Hands-On Strategies for Clinicians: Hope in Action

• Use direct suicide screening: Ask clearly and calmly about suicidal thoughts, intent, plan, access to means, and previous attempts rather than relying on indirect questions.
• Create or update a Safety Plan: Develop one collaboratively with the client and include specific warning signs, internal coping strategies, people they can contact, professional resources, and ways to increase safety.
• Practice “Hope Mapping”: Ask clients to identify one person, one place, one activity, and one reason that can help them stay connected to life during difficult moments.
• Identify the next small step: When a client feels overwhelmed, shift from solving everything to asking, “What is one thing you can do in the next 10 minutes that moves you toward safety?”
• Strengthen protective factors: Regularly revisit relationships, responsibilities, future goals, spirituality/values when relevant, pets, meaningful activities, and other reasons for living.
• Develop a coping menu: Help clients create a short list of strategies they can use when distressed, such as grounding, sensory regulation, movement, distraction, contacting someone, leaving an unsafe environment, or using crisis supports.
• Rehearse the plan in session: Don't just write a safety plan. Practice what the client will say when contacting a support person or calling 988.
• Address access to lethal means: When clinically appropriate, have direct conversations about reducing access to firearms, medications, or other potentially lethal means and involve appropriate supports.
• Increase follow-up after elevated risk: Consider additional contact, increased session frequency, coordination with other providers, or referral to a higher level of care when clinically indicated.
• Use documentation as a clinical tool: Clearly document risk factors, protective factors, clinical assessment, interventions, consultation, safety planning, and the rationale for the level of care.
• Consult when you're unsure: Clinicians should not have to determine risk alone. Use supervision, consultation, crisis services, or emergency evaluation when risk is unclear or escalating.
• Focus on recovery, not just crisis prevention: Once immediate safety is addressed, help clients identify what they want their life to look like beyond survival—relationships, identity, work, hobbies, purpose, and future goals.

Ask → Assess → Plan → Practice → Connect → Follow Up