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A safety plan is a brief document a clinician and client build together during or after a suicidal crisis: personal warning signs, coping strategies, people and places that help, professional and crisis contacts, and steps to make the environment safer. The client keeps a copy. Most follow the six-step Stanley-Brown format, often with an optional reasons-for-living step, and take 20 to 45 minutes to complete together.
Therapists, psychologists, counselors, social workers, psychiatric clinicians, crisis and emergency department teams, with the client as co-author
The client, who keeps a copy; the treating team, crisis services, accreditation surveyors, and sometimes family or supports
150 to 400 words · 20 to 45 minutes with the client (clinical team estimate)
Risk mitigation document (compare: suicide risk assessment, crisis note, relapse prevention plan)
After a positive suicide risk screen or crisis, at ED or inpatient discharge, and whenever risk or supports change
No US law prescribes the form; accreditor expectations, one state discharge statute, and Medicare's G0560 rules shape what must be present
A safety plan is a short, prioritized list of coping strategies and sources of support that a clinician and client build together during or after a suicidal crisis, for the client to use when warning signs return. The dominant format is the Safety Planning Intervention developed by psychologists Barbara Stanley (Columbia University) and Gregory Brown (University of Pennsylvania), first published as brief instructions for the VA in 2008 and described fully in 2012. Clinicians and payers also call it a Stanley-Brown safety plan, a crisis safety plan, a patient safety plan, or SPI; the closely related crisis response plan (CRP) grew out of military settings and covers the same ground with a slightly different structure. The developers are explicit that the intervention is more than the form: their protocol includes a risk assessment first, a rationale, collaborative drafting, a how-to-use conversation, and a follow-up review of whether the plan helped.
Two boundaries keep getting blurred. First, a safety plan is a behavioral health document, distinct from the safety planning a domestic violence advocate does and from wellness tools like WRAP; if you searched "safety plan template," this page covers the suicide-prevention document. Second, a safety plan is what replaced the no-suicide contract: instead of asking the client to promise not to act, it gives the client specific things to do, and the evidence comparison has favored the planning approach (see the FAQs). It also sits apart from the suicide risk assessment that precedes it and the crisis note that records the encounter around it: the safety plan is the one document the client takes home.
Safety plans show up wherever suicide risk is managed: outpatient therapy practices, community mental health, emergency departments, inpatient units at discharge, crisis teams, school-based clinicians, and the VA, where the format originated. The trigger is a positive risk screen or a suicide risk assessment that finds elevated risk, a crisis encounter documented in a crisis note, or a discharge from an ED or inpatient stay, the window accreditors single out for follow-up planning. Reach for a safety plan rather than its neighbors when the job is giving the client something to use between sessions: the risk assessment records your clinical judgment, the treatment plan sets the course of care, and the safety plan is the one document written for the client's own pocket. It gets reviewed and updated at follow-up visits, after any new crisis, and whenever contacts or circumstances change.
The structure below follows the Stanley-Brown Safety Planning Intervention, the format the developers published for the VA in 2008 and the one most agencies and EHRs have adopted. The official form runs six steps; the optional reasons-for-living step used by the VA adaptation appears here as step 7. Two things make a safety plan different from every other document on this site: the client is the co-author, and the client keeps a copy. Write every entry in the client's own words. One licensing note: the official Stanley-Brown form permits individual clinical use but requires the authors' written permission for any changes or for use in an EHR, so the template below is our own wording of the standard components, free to adapt.
Step 1: Warning signs. The personal thoughts, images, moods, situations, or behaviors that tell this client a crisis may be building. These cue the client to open the plan, so they come first. Pitfall: generic entries like "feeling sad." A warning sign only works if the client recognizes it as theirs; "lying awake replaying the layoff" cues action, "sadness" does not.
Step 2: Internal coping strategies. Things the client can do alone to ride out the surge: a shower, a playlist, a walk, paced breathing. The point is to let time pass without contacting anyone, because crises crest and fall. Pitfall: strategies the client cannot actually reach at 2 am. Test each one: "could you do this alone, tonight, without leaving home?"
Step 3: People and places that provide distraction. Social contacts and settings that take the client's mind off the crisis without requiring disclosure: a friend to text, a coffee shop, a group. The client does not have to say anything is wrong. Pitfall: collapsing this step into step 4. Distraction and asking for help are different jobs, and the developers kept them separate on purpose.
