The following article outlines the Safety First Model for working with high-risk young people in crisis. This hierarchical model prioritises emotional and physical safety by using multi-systemic and family-based interventions. A typical case example is used to illustrate the model and the structures and strategies employed at each level. The intervention model empowers families, facilitates their connections with other providers, and minimises the need for hospital admissions. The model also promotes collaborative and systemic practice in a child and adolescent mental health service.