In safety planning during a psychiatric assessment, which element should be documented?

• A. Document the safety plan with risk assessment, involve support networks, and follow-up arrangements.
• B. Remove means and isolate the patient.
• C. Initiate involuntary hold in all cases.
• D. Ignore risk and discharge when feasible.

Answer: (B)

Safety planning in a psychiatric assessment centers on documenting a proactive, collaborative plan that keeps the patient safe while respecting rights. The essential element to record is a safety plan that includes a structured risk assessment, clear steps to reduce risk, involvement of the patient’s support network (with consent), and concrete follow-up arrangements. This approach provides a map for action if scenarios escalate, ensures continuity of care, and guides all clinicians and care partners on what to do next. While immediate risk sometimes requires actions like removing access to dangerous means, the safety plan itself should articulate ongoing strategies, who is involved, and how follow-up will occur. Initiating holds in all cases or discharging when risk remains present are not appropriate universal steps, and safety planning emphasizes collaboration, documentation, and shared decision-making to protect the patient and others.