
- Review and revise the plan at each contact — what got used, what didn’t, what’s changed.
- Confirm follow-through on means restriction and connection to any referrals.
- Have a clear no-show / missed-contact outreach procedure for high-risk clients.
Crisis resources to pre-populate
988 Suicide & Crisis Lifeline (call/text 988) · Crisis Text Line (text HOME to 741741) · NH Rapid Response Access Point 1-833-710-6477 · nearest emergency department · 911 for imminent danger.
Reference: Stanley B, Brown GK. Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cogn Behav Pract. 2012. Formal SPI training and your agency’s policy govern practice.