Appendix to Discharge Policy (i) | Safety Planning in Forensic Setting | The Atrium Prison Counselling Service.

Forensic Document Information

The scientific base for the effectiveness of risk assessment as an intervention to predict harm is weak. We cannot guarantee to keep anyone safe, but we can through thoughtful practice support people to feel safer and manage their safety better.

If we become aware that a client is at risk in our public facing services, we should always safety plan. This information may come about through a risk assessment, a mental health wellbeing assessment or something the client says or a concern for something indicated in their history. Safety planning is a useful intervention in itself and can be reframed as self-care or distress management if this is more likely to gain the collaboration of the client. Safety planning or alternatively named is useful to end work and part of planning for further help or waits for other services. Safety planning is for everyone and is best when it is integrated with standard practice or preparation for setbacks going forward. Typically, when people are under severe distress they struggle to think rationally and that is why they need a plan to guide them. That is why a safety plan is best completed with client routinely before distress becomes overwhelming, not least before we start troubling work with them which might lead to them feeling temporarily unsafe. Adjust or select the questions to fit the circumstance. Send plan to client too to complete for themselves and own it if appropriate.

Dealing with a crisis when talking to client through incell-phone – If you feel a person is unsafe at the time you are talking to them through the cell phone it is best practice to go and see the person immediately and notify officers of your concerns. If appropriate further assess risk in person (through cell door if otherwise not possible) and open an ACCT document if appropriate. If not able to talk to client open an ACCT immediately and notify Senior Officer, landing officer and safer custody.

Document event and steps taken on System 1 notes as soon as possible.

Basic Safety Plan – Questions for clients.

Preliminary questions when safety planning is standard

1. How will clients know they are at risk of harm? What are the signs? Who else will notice? These are the preliminary questions before the safety plan questions.

Reason to use safety planning as risk emerges

1. How are you going to get through right now/or when things are tough? How can you buy time for help to be accessed or what activity do you start whilst wait happens? Who is there with you now? Samaritans? Tel number. Other agencies?(What can you do? If history of previous harm, can you avoid triggers that led to acts?) e.g use of rubber band
2. How can you make the situation safer right now or if you have a setback? Are you or do you need to be on an ACCT? Press the bell and talk to officers? Is there somewhere you can go, where there is support there? Listeners, cell-mate other friends/ support on wing/ trusted officers or other members of staff (e.g. nurses on wing hatch, chaplaincy etc)Can you take away or lock away the source of harm? Press the bell and give them to officers? Can you call someone who can make you feel safer? Who and what number?Is there something you can read, watch, or listen to that can make you feel safer? Inspiring quotes, helpful thoughts and challenges or balanced statements in response to unhelpful thoughts (any helpful resources or handouts? What applies to you?
3. Things to lift your mood. Relaxation, breathing, calming music, distraction, exercise, creativity, a rehearsed moment you treasure conjured up in your mind or other prepared visualised positive situations, people you love and who offer protective effect and keep you safe, things you are looking forward to. What applies to you?
4. Things to distract you. Concentrated task, TV, films, upbeat music, creative tasks, going out on the yard, exercise, cleaning, going to work, education etc
5. People to support you.
   • Who are they?
   • What are their names and contact details?
   • Who matters in my life and to whom do I matter?
   • What words would they offer you that are helpful?
   • Who are the professionals who can help? e.g Samaritans.