It’s time to revisit best practices and improve safety with skills and confidence.
Two years ago, I wrote about
best practices for staying safe during home visits. It’s time to update and expand upon that initial advice based on what I’ve experienced with my own clinical staff, who prep for and complete off-site visits in a series of stages. Why dive deeper? Because exploring potential safety concerns before they arise can help you identify opportunities to make constructive changes that empower professionals and support client success.
During my behavioral health agency’s last safety survey, for example, our community-based staff expressed the need to be able to request help immediately if they needed it during off-site visits. After considerable research and piloting, our safety committee recommended a personal safety device for outreach staff—and our senior leadership agreed that this was a vital investment in our organization and its people.
As you read through these tips, it might seem overwhelming to stay mindful of so many suggestions and focus on the purpose of the visit. I often tell my staff to think back to when they first learned a complex behavior like driving—initially, it demanded constant attention. Over time, you master the best practices of driving, and aren’t consciously thinking of each step. You can achieve that same level of mastery in other tasks with planning, practice, and purpose.
Make your pre-appointment contact thoughtfully—set the stage for a successful visit.
Do your homework, and plan for a team approach to any initial visits/intakes.
We usually recommend a team approach of two staff for any off-site initial visits or intakes. In addition to all the usual paperwork, the team members make sure that they’re aware of all safety considerations, including their client’s disposition, history, the meeting location, and any immediate concerns in the neighborhood.
The best predictor of future violence is past violence, so we have added a history of violence question to all intake processes. During assessments, we identify the events and stressors that have contributed to past violence. These Precipitating Factors
can help staff identify patterns of behavior (that may or may not be part of the client’s awareness)—this helps staff to be fully engaged in the moment while still being vigilant.
Set clear expectations and identify any mandated reporting requirements in advance.
Before any off-site visit, make sure you have discussed mandated reporting requirements and visit expectations in advance. As I advise my staff, filing a report of abuse or neglect with a state agency should not be the first time a client learns that you are a mandated reporter. Also, take time to discuss separate policies regarding weapons or intoxication.
Establish an agenda and prepare to follow it during the appointment.
A pre-determined agenda provides focus, lessens professional anxieties, and demonstrates that you take your client seriously enough to thoughtfully prepare to meet with them. Of course you need to be flexible about addressing acute concerns, but an agenda establishes a helpful framework for the off-site visit.
Consciously choose what you reveal about yourself.
Don’t give out personal information to clients. Thoughtfully choose what sort of bumper stickers or other potential identifiers you put on your vehicle or belongings.
Ask ahead about pets.
When you’re pre-planning a home visit, it’s a good idea to ask if there are pets and then determine what steps should be taken regarding your health and safety. Do you have allergies? Is the pet friendly? Can the pet be secured?
Prep for your trip to and from the appointment site strategically and thoroughly.
Keep in touch through established call-in procedures.
Set up a call-in procedure with your office if one is not already in place. Make sure people know where you’re going and how long you’ll be there.
At my agency, we have a few different call-in systems in place for off-site appointments. There’s a calendar system that lets supervisors know exactly where staff are throughout the day. And some programs require a staff member to contact their supervisor at the end of the day to let them know they’ve completed their work safely—if the supervisor doesn’t get the call, they follow up immediately with an identified emergency contact. We also offer the option for staff to request a teammate go with them or move the call-in from end of day to a pre-arranged time close to the appointment.
Dress professionally and functionally.
Make sure that your work attire affords you ease of movement.
Make sure your vehicle is ready.
Do you have enough gas? Tires inflated? Engine running reliably? You don’t want to be stranded at any point during your journey.
Check your vehicle before you enter it.
Always make sure you’re the only person gaining entry—investigate your vehicle from outside before you get in, even during the day time.
Keep all valuables out of sight.
Valuables can identify you, your family, where you live, and other important aspects of your personal privacy. Secure items that might get lost, go missing, or could potentially be used as weapons. If you need to stow valuables in your trunk, do it before
you travel to the appointment so that you’re not advertising what you do not want somebody else to target.
Plan what you’ll carry—and make sure you’re toting as little as possible.
In an emergency, you may have to leave a location quickly, and you may end up leaving belongings behind—so let this expectation inform what you choose to bring to an appointment. To ensure that keys, phones, or personal safety devices are never left behind, carry them on your person at all times.
Know exactly where you’re going—and scout your route if you’ve never been there before.
If you haven’t been to the appointment location before, take time to drive around the area before the appointment. This helps you learn alternative routes, identify areas of possible risk, and boosts your confidence that you’ll know how to maneuver through the area in the event you need to leave for safety reasons.
