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Suicide and crisis terms

Safety plan

Shariq Refai, MD, MBA, board-certified psychiatrist and the reviewer of this article.

Reviewed by Shariq Refai, MD, MBA·Updated March 15, 2026·About 3 minutes

About this term

Quick definition
A short written document created with a clinician that lists warning signs, internal coping strategies, social contacts, professional contacts, and steps to make the environment safer.
Crisis note
If you are having thoughts of suicide with intent or a plan, call or text 988 in the United States, or call 911. The Suicide and Crisis page on this site lists more options.
Full clinical definition
A safety plan is a brief, prioritized, written intervention developed collaboratively between a person at risk of suicide and a clinician. The most widely used version is the Stanley-Brown Safety Planning Intervention, which has six sequential steps. The plan is the patient's document, kept where it can be found in a crisis (phone, wallet, refrigerator), and reviewed and updated at follow-up visits.
Epidemiology
In a randomized study of suicidal patients in Veterans Affairs emergency departments, those who received the Safety Planning Intervention with structured follow-up had a 45 percent reduction in suicidal behavior over the following six months compared with usual care (Stanley et al., JAMA Psychiatry, 2018). Safety plans are recommended as standard practice after any positive suicide screen by The Joint Commission, the VA/DoD, and SAMHSA.
What is in it
The Stanley-Brown Safety Planning Intervention has six steps:
  1. Warning signs that a crisis may be developing.
  2. Internal coping strategies the person can use on their own.
  3. People and social settings that provide distraction.
  4. People the person can ask for help.
  5. Professionals and agencies to contact in a crisis (including 988).
  6. Steps to reduce access to means.
What it can feel like
A safety plan turns an abstract risk into a concrete, written set of steps. Many patients report that the act of writing the plan itself reduces the sense of being trapped, because the next move is no longer something to figure out under pressure. Means restriction (especially firearms and medication stockpiles) is often the most uncomfortable step and the one with the strongest evidence.
How clinicians assess and use it
A safety plan is built during a focused 20 to 30 minute conversation, usually after a positive suicide screen on the Columbia Suicide Severity Rating Scale (C-SSRS), the ASQ, or PHQ-9 item 9. The plan is reviewed at each follow-up visit and updated as warning signs and supports change.
Treatment implications
A safety plan is not a treatment for the underlying psychiatric condition. It is a bridge that lowers immediate risk while treatment proceeds. Safety plans pair with treatment of depression or other psychiatric conditions, addressing substance use, and ongoing follow-up. Templates are publicly available, including from the Suicide Prevention Resource Center and the Stanley-Brown Safety Plan Form.
Related terms
Suicidal ideation. Active suicidal thoughts. Passive suicidal thoughts.
Related articles
Safety plan template (printable). Safety plan (save-to-device). Support person checklist. Support person guide. Suicide and crisis. Suicidal thoughts.

Sources

  • Stanley B, Brown GK. Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cognitive and Behavioral Practice. 2012.
  • Stanley B, et al. Comparison of the Safety Planning Intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry. 2018.
  • Suicide Prevention Resource Center. Safety planning resources.

Frequently asked questions

What is a safety plan?
A safety plan is a brief written plan, made with a clinician, that lists warning signs, internal coping steps, people and places that distract, people to contact for help, professional and crisis contacts, and ways to make the environment safer. The Stanley-Brown Safety Planning Intervention is the most widely used template.
Does a safety plan actually reduce risk?
Yes. In a randomized study of patients seen in the emergency department for suicidality, the Stanley-Brown Safety Planning Intervention with structured follow-up was associated with about half the rate of suicidal behavior over six months compared with usual care (JAMA Psychiatry, 2018).
What are the steps of a safety plan?
The standard six steps are: (1) personal warning signs; (2) internal coping strategies you can do alone; (3) social contacts and settings that provide distraction; (4) people you can ask for help; (5) professionals and crisis lines including 988 and your clinician; and (6) means safety steps to reduce access to firearms and stockpiled medication.
Why is means restriction part of the plan?
Most suicide attempts are decided on within an hour of acting. Putting time and distance between a person and a lethal method, especially firearms and stockpiles of medication, reduces both the chance of an attempt and the chance that an attempt will be fatal. Means restriction is one of the strongest single interventions in suicide prevention.
How often should a safety plan be reviewed?
A safety plan should be reviewed at least every few months and after any crisis. Phone numbers change, contacts move away, and personal warning signs evolve. A plan that is six months out of date is harder to follow under stress.

Last reviewed March 15, 2026.

Every clinical page on DepressionResource.org is written in plain language, dated, and reviewed by a board-certified psychiatrist against current clinical guidelines. See our editorial standards and medical review process.