Step 4: People I can ask for help. Family or friends the client is willing to tell "I am in crisis and need support," with phone numbers. Pitfall: names without numbers, or contacts the client would never actually call. Ask "who would you honestly reach out to?" and write down what they say.
Step 5: Professionals and agencies to contact in a crisis. The treating clinician with after-hours instructions, crisis lines (988 in the US, 9-8-8 in Canada, Lifeline 13 11 14 in Australia), and the nearest emergency department with its address. Pitfall: listing only the therapist's office line. A plan used at midnight needs a number that answers at midnight.
Step 6: Making the environment safer. The means-safety steps the client agreed to, stated as protective actions with who is helping and when it will be reviewed. Document the conversation even when the client declines a step. Pitfall: skipping or vaguing out this step. The developers call means safety a key component of the intervention, and it is the entry reviewers look for first.
Step 7: Reasons for living (optional). What makes life worth living for this client, in their words. The official form has six steps; the VA adaptation adds this one, and many clinicians keep it because it personalizes the plan. Pitfall: filling it in for the client. A borrowed reason persuades nobody, least of all the person in crisis.
Documentation wrapper. Around the plan itself, the chart should show the date, that the plan was built collaboratively, that a copy went home with the client and where they will keep it, who else received it with consent, and when it will be reviewed. Pitfall: a completed plan with no record that the client ever received a copy. The intervention assumes the client can reach the plan in a crisis; a copy that lives only in the EHR protects the file, not the person.
Client: [initials] Date: Completed with: [clinician, credentials] Step 1. Warning signs a crisis may be building (my thoughts, moods, situations, behaviors): 1. 2. 3. Step 2. Internal coping strategies (what I can do on my own to let the surge pass): 1. 2. 3. Step 3. People and places that provide distraction (no need to disclose): Name/place: Contact: Name/place: Contact: Step 4. People I can ask for help (I will tell them I am in crisis): Name: Phone: Name: Phone: Step 5. Professionals and agencies I can contact in a crisis: Clinician + after-hours instructions: Crisis line: 988 (US) · 9-8-8 (Canada) · Lifeline 13 11 14 (Australia) Nearest emergency department + address: Step 6. Making my environment safer (agreed protective steps, who is helping, review date): 1. 2. Step 7. Reasons for living (optional): Copy given to client: [ ] yes Where I will keep it: Shared with (with consent): Review date: Clinician signature/credentials: Date signed:
Free to use and share, no signup. The PDF includes a one-page cheat sheet with section-by-section pitfalls and a pre-sign checklist; the DOCX is the blank template, ready to adapt.
Scenario: adult outpatient client with major depressive disorder, seen two days after an emergency department visit for suicidal ideation without attempt. The plan was completed collaboratively in a 40-minute session, and the entries are in the client's own words. All details are fictional.
Client: M.T., 29 · Date: 07/16/2026 · Completed with: J. Alvarez, LCSW, in office, plan built collaboratively over 40 minutes
Step 1, warning signs: Staying in bed past noon on days off. Turning my phone face down and letting texts pile up. The "everyone would be fine without me" loop starting at night.
Step 2, internal coping: Hot shower, then the running playlist. Take Biscuit for a walk around the block. The 4-7-8 breathing we practiced until the wave passes.
Step 3, people and places for distraction: Pickup basketball at the rec center (Tuesday and Thursday evenings). Texting my cousin D. about the game. The coffee shop on 5th where I do crosswords.
Step 4, people I can ask for help: Sister, A.T. (phone in my contacts, she knows about this plan). Roommate, C., can sit with me and handles mornings well.
Step 5, professionals and agencies: J. Alvarez, LCSW, office line with after-hours voicemail instructions. 988 by call or text, saved to favorites. St. Mary's Hospital emergency department, 1400 Oak Street, 10 minutes away.
Step 6, making my environment safer: Medications moved to a lockbox that C. keeps; I hold a two-week supply. Agreed to keep alcohol out of the apartment for now. Review both steps with J. Alvarez on 07/30/2026.
Step 7, reasons for living (optional): Biscuit. Watching my niece grow up. Finishing the welding program I started.
Documentation wrapper (chart note): Plan completed collaboratively; client generated all entries and read the plan back. Printed copy given to client, who will keep it folded in their wallet; photo saved on their phone. Copy shared with sister A.T. with written consent. Plan to be reviewed at each session through August and after any crisis contact. Next session 07/23/2026. Signed: J. Alvarez, LCSW, 07/16/2026.
