Creating a Safety Plan for clients at increased risk of danger to self or others

Completing a Safety Plan with a client at increased risk for suicide, risk to others, or self-harming behavior is an essential step to ensuring a client’s care needs are being met. At Rula, we recommend using an evidence-based safety planning template, such as the Stanley Brown, which you and your clients can easily access in a few ways.  

Note: For therapists participating in the Beta for clinical documentation in the Rula provider portal, see [Beta] Adding or updating a safety plan in the Rula provider portal.

Option 1: Create a Safety Plan directly in AMD

This option offers the ability to collaboratively create a Safety Plan with the client in session and document the safety plan directly in the client's record. You can also send the client a PDF copy of the safety plan once it's finished.

How to create a safety plan using the template in AMD

  • Open the client's chart and find your most recent session with the client on the timeline.
  • Click the three dots to add a linked note and open the note template page.
  • Click the drop-down arrow next to the template field, and select "safety plan" from the drop-down menu. And the Stanley Brown template will open up. 
  • You'll then walk through the six sections of the safety plan with your client. 
  • Once complete, ensure all the required yellow fields are completed and you will sign. The client does not need to sign the safety plan.

How to Download a PDF of the completed Safety Plan that you can send to your client

Please note that directly sharing a document from the client's chart is ONLY allowed for the Safety Plan. We strictly prohibit releasing any other component of the medical record outside of our medical records request process, as Rula is the custodian of record.

  • Open the client's chart.
  • In the "Notes" section, find the completed, signed Safety Plan and open it on the screen.
  • Click the "narrative" tab - generating the narrative takes about a minute.
  • Click the PDF download button to download
  • Email the PDF of the safety plan to your client.

*Note that creating a safety plan this way requires a new PDF to be downloaded and sent to the client when any changes are made to the safety plan.

 

Option 2: Use of Safety Planning Apps 

You can have the client download a safety planning app, many of which use the Stanley Brown template, to complete and store the safety plan on their phone. Ensuring clients have ready access to their safety plan when in crisis is crucial, so this is often a preferred option by clients.

A few of the most commonly used apps are: 

mceclip2.png Stanley Brown Safety Plan (App badge: Green Cross) 

mceclip1.png Be Safe - Suicide Safety Plan (App badge: White-letter C, blue background)

mceclip0.png   Suicide Safety Plan (App badge: White cross, blue background) 

 

After the client has downloaded the app to their phone, You would collaboratively navigate the prompts together during the session and encourage them to utilize it as clinically indicated.

Please know that although a standard best practice, keeping a copy of the safety plan in the chart in AMD is not required. The safety plan is for the client. If the client completes a safety plan via an app, the only required documentation is a statement in a note that a safety plan was completed with the client and that the client has a copy. 

 

Safety Plan FAQ:

  • How do I update the Safety Plan? In AMD, you cannot update or edit a safety plan note once signed; If updates are needed, you can create a new safety plan at any time.
  • Can I bill for completing a Safety Plan with a client? Safety Planning should occur collaboratively during the session with your client, and you will capture the time spent creating the Safety Plan in the CPT code you are already using. For example, you might spend 20 minutes safety planning during a 55-minute 90837 Individual Therapy session. 
  • Can I just use a “safety contract” with clients instead of a safety plan? As a profession, we do not “contract for safety” or use a “no-suicide contract.” There is no evidence that these approaches work, nor are they considered trauma informed approaches to managing risk. Additionaly, a no-suicide contract does not protect therapists from potential liability should a client's suicide occur.  
  • Does Rula have a Policy on Risk Assessment and Safety Planning? Yes, it can be found here
  •  Can I see an example of a completed safety plan? You got it! Click HERE

If you have questions or support needs related to Safety Plans, reach out to our clinical quality team at quality@rula.com. Therapist to therapist - we’re here for you!

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