Safety planning and risk assessment

By Caroline Harroe (Harmless CEO)

Safety planning and risk assessment are two interventions used in mental health care, particularly in suicide prevention. Safety planning involves identifying strategies to reduce the risk of suicidal behaviours and developing safety measures to manage crises. On the other hand, risk assessment involves evaluating the likelihood of an individual engaging in suicidal behaviour, determining the severity and immediate danger it poses to the individual and others, and creating a risk management plan accordingly.

Safety planning is a proactive and collaborative intervention that involves the individual, their support networks and mental health professionals working together to identify and manage potential triggers for suicidal ideation and behaviours. It is a person-centred and strengths-based approach that emphasises the individual’s resilience and coping skills. In contrast, risk assessment can be a reactive approach that focuses on predicting the likelihood of future suicidal behaviour and can lead to the labelling and stigmatising of individuals as being at high risk for suicide.

Despite its widespread use in clinical practice, risk assessment has been criticised for its lack of reliability and accuracy. Research has shown that suicide risk assessments have low predictive validity and that clinicians’ intuition and clinical judgment are often inaccurate in predicting suicide. In contrast, safety planning has been found to be more effective in reducing suicidal ideation and behaviours, and increasing coping skills and help-seeking behaviours.

Suicide prevention is a complex process that requires a multi-dimensional and multi-disciplinary approach. Safety planning is considered a promising intervention that can help people manage suicidal crises and develop coping strategies to reduce the risk of future suicide attempts. It is a collaborative and empowering approach that centres on the individual’s strengths and resilience and provides a framework for managing crises. In contrast, risk assessment has been criticised for oversimplifying the complex nature of suicidal behaviour and may not be effective in reducing the risk of suicide. Therefore, safety planning is an important intervention for mental health professionals working in suicide prevention, and it should be used as the primary approach to managing suicidal ideation and behaviours.

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