This sample is fictional and for educational purposes. It does not describe a real patient.
Writing these after every session? BastionGPT drafts complete notes from bullets, dictation, or a transcript.
Generate a note from bulletsA safety plan lives in two places at once: the copy in the client's hands and the record in the chart, and the chart side is what surveyors and reviewers read. For Joint Commission-accredited organizations, NPSG 15.01.01 requires documenting each at-risk patient's overall risk level and "the plan to mitigate the risk for suicide" (EP 4), and requires written policies for counseling and follow-up care at discharge (EP 6), where the Commission's own rationale names developing a safety plan with the patient and providing crisis numbers as what works. One state goes further: for elevated-risk patients at psychiatric centers and OMH-licensed inpatient services, New York's Mental Hygiene Law 29.15 requires "an individualized community suicide safety plan completed before discharge," provided to the patient's aftercare providers. Chart the collaboration, not just the artifact: who participated, that the client kept a copy and where, who else received it with consent, and when it will be reviewed. When a safety plan follows a duty-to-warn situation or a mandated report, consult your attorney or board; state rules vary. If you or a client needs immediate support: call or text 988 (US), 9-8-8 (Canada), or Lifeline 13 11 14 (Australia).
The payer layer is new and worth knowing. Since January 1, 2025, Medicare pays separately for safety planning interventions under G0560: for patients in crisis, including suicidal ideation or risk of suicide or overdose, performed by the billing practitioner in a variety of settings and billed in 20-minute increments, so the time and the personalized work need to be visible in the note. The same rule created G0544, a monthly bundle of four follow-up contacts after an emergency department discharge for a crisis encounter, and safety planning joined the Medicare telehealth list on a permanent basis. Two details from the final rule matter for documentation: CMS finalized G0560 as a stand-alone service that the billing practitioner performs personally, so a template completed by other staff does not become billable through a co-signature, and CMS deliberately kept a crisis narrative and a specific written form out of the code definition, so the personalized elements themselves are what your note has to show. The form is a convention; the collaborative work, the time, and the copy in the client's hands are the requirement. When the plan changes what treatment looks like, close the loop in the treatment plan and the next progress note.
The audit record for safety plans comes from the system that invented the format. The VA inspector general's December 2024 national review of 200 inpatient mental health discharges found no completed safety plan for 12 percent of patients, and among the completed plans that missed required elements, insufficient contact information was the leading defect. An earlier lethal-means review found that when patients with firearm-related suicidal behavior reported firearm access, 21 percent of safety-planning records had no documented safe-storage discussion. Medicare's G0560 is too new for any of this: as of July 2026 there were no published denial rates or utilization data for the code, so the payer-side audit record is still being written. The BastionGPT Clinical Advisory Board sees the same errors most often in safety plan reviews:
| Aspect | United States | Canada | Australia |
|---|---|---|---|
| Status | No federal law prescribes the form; Joint Commission NPSG 15.01.01 requires risk and mitigation documentation plus discharge policies, New York mandates a pre-discharge plan in covered psychiatric settings, and Medicare pays G0560 for the intervention | Convention plus accreditation: the national suicide-prevention standard CAN/HSO 5064:2023 builds safety planning into accreditation programs; provincial college record standards govern the documentation | Convention plus accreditation: NSQHS Comprehensive Care actions 5.31 and 5.32 require systems for identifying and responding to suicide risk, with no form prescribed |
| Terminology | Safety plan, Stanley-Brown safety plan, SPI; crisis response plan in military settings | Safety plan, crisis plan | Safety plan, crisis plan; part of "safety planning" in NSW policy |
| What changes | The payer layer: G0560, G0544, and the telehealth listing are Medicare-specific | Crisis line is 9-8-8; no national billing code; Ontario supervisors co-sign plans relied on for care decisions | Crisis line is Lifeline 13 11 14; NSW public services must give the person a copy and document one in the eMR; no MBS safety-planning item |
| Retention | Follows the chart, not the form: no universal HIPAA rule; Medicare hospital records five years, state law and payer contracts govern beyond that | Provincial; Ontario colleges expect 10+ years from last interaction, or from the client's 18th birthday | State rules; NSW requires 7 years for adults and until age 25 for minors |
The plan itself travels well: warning signs, coping steps, and contacts work the same way everywhere. What changes is the crisis number on step 5, the billing layer around the intervention, and the copy and retention rules for the chart.
