The Safety Planning Intervention (SPI) is a collaborative and patient-centered strategy to reduce risk of suicide. The goal is to develop step-by-step instructions for an individual to use to stay safe during stressful times or a suicidal crisis.

The Safety Plan components include:

Step 1: Triggers, Risk Factors, and Warning Signs
Step 2: Internal Coping Strategies
Step 3: Social Contacts Who May Distract from the Crisis
Step 4: Family Members or Friends Who May Offer Help
Step 5: Professionals and Agencies to Contact for Help
Step 6: Making the Environment Safe

VA Safety Planning Intervention Manual

The VA Safety Planning Intervention Manual provides instructions for developing individualized safety plans with Veterans at risk for suicide. It offers a structured approach to help Veterans recognize triggers and early warning signs that may signal an increased risk for suicide, and identify coping strategies and resources to use prior to or during a suicidal crisis. The manual emphasizes collaboration between the provider and Veteran, making the safety plan personalized and practical.

In addition to following the guidance available in the manual, providers engaged in safety planning with Veterans should pursue training (see options below) to assess and improve the quality of their safety plans. Higher quality, higher fidelity safety plans have been found to improve outcomes, including reductions in subsequent hospitalizations and emergency room visits for suicidal thoughts and behaviors[1,2] and higher patient satisfaction.[3]

Permission to use or adapt this manual outside of the VA should be obtained from Gregory K. Brown, PhD, email: gregbrow@pennmedicine.upenn.edu

Collaborative Safety Planning Supplementary Tools

Coming Soon!

These collaborative safety planning supplementary tools are intended to be used in conjunction with the VA Safety Planning Intervention Manual. They were developed jointly by the following U.S. Department of Veterans Affairs (VA) Mental Illness Research, Education and Clinical Centers (MIRECCs) and Center of Excellence:

• VA Mid-Atlantic (VISN 6) MIRECC for Post-Deployment Mental Health
• VA South Central (VISN 16) MIRECC
• VA Rocky Mountain (VISN 19) MIRECC for Suicide Prevention
• VA (VISN 2) Center of Excellence for Suicide Prevention

The safety planning supplementary tools provide information on elevated suicide risk factors for these Veteran populations and share suggestions for how to tailor the safety planning approach to these populations’ unique warning signs, barriers to maintaining safety, and strengths. The supplements also provide population-specific tools and resources that may enhance the quality and content of safety plans.

Check back soon for the safety planning supplementary tools.

Learn More About Safety Planning

Training

Stanley-Brown Safety Planning Intervention Training

VA Providers can email SRMConsult@va.gov for internal VA training resources.

VA Safety Plan Form

Printable Safety Plan

VA Safety Plan App

Additional Resources:

The following VA resources include clinical practice guidelines, webinars, supporting literature, and practical tools for providers.

• VA/DoD Clinical Practice Guideline Website
• SRM Lectures
  • Challenging Barriers to Safety Planning: Considering Context and Clinical Complexity, November, 2023
  • Emergency Department Care Plans, July 2021
  • Safety Planning – Basics and Beyond, May 2020
• Therapeutic Risk Management (TRM) with Patients at Risk for Suicide
• Lethal Means Safety and Suicide Prevention

References

1. Gamarra JM, Luciano MT, Gradus JL, Wiltsey Stirman S. Assessing Variability and Implementation Fidelity of Suicide Prevention Safety Planning in a Regional VA Healthcare System. Crisis. 2015;36(6):433-439. doi:10.1027/0227-5910/a000345
2. Wilson MP, Waliski A, Thompson RG Jr. Feasibility of Peer-Delivered Suicide Safety Planning in the Emergency Department: Results From a Pilot Trial. Psychiatr Serv. 2022;73(10):1087-1093. doi:10.1176/appi.ps.202100561
3. Hendley T, Starkey A, Yaccarino C, Bolner J, Hill RM. A Comparison of In-Person and Digital Suicide Safety Planning Quality: A Randomized Controlled Trial of Three Safety Planning Administration Methods. Behav Ther. 2025;56(6):1025-1040. doi:10.1016/j.beth.2025.03.006