Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Safety cannot be maintained in the current setting
An attempt in progress, life-threatening injury, current violent action, available lethal means, severe intoxication, acute brain dysfunction or inability to use any delay strategy requires emergency escalation rather than a paper plan.
Action: Call emergency services or the responsible resuscitation and security response, provide time-critical physical treatment, create proportionate observation and remove immediate hazards. Arrange urgent mental-health assessment, identify dependants and potential victims, and document capacity, information sharing and the legal basis of any restriction.
Synopsis
Create a practical, collaborative safety plan for the next crisis interval, restrict access to relevant means, define escalating support and transfer responsibility clearly while using emergency and legal powers only when ordinary voluntary care cannot keep people safe.
Write the plan with the person in their own language and format, involving a chosen supporter with consent where safe and useful.
Begin with personal warning signs and the sequence from manageable distress to imminent danger so the earliest feasible intervention is clear.
List internal coping actions that can be started without contacting anyone, followed by safe places or activities that reduce intensity.
Key red flags
A safety plan is insufficient when the person intends to act now, cannot delay, has concealed lethal means or is too intoxicated, delirious or disorganised to use agreed steps.
Investigation priorities
01
Warning-sign sequenceFirst step
Identify personal cognitive, emotional, behavioural, substance and situational markers of escalation.
Management branches
Collaborative planBuild from warning signs to emergency help
The person can participate and immediate danger is sufficiently contained for planning.
Identify personal warning signs, internal coping and safe distraction steps that can create time before direct help is needed.
Add named supporters and professional contacts in escalating order, verifying access, consent boundaries and alternatives.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.