BastionGPT is specifically trained, tuned, and clinically tested on safety plans.
See how clinicians use it day to day on the AI therapy notes page.
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HIPAA-compliant with a signed BAA on every plan. Your data is never used to train models. BastionGPT drafts, you review and sign.
No federal law prescribes a safety plan form. What exists is an accreditation and payment layer: Joint Commission-accredited organizations must document each at-risk patient's risk level and mitigation plan and follow written discharge follow-up policies under NPSG 15.01.01, and Medicare pays for the intervention through G0560 without mandating it. One state statute does exist: New York's Mental Hygiene Law 29.15 requires an individualized community suicide safety plan before discharge for elevated-risk patients at OMH-licensed psychiatric settings. Everywhere else, the safety plan is how organizations satisfy broader expectations, which is different from the form itself being required.
A no-suicide contract asks the client to promise not to act; a safety plan gives the client specific things to do when warning signs appear. The only randomized trial to compare the approaches, Bryan and colleagues' 2017 study in US Army soldiers, found crisis response planning outperformed contracts for safety on subsequent attempts. Patient-safety guidance points the same way: the Pennsylvania Patient Safety Authority titled its advisory on the practice "Contracting for Safety: A Misused Tool." If a document asks for a signature on a promise, it is a contract, whatever the header says.
Under Medicare, yes, since January 1, 2025. HCPCS G0560 pays for safety planning interventions for patients in crisis, including suicidal ideation or risk of suicide or overdose, performed by the billing practitioner in a variety of settings and billed in 20-minute increments, and the service sits on the Medicare telehealth list permanently. The same rule created G0544, a monthly bundle covering four follow-up contacts after an emergency department discharge for a crisis encounter. Document the time and the personalized, collaborative work; a photocopied form does not show a 20-minute intervention.
The evidence is favorable with honest caveats. A 2021 meta-analysis of six studies with 3,536 participants found safety-planning-type interventions cut suicidal behavior nearly in half (relative risk 0.570, number needed to treat 16), with no measured effect on suicidal ideation. The best-known single study, the 2018 comparison across nine VA emergency departments, found 45 percent fewer suicidal behaviors (3.03 versus 5.29 percent over six months) and twice the odds of engaging in outpatient care; that result covers the plan plus follow-up calls, not the form alone. The 2024 VA/DoD guideline, which counts only randomized trials, graded the trial evidence insufficient while keeping safety planning as standard care in both systems and noting no evidence of harm.
Yes; the copy in the client's hands is the intervention. The developers' protocol includes discussing where the plan will be kept and the barriers to using it, and the Joint Commission's discharge rationale pairs the plan with crisis numbers the patient leaves with. Document that a copy was given, where the client will keep it, and who else received one with consent. A plan that exists only in the EHR protects the file, not the person.
Plan for 20 to 45 minutes of collaborative conversation, the range the developers themselves published; the VA/DoD guideline notes the intervention can be completed in a single session. The written product is short, usually 150 to 400 words across the six steps of the Stanley-Brown format, plus the optional reasons-for-living step the VA adaptation uses. The time goes into eliciting entries the client will actually recognize and use, which is also what G0560's 20-minute increments are paying for.
They answer different questions. The suicide risk assessment records how you evaluated risk and why the disposition was safe; it is written for the record. The crisis note documents a crisis encounter: what happened, what you did, and where the client went. The safety plan is the take-home product of that work, written with and for the client. A high-risk presentation often generates all three on the same day, each doing its own job.
No regulation sets a universal frequency. The 24-hour and 120-day windows clinicians sometimes cite come from MIPS Quality ID 504, a reporting measure that only applies when a clinician reports it, not a chart deadline. The Joint Commission requires written policies that include guidelines for reassessment, and the developers' protocol ends with a follow-up review of whether the plan helped. In practice: review at each visit while risk is elevated, after any crisis contact, and whenever a contact, medication, or living situation on the plan changes. Date each review; a plan with a review trail reads as risk management, a plan without one reads as paperwork.
Yes. Give it your session bullets and it drafts the plan with every entry kept in the client's own words, flags empty steps and contacts without numbers, and can rewrite the finished plan in plain language for the client's copy. BastionGPT is HIPAA-compliant with a signed BAA on every plan, and your data is never used to train models.
The compliance claims on this page trace to these authorities, last verified July 2026:
Educational content, not legal or billing advice. Sample notes are fictional. Follow your organization's policies and your board, payer, and jurisdiction requirements.