A safety plan is a clinical document that a mental health provider collaboratively creates with a client to help a client maintain safety when they may be at risk for self-harm or harm to others. Many clients will never require a safety plan, but you should be prepared to develop one as a standard of care if safety concerns arise.
What is safety planning?
Safety Planning is a collaborative, evidence-based intervention used to support clients who may be at risk of self-harm or harm to others. It is widely recognized as a best practice and is considered a gold standard in suicide prevention.
A Safety Plan is not something a client completes independently. It is completed collaboratively, in-session, between the provider and the client.
Research shows that Safety Planning can help reduce suicidal behavior and increase engagement in care. The goal is to identify early warning signs and outline clear, practical steps a client can use to decrease distress.
Occasionally, individuals such as a parent, guardian, or partner may participate in developing the document, as they may play an active part in the plan. A plan copy should always be dated and given to the client while the original remains in your records.
Why is a safety plan important?
A safety plan helps clients during challenging times by reminding them of their coping skills and support system when experiencing unsafe thoughts or behaviors. Common unsafe thoughts or behaviors can include:
Suicidal thoughts
Urges to engage in self-harm
Thoughts of hurting someone else
Experiencing or hearing internal voices encouraging or commanding a client to act in a dangerous manner
A safety plan provides various benefits to the provider and client, including:
Client safety: Safety plans play an important role in supporting clients who may experience mental health crises or periods of heightened distress. These plans outline individualized steps and strategies to help clients manage their emotions and behaviors when they feel overwhelmed.
When supportive others are included in the plan, safety planning can also strengthen a client’s broader support system. For youth in particular, involving parents or caregivers in the safety planning process can help ensure everyone understands warning signs, coping strategies, and next steps during a crisis, which can support caregivers in responding effectively and compassionately between sessions, while reinforcing the youth’s sense of safety and connection.
Supports providers: Safety plans can also support providers when a client presents to a session in crisis. When a safety plan is on file, you can reference it in real time and walk the client through the agreed-upon steps. This structure can help ground the session, support de-escalation, and reinforce previously identified coping tools and supports. Having a documented plan available may also help you feel more prepared and confident in navigating higher-risk clinical moments.
Liability and Risk Management: While a safety plan does not guarantee a client's safety, it demonstrates that a provider has assessed for risk and addressed the concern to the best of their ability. By having access to safety plans, providers can demonstrate that they are taking appropriate precautions to ensure the safety of their clients. This proactiveness can be essential in liability and risk management, as it shows that providers follow best practices and ethical standards in their field and can protect you from potential legal action.
Improved Care Outcomes: Safety plans help clients manage difficult situations and reduce the risk of self-harm or harm to others. When providers have access to these plans, they are better equipped to help clients implement the strategies outlined in the plan, ultimately leading to improved client outcomes and better mental health.
What is included in a safety plan?
The questions and prompts within the Grow Therapy safety plan cover the following:
Warning signs: The thoughts, images, moods, feelings, or behaviors that signal a client may be beginning to experience unsafe thoughts or behaviors. These are early indicators that it may be time to use the Safety Plan.
Coping options: Strategies the client can use on their own, without relying on another person, to manage distress. These should be safe, practical, and accessible at any time (including late at night or during unexpected moments). Examples may include grounding exercises, paced breathing, journaling, listening to music, or going for a walk. Coping options should focus on wellness-oriented strategies and not include substance use.
Places to go for distraction: This section identifies safe places the client can go when they need a distraction or a change in environment. Examples may include a park, coffee shop, gym, library, or other public setting where the client feels more regulated or less isolated. The goal is to proactively identify environments that support stabilization.
When discussing these options, you may consider transportation and safety in advance. Clients experiencing significant distress or impaired concentration are not advised to drive. Exploring alternatives, such as walking to a nearby location, using a rideshare service, contacting a supportive person for transportation, or choosing a safe space at home, can help ensure distraction strategies remain accessible and aligned with client safety.
Creating a safer environment (reducing access to lethal means): This section identifies steps the client can take to remove or limit access to potentially lethal means, such as firearms, excess medications, or sharp objects. Examples may include storing firearms securely outside the home, using lockboxes, limiting access to medications, or safely disposing of unused prescriptions.
Reducing access to lethal means is a critical component of Safety Planning. It is an evidence-based intervention and a national best practice in suicide prevention. Addressing this step directly can significantly reduce risk during periods of elevated distress.
Reasons for living: This section explores the client’s reasons for living. These may include relationships, responsibilities, values, goals, or other personally meaningful connections.
When clients are experiencing suicidal thoughts, they may have difficulty accessing their reasons for living. Allow the client to name these themselves rather than suggesting or prompting specific reasons. Reasons for living are deeply personal and should come from the client.
If a client does not identify any, allow that to be the case. You may consider whether building or strengthening reasons for living could be a therapeutic focus over time.
Support system: The individual(s) a client has identified as safe and supportive to contact during periods of distress. These should be people who are likely to respond in a stabilizing and helpful way.
