Crisis Assessment & Safety Planning
Assess crisis situations and generate trauma-informed safety plans with clinical documentation.
What You Can Do
You can rapidly evaluate acute crisis presentations—including suicidal ideation, homicidal threats, domestic violence, and psychiatric decompensation—using structured decision pathways that determine appropriate intervention levels. The skill guides you through systematic risk stratification across multiple domains (intent, means, protective factors, access to support) and generates specific, behavioral safety plans with clinical documentation that meets liability standards and supports continuity of care.
Features
evaluates intent, means, access, and protective factors across suicide, homicide, self-harm, and abuse domains
gathers safety information using de-escalation language and psychological safety principles
guides decisions between emergency department referral, intensive outpatient, hospitalization, or community-based intervention
produces specific, behavioral safety planning language with crisis contacts, de-escalation strategies, and means restriction steps
generates clinical notes with decision-making rationale, risk formulation, and intervention justification for chart compliance
systematically identifies and mobilizes existing strengths, relationships, and coping resources to support safety
incorporates validated screening elements for suicide and homicide risk across acute and chronic indicators
generates continuity planning language for referrals to psychiatric care, substance use treatment, or community resources
Example Output
Example 1: Suicidal Ideation Assessment Output
Risk Stratification Summary
- Intent: Active suicidal ideation with specific plan (hanging)
- Means: Access to ligature (rope in garage); stated intent to act within 48 hours
- Protective Factors: Two adult children local; steady employment; no prior attempts
- Risk Level: HIGH — Requires emergency evaluation
Safety Plan Generated
- Crisis Contacts: Emergency room (State Hospital): 555-0123 | Crisis Line: 988 | Daughter (Jennifer): 555-0456
- Immediate Actions: Remove access to ligature; contact adult daughter to provide supervision through evening
- De-escalation Strategy: When thinking of ending life, call Jennifer first; if unavailable, go directly to emergency room
- Documentation: Client able to articulate plan; motivated by recent job loss and isolation; daughters willing to provide monitoring; client agreeable to emergency evaluation.
Example 2: Domestic Violence with Housing Instability
Risk Formulation
- Threat: Partner escalating verbal abuse to physical intimidation; client asking about shelter options
- Safety Barriers: No transportation, limited financial resources, two minor children
- Protective Factors: Supportive sister; client employed part-time; children's school provides meals
- Risk Level: MODERATE-HIGH — Intensive outpatient with emergency shelter backup
Safety Plan & Referral Strategy
- Week 1: Connect with domestic violence shelter for intake (provide phone and backup email contact)
- Safety in home: Pack "go bag" with documents, medications, $200 cash; keep car fueled; memorize domestic violence hotline
- Income bridge: Apply for emergency TANF; connect with job training program (provide referral contact)
- Documentation supports continuity with shelter social worker and follow-up safety assessment at day 3 post-discharge.
What's Included
- SKILL.md: Core crisis assessment protocol with decision trees and lethality screening guidance
- Risk Stratification Worksheet: Structured template for evaluating intent, means, access, and protective factors across domains
- Safety Plan Template: Customizable format for behavioral safety planning with crisis contacts, de-escalation strategies, and means restriction steps
- Level-of-Care Decision Tree: Flowchart for determining emergency vs. intensive outpatient vs. hospitalization vs. community-based intervention
- EMR Documentation Checklist: Compliance framework for clinical note documentation with liability protection language and decision-making rationale
Who It's For
- Clinical Social Workers — Community mental health centers, crisis hotlines, psychiatric hospitals, community action agencies
- Crisis Intervention Teams (CIT) — Law enforcement-embedded social workers, mobile crisis units, emergency response teams
- Nonprofit Crisis Programs — Domestic violence shelters, suicide prevention programs, substance use crisis response teams
- Hospital Social Work Departments — Emergency departments, psychiatric units, observation units conducting intake assessment
- Case Management Organizations — Intensive case management programs providing crisis stabilization and safety planning services
Best For
- Suicidal ideation assessment and safety planning — active, passive, or latent intent across all age groups
- Homicide risk and threat assessment — evaluating imminent danger to others and appropriate intervention level
- Domestic violence crisis intervention — rapid safety assessment with housing and protective resource coordination
- Acute psychiatric decompensation — determining whether presentation requires emergency hospitalization or intensive outpatient stabilization
- Substance use crises — overdose risk assessment, intoxication safety planning, and treatment referral coordination
- Child and elder abuse disclosure — initial safety assessment, mandatory reporting documentation, and child protective services coordination
- Housing crisis stabilization — imminent homelessness assessment with emergency shelter navigation and continuity planning
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