Rethinking Safety Planning for Overlapping Risks

Fernanda Rossi didn’t set out to become an implementation scientist. She got there by building tools that worked well, then watching, with some frustration, as they sat unused.

Rossi is a licensed clinical psychologist and researcher whose work now sits at the intersection of clinical practice and implementation science. Her research began elsewhere, in intimate partner violence (IPV) within the divorce process, where she worked to improve how the legal system identified and responded to IPV. Clinical training at the VA Palo Alto Health Care System later shifted her focus toward veterans’ healthcare. In both settings, she built tools to meet IPV-related needs, an IPV assessment for legal professionals with embedded clinical decision support, and a similar tool to help VA primary care providers screen for IPV and determine next steps.

“You can develop the most perfect and effective tool, but that doesn’t mean people are going to use it,” Rossi said. That realization redirected her career toward implementation science, which she saw as a way to close the gap between building something good and getting it into practice.

Rossi’s research now centers on IPV, suicide, and drug overdose risk, three areas the field tends to treat as distinct problems. “These are not separate groups of people,” she said. “It is often that people have multiple of these issues conjointly, so we have to think about these issues together.”

One example is safety planning. A standard IPV safety plan, a suicide safety plan, and a substance use safety plan largely look the same, differing mainly in emphasis. Rossi has questioned why someone facing more than one of these risks, which is common, should need three separate plans instead of one built to protect them across all three.

Rossi has written about a similar problem in the context of dashboards, arguing that developers often fail to evaluate whether the tools they build are actually used the way they were intended. “It’s not guaranteed that something you develop is going to get used, and in the way that you want it to get used,” she said. Her recommendations draw on human-centered design and implementation science, pushing developers past simple metrics like click counts toward outcomes that better indicate whether a tool is truly working.

For Rossi, the C-DIAS Fellowship filled a gap that few other programs could. Implementation science is a field crowded with theories, models, and frameworks but light on accessible entry points, and the fellowship gave her a real foothold in it. It also connected her with a mentor network that has since helped her land implementation-science grants and get published in the field. “I don’t think I could have done this otherwise,” she said.

Her advice to others building their own tools is to start thinking about implementation and sustainability on day one. “You can put a lot of energy into developing something, but if you’re not thinking about where it’s going to get implemented and how it can be sustained, you may spend a lot of time and resources for nothing,” she said.

Looking ahead, Rossi hopes to see increased implementation of suicide safety planning within opioid treatment programs, a practice she has found is inconsistent. Suicide risk is common among people who use opioids, and she is hopeful future projects will make a real dent in closing that gap.

Clinical work remains central to her identity alongside research, offering something research often can’t, a visible, immediate change. “It’s a way, an opportunity for me to see change, positive change in others,” she said, adding that lessons from her patients feed directly back into her research.

Looking back at how her work has evolved, from divorce mediation to veterans’ health to implementation science, Rossi says the throughline has always been impact. Earlier in her career, she felt she was helping, but at a distance. Implementation science changed that. “I now have a path to be able to do that,” she said.

When she’s not working, Rossi stays active by playing tennis with her husband, hiking, dancing, and jogging. She also enjoys reading psychological thrillers in her downtime.