Put safety first when traveling to the appointment.
Again, know where you’re going.
Have you researched and mapped your route? Are you familiar with entrances, exits, and the neighborhood in which you’ll be conducting your appointment?
Stay safe inside your vehicle.
Make sure your doors are locked and your seat belt is on—minimize distractions from within the car.
Stay safe on the road.
Keep at least a car length between you and the car in front of you whenever you stop—a safe following distance gives you space to maneuver if you find yourself in danger.
Park in a well-lit, visible area.
Backing in allows you to pull out quickly. Before you park in a driveway, make sure somebody can’t pull in behind you.
Arrive safely by taking in your surroundings and looking for potential risks.
When you arrive at the appointment site, look to see if you notice any groups or individuals in the immediate and surrounding areas.
Are these people friendly? Could their presence impact your visit?
Note the layout of the location and any potential risk factors.
Look for anything that might compromise safety—such as weapons or drug paraphernalia. Try to keep a clear path to the door and be aware of all possible exits. You may have to leave differently from how you entered.
Be aware of the signs of intoxication.
If somebody appears to be impaired by drugs and alcohol, LEAVE. You can always reschedule. How much work can you really do when an individual is in an altered state?
Establish the duration of the appointment as soon as you arrive.
Make it clear that you have a schedule to keep and that you are expected elsewhere later. This establishes expectations and boundaries up front in case you need to leave for any reason.
Be aware of other individuals who are present when the appointment takes place.
Particularly when it comes to home visits, be mindful of other people who may be on the premises for confidentiality and safety reasons.
Listen to your internal warning signals.
Trust your instincts—and leave if you don’t feel safe.
If something goes wrong—stay calm and trust your training.
If something goes awry during an off-site visit, and all other safe and effective interventions have been tried—we expect staff to call for assistance.
If you need to leave, make sure you take your keys and have a way to call for help.
We tell staff that “workspace” can include anyplace that you are with a client, such as a home, car, or in transport. If you must leave your car due to safety concerns, take the keys with you. Call for help by dialing 911 or using your personal safety device.
In my state, 911 does not connect to the most local police department, so at my agency, we recommend utilizing a personal safety device that is always answered by an operator who can immediately patch in first responders or a supervisor.
If you’re on foot late at night, in a poorly lit area, or feel unsafe for any reason, get somebody on the line either by phone or on your personal safety device and have them talk with you while you’re walking to your destination. And remember to check your car again before entering it!
After the appointment, remain safe by thoughtfully guarding your privacy.
Be mindful of your social media presence.
You decide and control what people know about you—monitor your privacy settings on social media platforms like Facebook, Instagram, and Twitter. Avoid sharing things that could reveal information about you, your family, or where you live, for example. You can’t control how somebody else might use this information if you do reveal it.
Community work can be impactful and rewarding, so set yourself up for success.
These tips aren’t meant to be exhaustive or inclusive, but they do identify the key stages to successfully preparing for and completing an off-site appointment. Community work can be very valuable, impactful, and rewarding. Preparation helps make it so.
Safety in the community starts well before you leave for your appointment. I mentioned safety surveys earlier; a prior survey helped our agency conclude that Nonviolent Crisis Intervention®
training would help staff work more constructively and safely with challenging clients. CPI training covers a range of behaviors and offers both personal safety and processing components. But even more importantly, it starts with redirection—think of tools like the Crisis Development Model℠
, or the Decision-Making Matrix
—that progress in a way that keeps both physical and psychological safety at the forefront. Like personal safety devices, this training was supported by our senior leadership and board of directors.
When it comes to safety during off-site visits, we expect staff to utilize their CPI training
, their wits, and any equipment that they have at their disposal. In addition to staying up to date and confident in your crisis prevention training, a bit of strategic planning can help you set the stage for an optimal outcome, and act with confidence and skill if things go wrong. I encourage every professional to approach off-site visits with a positive frame of mind, ample preparation, and confidence in their training and skills.
ABOUT THE AUTHOR
T. D. Loftus is a Senior Level CPI Certified Instructor. With a Master of Science degree from Northeastern University in Counseling Psychology and a BA in Psychology from Boston College, he’s a Licensed Mental Health Counselor (LMHC) in the Commonwealth of Massachusetts and a compliance officer in a community mental health agency. T.D. is also a Reiki Master Level II and a Kettlebell Instructor through the International Kettlebell and Fitness Federation (IKFF).