Safety Plan Documentation Template: A Lifesaving Tool
Introduction: Proactive Crisis Support
The Safety Plan (often based on the Stanley-Brown intervention) is a prioritized list of coping strategies and supports that a patient can use before or during a suicidal crisis. Documentation of this plan is a cornerstone of modern suicide prevention and liability management.
Why the Safety Plan is Essential
Unlike a passive "contract," a safety plan is an active tool:
- Empowerment: It gives the patient concrete steps to take when they feel overwhelmed, reducing feelings of helplessness.
- Memory Aid: During a crisis, cognitive function (problem-solving) shuts down. The plan serves as a simple instruction manual.
- Collaboration: Creating it builds a therapeutic alliance, showing the patient "we are in this together."
- Risk Reduction: Explicitly addressing access to lethal means (guns, pills) is the single most effective intervention for reducing suicide.
Key Components of a Standard Safety Plan
A standard plan has 6 prioritized steps.
- 1. Warning Signs: How do I know the crisis is starting? (e.g., "Pacing," "Drinking alone").
- 2. Internal Coping: What can I do *by myself* to distract? (e.g., "Walk the dog," "Listen to playlist").
- 3. Social Distraction: People/places to go just to not be alone (e.g., "The mall," "Call Grandma").
- 4. Support Network: People I can tell "I am in crisis" (e.g., "Call Sister," "Call Partner").
- 5. Professionals: Therapists, 988, ER locations.
- 6. Environment: Making the home safe (e.g., "Give gun key to neighbor").
Complete Safety Plan Template
PATIENT SAFETY PLAN
Patient Name: [Name] | Date: [Date]
Clinician: [Name]
Step 1: Warning Signs (Thoughts, images, mood, situations, behavior)
1. Thinking "Everyone would be better off without me."
2. Staying in bed all day / excessive sleeping.
3. Feeling trapped and anxious in chest.
Step 2: Internal Coping Strategies (Things I can do to take my mind off my problems without contacting another person)
1. Play guitar for 30 minutes.
2. Take a cold shower (TIPP skill).
3. Walk around the block.
Step 3: People and Social Settings that Provide Distraction
1. Go to the coffee shop on Main St.
2. Call friend John (555-0101) to talk about basketball (not crisis).
Step 4: People Whom I Can Ask for Help
1. Call Sister Mary (555-0102) - tell her "I need help."
2. Call AA Sponsor Bill (555-0103).
Step 5: Professionals or Agencies I Can Contact During a Crisis
1. Therapist Dr. Lee (555-0199)
2. Suicide & Crisis Lifeline: Call or Text 988
3. Local ER: General Hospital, 123 Health Ave.
Step 6: Making the Environment Safe
1. Firearm: Gave to brother to store at his house.
2. Pills: Keeping only 1 week supply; wife locks the rest.
The one thing that is most important to me and worth living for is:
My daughter, Sarah.
Signatures:
Patient: _________________________
Clinician: _________________________Automating Safety Planning with HealOS
Documentation must be seamless so you can focus on the patient's distress. HealOS AI agents assist:
- Clinical Documentation Agent: Automatically populates the Safety Plan template into the EHR note from the transcribed session, ensuring no steps are missed.
- Patient Data Management Agent: Pushes the finalized plan directly to the patient's mobile app/portal so it is always in their pocket.
- Regulatory Compliance Agent: Scans the document to ensure "Lethal Means Restriction" was addressed, flagging the provider if this critical liability step is missing.
Automated Workflow Diagram(Mermaid)
graph TD
A[Risk Identified] --> B[Provider & Patient Create Safety Plan];
B --> C[HealOS Agent Records & Structures Plan];
C --> D[HealOS Verifies Lethal Means Addressed];
D --> E[Plan Finalized in EHR];
E --> F[HealOS Sends Copy to Patient's Phone/Portal];
F --> G[Alert Set for Follow-up Review];Frequently Asked Questions (FAQs)
Q: What is a 'Safety Plan' versus a 'No-Suicide Contract'?
'No-Suicide Contracts' (asking patient to promise not to kill themselves) are outdated and ineffective. A 'Safety Plan' is a proactive, prioritized list of coping strategies the patient agrees to use when crises arise. It is evidence-based.
Q: Who should have a safety plan?
Anyone who has expressed suicidal ideation, has a history of attempts, or is currently at high risk for self-harm.
Q: Is it a legal document?
It is a clinical tool, not a contract. However, documenting that a safety plan was created is legally critical to show the standard of care was met.
Q: Should the patient keep a copy?
Absolutely. The patient should have a physical copy or a photo on their phone. The original stays in the chart.
Q: What is 'Lethal Means Restriction'?
The specific step of removing dangerous items (guns, pills) from the patient's access. Documenting *who* removed them (e.g., 'Wife locked guns in safe') is vital.
Q: How detailed should the warning signs be?
Personal specificity is key. Instead of 'Depression', use 'I start sleeping 14 hours a day' or 'I stop answering texts'.
Q: Can I do this via telehealth?
Yes, but you must ensure the patient can write it down or email/text them the completed plan immediately for them to save.
Q: How do HealOS agents help?
They can auto-populate local crisis resource numbers (like nearest ER or 988) and save the plan directly to the patient's portal for easy access.
Q: Does it work for non-suicidal self-injury (NSSI)?
Yes, the same principles (identifying triggers, distractors, and supports) apply effectively to NSSI management.
Q: What if the patient refuses to make a plan?
Document the refusal. This often indicates high risk and may necessitate a higher level of care (e.g., hospitalization) if safety cannot be assured.
A Plan for Hope
Safety plans save lives. Use HealOS to ensure they are created efficiently, stored securely, and accessible instantly when your patients need them most.
Example Safety Plan Template
