What is a Safety Assessment?

In therapy, a safety assessment is a structured evaluation done by a qualified therapist to understand whether someone is at risk of harming themselves, harming others, or being harmed (for example, through abuse or unsafe living conditions).

 

A safety assessment usually includes:
 

• Suicidality: Asking about thoughts of suicide, intent, plan, access to means, and past attempts.

• Self-harm: Exploring behaviors like cutting, burning, or other non-suicidal self-injury.

• Risk to others: Assessing anger, violent thoughts, threats, or behaviors that could put others in danger.

• Abuse and victimization: Checking if the client is currently experiencing or at risk for physical, emotional, or sexual abuse, neglect, or exploitation.

• Substance use & impulsivity: Considering whether drugs, alcohol, or impulse-control issues increase risk.

• Protective factors: Identifying reasons for living, coping skills, supportive relationships, spirituality, or responsibilities that help keep the person safe.
   

The therapist assesses this information and decides on next steps—whether that’s creating a safety plan, involving supports, increasing session frequency, referring to a higher level of care, or, in higher-risk cases, contacting emergency services or arranging hospitalization.

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When should someone seek a safety assessment?

• They are having thoughts of suicide, self-harm, or harming others but do not intend to act on them right now.

• They want help understanding and reducing their risk, or need a safety plan.

• They’re struggling with unsafe situations (like domestic violence or substance use) but aren’t in immediate danger.

• They’re feeling increasingly overwhelmed and want professional support before things escalate.

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When someone should go to the ER (or call 911/988 immediately):

• They have a current plan, intent, or means to hurt themselves or someone else.

• They feel they cannot keep themselves safe in the moment.

• They are in an unsafe environment (abuse, violence, or medical emergency related to substance use or self-harm).

• They’ve already taken steps to harm themselves (e.g., overdose, cutting, or otherwise injured).

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Key distinction:

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• Safety assessment = proactive, preventative, outpatient (when risk is present but manageable with support).

• ER or 911/988 = crisis, immediate intervention needed (when risk is urgent and safety cannot be guaranteed without emergency help).

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How Long Does it take to complete a Safety Assessment?

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Because of what's involved, it can take anywhere from 1 to 3 hours to complete a Safety Assessment. In addition to time spent with the client, the therapist also needs to communicate with the appropriate authorities, primary care providers, and the client's support system. In addition, reports need to be completed and filed, and with children, a documented school plan is often necessary.

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What is the difference between a Safety Assessment and what my therapist does in session?

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Safety Assessments are not usually scheduled sessions. They are a response to an acute crisis outside of the provider's usual client care hours. IF you are in a scheduled session and disclose a risk factor, your therapist will respond to you immediately. Any request made for an Assessment outside of scheduled hours will be considered an acute need. As a practice, Key Therapy is not a crisis clinic and does not offer 24/7 crisis intervention. If your symptoms are at crisis level, please call 988, 911, or 211.

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Who Pays for Safety Assessments?

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Safety Assessments are a service not covered under insurance outside of a hospital setting, therefore any Safety Assessment requested outside of a scheduled session will be billed directly to the Client or their guardian. The cost of a complete Safety Assessment at Key Therapy is $225 for up to 3 hours and $75 per hour after that.

 

How do I request a Safety Assessment?

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Reach out to our office directly at 203-261-7090 to see if someone is available to help you. If you are unable to reach someone in a timely manner, please visit your nearest walk-in-clinic or ER, and/or call 988. 911, or 211

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211 → For community resources and non-emergency help.

Example: You can’t pay rent, need food, childcare, transportation, or mental health services.

Goal: Connects you to local programs and support services.

911 → For immediate emergencies (life-threatening situations).

Example: Someone is having a heart attack, there’s a fire, or a crime in progress.

Goal: Sends police, fire, or medical emergency responders.

988 → For suicide prevention and mental health crises.

Example: You or someone else is in emotional distress, having suicidal thoughts, or in a mental health crisis.

Goal: Connects you to the Suicide & Crisis Lifeline with trained counselors.

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​See Below for other useful numbers:

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Hotlines

Emergency: Dial 911

Connecticut Mental Health Crisis: 988
National Suicide Prevention Lifeline: 1-800-273-TALK(8255)
American Association of Poison Control Centers: 1-800-222-1222
National Domestic Violence Hotline: 1-800-799-7233
National Association of Anorexia Nervosa and Associated Disorders: 1-630-577-1330
National Eating Disorders Association Helpline: 1-800-931-2237
Overeaters Anonymous: 1-505-891-2664
Planned Parenthood Hotline: 1-800-230-PLAN (7526)
LGBT Hotline: 1-888-843-4564
Trevor Crisis Line (LGBTQ): 1-866-488-7386
Substance Abuse and Mental Health Administration Helpline: 1-800-662-HELP (4357)
Veterans Crisis Line: 1-800-273-8255
Text Support Lines
Crisis Text Line: Text "HOME" to 741-741
Veterans Crisis Text Line: Text 838255
Online Resources
SAFE Network: www.selfinjury.org
Veterans Crisis Line: www.veteranscrisisline.net
National Eating Disorders Association: www.nationaleatingdisorders.org
Suicide Prevention Wiki: www.findahelpline.com

 

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