How to make a safety plan with a client (with a free template)

A safety plan is written with the client, in their words, and kept somewhere they can reach in a crisis: on their phone, in a wallet, on the fridge. The approach most clinicians use was developed by Barbara Stanley and Gregory Brown.

It is not a "no-suicide contract". Asking a client to promise not to harm themselves offers no protection and can stop them telling you the truth. A safety plan instead gives them things to do.

Work through the steps in session, usually taking 20 to 45 minutes. Each step is used only if the one before didn’t help.

1. Warning signs. What thoughts, feelings, situations or behaviours tell the client a crisis may be building? Use their own words: "When I start thinking everyone would be better off without me."
2. Things I can do on my own. Activities that take their mind off things or calm them: a walk, music, a shower, prayer, a breathing exercise. Ask how likely they are to actually do each one.
3. People and places that help me feel better. Friends, family or places (a temple, a park, a café) that offer distraction and company, without needing to talk about the crisis.
4. People I can ask for help. Trusted people they can tell they are struggling, with phone numbers. Discuss what might stop them calling.
5. Professionals and crisis lines. You, your clinic, their psychiatrist, the nearest emergency department, Tele-MANAS (14416 / 1-800-891-4416) and 112.
6. Making my surroundings safer. Reduce access to the means they have thought about: medicines, pesticides, sharp objects, ropes, alcohol. Agree concrete steps and who will help, often a family member.
7. Reasons for living. What matters most to them and is worth staying alive for. Some clients find this the most important part.

• Use the client’s words, not clinical language.
• Keep it short. A plan that fits on one page or one phone screen gets used.
• Ask "how likely are you to use this?" for each step, and problem-solve the barriers.
• Rehearse it: ask the client to talk you through what they would do tonight.
• Involve family in reducing access to means, with the client’s agreement. In India, pesticides and medicines at home are common means.
• Review and update it at every session while risk remains, and after any crisis.
• Record it in the client’s file along with your risk assessment.

Our template follows the steps above with Indian crisis numbers filled in. Fill it in on screen with your client and print it or save it as a PDF. Nothing you type is sent anywhere.

In MindConnect you build the safety plan in the client’s record next to their risk assessment. Every version is kept, it prints on your letterhead, and you can share it to the client’s phone, where it opens even without internet. A red prompt appears when a client at moderate or high risk has no plan. If the client taps "Get help" in their app, the care team is alerted. Read more for psychologists.