When working with youth, Safety Plans can help clarify how parents or caregivers can support their child between sessions and during moments of crisis.
You may also consider discussing whether the client would like to provide verbal consent for you to contact a designated supportive person if they miss an appointment and you are unable to reach them. If consent is provided, document the verbal consent and the supportive person’s contact information in the client’s record.
If a client does not have an identified support system, your plan may include a Warm Line (non-crisis peer support line), if appropriate and available.
Professional support: Resources a client can use if they believe they cannot maintain their safety independently. This includes 988 (Suicide & Crisis Lifeline), local crisis lines, emergency services, or presenting to the nearest emergency department. You can find additional crisis resources in the Help Center Emergency Resources article.
Acknowledgment: Ensure a copy of the plan is dated and given to the client while keeping a version in your records.
Once completed, the Safety Plan will be emailed to the client. Encourage them to keep it somewhere easily accessible (e.g., printed, saved on their phone, or photographed).
When should a client use their safety plan?
Safety plans are intended to be used before a crisis escalates. By identifying warning signs early, clients can take action to prevent a crisis whenever possible. At the same time, the plan provides clear steps to follow if a crisis does occur.
You might think of safety planning like learning “stop, drop, and roll.” We learn what to do before we are ever in a fire, so we can respond quickly if needed. A mental health crisis can escalate quickly, and having a clear, accessible plan in place helps clients respond in the moment.
Before finalizing the plan, review with the client when to use it, specifically when warning signs begin to emerge, not only during a full crisis.
When should I create a safety plan with a client?
Creating a safety plan for clients identified as high-risk is considered a clinical best practice. Examples include, but aren't limited to:
Clients who express thoughts or feelings about harming themselves or others.
Clients who engage in behaviors that may harm themselves or others.
Clients who have stepped down or returned from a higher level of care (HLOC) to outpatient therapy care.
Clients whose response to PHQ-9 question #9 indicates frequent thoughts that they would be better off dead or of hurting themselves in some way.
Any time your clinical judgment indicates a client may benefit from a structured plan to support safety between sessions.
How do I create a safety plan with Grow Therapy?
Your Grow provider portal enables you to create a safety plan with a client.
Safety planning is intended to be completed collaboratively with the client during the session. While the Provider Portal allows you to send the form to a client, independent completion is not recommended. Safety planning is a clinical intervention that requires discussion and collaboration in-session.
Collaboratively complete the safety plan with the client
During a Grow Telehealth session:
To complete the Safety Plan with the client while in a Grow Telehealth session:
Join your Grow Therapy meeting room and admit the client.
Select the Client Information button from the telehealth toolbar. The pop-out sidebar will display the associated client's information, between-session activity, measures, forms, and appointment options.
From the Treatment tab, locate the "Measures and forms" section. Here, you will find forms and measures along with their status (complete or incomplete). Select Safety Plan and a fillable version will appear in the pop-out menu.
Via the client chart:
If you aren't using Grow Telehealth, you can collaboratively complete the safety plan with your client by accessing the form in their profile. To do so:
Select Clients from the sidebar navigation.
Search for and select the desired client from the dashboard.
Select the Forms & Files tab beneath their name.
Locate the Safety Plan form, click the three-dot menu at the far right of the line, and select the Fill Out for Client option from the dropdown menu.
How do I review existing or past client plans?
Once you or a client has completed the safety plan, you will see the results recorded on their profile. You can review a client's safety plan(s) on their profile. To do so:
Select Clients from the sidebar navigation.
Search for and select the desired client from the dashboard.
Select the Forms & Files tab beneath their name.
To view the client's Safety Plan submission, select it directly. If multiple versions have been received, you may see a listing of dates. If so, select the desired version.
Updating a client’s safety plan
At this time, existing Safety Plans cannot be directly edited. To update a plan, create a new Safety Plan with the client. You may copy the information from the original plan that remains accurate and update sections in the new plan as needed.
It may be helpful to revisit the Safety Plan periodically throughout treatment. You might consider asking: “Did you need to use your Safety Plan this week?” or “Does anything need to be updated?”
What is considered to be a quality safety plan?
A quality safety plan:
Uses the client’s own words whenever possible
Includes strategies the client feels willing and able to use
Clearly identifies warning signs and when to use the plan
Is reviewed and updated as needed throughout care
Includes more than one coping strategy per section when possible
Addresses access to lethal means and confirms follow-through on agreed steps
May include Warm Lines (non-crisis peer support lines), if appropriate and available
Steps for including others in safety planning
When clinically appropriate:
Discuss with the client who should be included (e.g., parent, caregiver, partner)
Clarify each person’s role in supporting the client
Obtain and document consent before sharing information
Ensure caregivers understand how to use the plan between sessions and have crisis contact information
Additional resources for safety planning
Mobile applications
Lethal Means Reduction & Counseling resources
Additional clinical risk support
Grow offers additional support for providers navigating client safety concerns, including:
Provider Community (peer discussion and shared resources)