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Crisis & safety worksheet

Safety Plan

A collaborative, prioritized list of coping strategies and supports to use when suicidal thoughts arise — based on the Stanley–Brown Safety Planning Intervention.

Name or initialsDate

How to use this worksheet

Complete this together with the client, in their own words, moving through the steps in order. Keep it brief, concrete, and realistic. The client keeps the finished plan somewhere accessible. Review and revise it over time — a safety plan is a living document, not a one-time form or a "no-suicide contract."
Prefer to build it on screen and copy or print? Open the interactive version
1.

Warning signs

Thoughts, images, moods, situations, or behaviors that signal a crisis may be developing.

2.

Internal coping strategies

Things I can do on my own to take my mind off my problems, without contacting another person.

3.

People and social settings that provide distraction

Healthy people or places I can go to take my mind off things. (Names, then a place I can go.)

1. Person / place
2. Person / place
3. Person / place
4.

People I can ask for help

Trusted family members or friends I can reach out to, and who I can tell I am struggling.

1. Name / contact
2. Name / contact
3. Name / contact
5.

Professionals and agencies I can contact during a crisis

Clinicians, urgent care, and crisis lines — with the numbers filled in ahead of time.

Clinician / therapist
Phone
Local emergency / community mental health center
988 Suicide & Crisis Lifeline — call or text 988
NH Rapid Response Access Point — 833-710-6477 (24/7)
6.

Making the environment safe

Steps to reduce access to lethal means (firearms, medications, other methods) — this is one of the most protective parts of the plan.

The one thing most important to me worth living for

A reason for living to return to in a hard moment.

Follow-up

  • Client has a copy of this plan and knows where it is kept.
  • Access to lethal means was discussed and a specific plan was made.
  • A follow-up contact / next appointment is scheduled.

Adapted from Stanley, B., & Brown, G. K. (2012). Safety Planning Intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256–264. For clinical use with appropriate training.

Meridian · New Hampshire mental health resources · This is a general clinical handout, not a substitute for professional judgment. If you or someone else is in immediate danger, call or text 988 or NH Rapid Response at 833-710-6477.