Creating a Mental Health Crisis Plan

A mental health crisis plan is a plan of action that’s made before a crisis occurs, so you and people in your support system know what to do when an emergency comes up.

Anyone can create a crisis plan by putting together a list of resources, information, and directions. This can make a big difference since decision making and logical thinking can go out the window when you’re under extreme stress.

The point of a crisis plan is to prepare for a mental health emergency.

You can create your crisis plan on your own, but you can also reach out to a mental health professional or any loved ones who might be involved in your support to help.

Your crisis plan can be for only you, or you can share it with your treatment team and loved ones. There are also legal documents you may find necessary for severe conditions.

Types of crisis plans:

Joint crisis plan

According to research in 2021, a joint crisis plan (JCP) is a “psychiatric advance statement that describes how to recognize early signs of crisis and how to manage crises.”

The three important things to include in a joint crisis plan are:

• crisis triggers — what might cause a crisis
• crisis manifestations — what your symptoms and behaviors are during a mental health crisis
• strategies to deal with the crisis

Psychiatric advance directives (PADs)

PADs are legal documents that allow someone to act on your behalf. Typically, you’ll write a PAD when you’re not in crisis, detailing everything you want for your treatment if you become unable to make these choices.

If you have a severe mental health condition or symptoms (like psychosis), you may want to create a PAD.

Want to learn more?

• The National Alliance on Mental Illness (NAMI) explains more details about PADs and has a webinar.
• The National Resource Center on Psychiatric Advance Directions has state-by-state information and links to forms.

Wellness recovery action plan

This plan helps you and your support team create a plan for your overall mental healthcare — in and out of crisis — and how to avoid future emergencies.

This plan may involve:

• a list of wellness tools
• a daily routine
• your stressors
• early warning signs of a crisis or your symptoms worsening
• a crisis plan
• a post-crisis plan

If you want a full outline, you can learn more here.

When drafting a crisis plan, you may want to take past emergencies into consideration. What happened? What support do you wish you had? What do you wish you knew then?

Your crisis plan — and whom you share it with — will be unique to you and your condition.

I’ve learned from my past crises that:

• I need to have numbers programmed in my phone at my fingertips
• my partner needs to know the plan
• if I show any signs of serious self-harm, a trip to the emergency room can provide immediate help

To create your crisis plan, we broke it into two pieces: medical information and the actual plan during a crisis.

Medical information

While you may not need this information in a crisis, having this information can help anyone (like an ER doctor) who isn’t familiar with your health history.

Consider the outline below:

• Basic medical information
  • emergency contacts
  • names of your primary care doctor and mental health pros like a therapist and psychiatrist
  • anything else that might be helpful, like insurance information
• Medical history
  • any allergies or reactions to medications
  • any history of severe side effects to psychiatric medications
  • past conditions, illnesses, or medical procedures
  • past psychiatric hospitalizations
• Current medical information
  • current diagnoses
  • current medications including the date prescribed, your prescriber, and the dosage
  • to prevent interactions, anything else you’re taking (supplements or recreational drugs)

Crisis plan

For your crisis plan, consider including:

• emergency resources (hotline numbers, your local mental health department or psychiatric care center, etc.)
• steps to follow if you need to seek help from professionals
• behaviors that mean you’ll go to a hospital
• behaviors that mean you’ll call 911

When creating your crisis plan, you don’t need to do it alone. A mental health professional may be able to help you find the best emergency resource numbers and figure out which behaviors to add to your list.

Pro tip:

For my emergency resource, I put the main number as *Crisis*, so it’s the first contact in my phone book.

Be sure to have a few copies of your plan (and share them with your support team!), and update the medical information whenever your meds change.

The National Alliance on Mental Illness provides helpful printouts in their resource guide — Navigating a Mental Health Crisis — that can be added to a mental health crisis plan.

Mental health crisis warning signs

While your crisis and symptoms will vary, here are some common behaviors and symptoms that could indicate a crisis:

• rapid, sudden, and intense changes in mood
• an inability to function in most daily tasks
• signs of psychosis such as hallucinations or delusions
• paranoia
• an increase in agitation, anger, or any violence
• increased use of alcohol or drugs
• suicidal ideation such as thoughts or feelings about suicide
• signs of self-injury

Crisis resources

Having a local resource for your crisis plan is helpful, but there are also several national resources for support:

• National Suicide Prevention Lifeline
• Crisis Text Line
• Trans Lifeline
• The Trevor Project
• Veterans Crisis Line

If you’re outside the United States, you can find a crisis hotline through Befrienders Worldwide or Suicide Stop: International Help Center.

Crisis plans are there as an act of prevention — it’s a lot easier to have information and directions written out before you need it, rather than relying on reacting at the moment.

I like to think about it like any other type of emergency preparedness plan. People have emergency packs for earthquakes, fires, and tornados so they don’t have to rush around, can act fast, and be safe as soon as possible.

Your mental health emergency deserves the same kind of prep. You deserve safety and peace of mind.

Crisis plans can also be helpful for:

• reducing forced or involuntary hospital admissions
• preparing your loved ones and support team to know how to best help you
• learning what works and what doesn’t
• making recovery more streamlined
• comfort in the knowledge that you’ll be ready in a mental health emergency

I wish I’d been given the resources to create a crisis plan before I knew what a crisis looked like.

A mental health crisis plan is my safety net. It’s the difference between an unknown, out-of-control situation and knowing that I’ve done what I can to prevent worse outcomes and get to safety.

You can’t always control or prevent a crisis entirely — mental health emergencies can occur even when you’re following your treatment plans and doing your best. But you can still be prepared.

With the right tools, we can seek help sooner and take care of ourselves now for moments when we may not be able to. Remember, you’re not alone. You deserve support.

If you’re not in a crisis but don’t currently have a mental health team, Psych Central has some resources that can get you started:

• What to do if you can’t afford therapy
• 10 tips to find the right therapist
• The best online therapy programs
• The best free online therapy and support services
• The best online psychiatry services