Creating a Mental Health Crisis Plan

Preparing for a mental health emergency can make a world of difference when you’re facing a crisis.

The day after I had a mental health crisis, I found all the sharp objects removed from the house. I felt hungover, wrecked — and very much eager to never go through that again.

I didn’t go to an emergency room, but not because I shouldn’t have. It was because I didn’t know what to do.

The next day, I met with my therapist and my partner. My therapist listed numbers to call and resources I could use for next time. Next time? I almost panicked at the very idea.

But the truth is — like millions of people worldwide — I live with mental health conditions. And without a crisis plan, I wouldn’t feel as safe or confident that I would know what to do if there is a next time.

If you feel you’re having a mental health emergency, now isn’t the time to create a plan. If you need to speak with someone immediately, you can:

• Call the Suicide & Crisis Lifeline at 988
• Text “HOME” to the Crisis Text Line at 741741
• Check out Befrienders Worldwide or Suicide Stop, if you’re not in the United States and need to find your country’s crisis hotline

If you decide to call an emergency number like 911, ask the operator to send someone trained in mental health, like Crisis Intervention Training (CIT) officers.

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
  • 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 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.

  A note on calling 911

  It’s completely OK if you don’t feel safe or comfortable calling 911 or an emergency number for a mental health emergency. According to the Treatment Advocacy Center, people with untreated mental health conditions are 16 times more likely to be fatally harmed by law enforcement.

  Because of this, you may want to consider calling 911 only if there’s an immediate danger to you or someone else or if you know your county has a crisis intervention team.

  Depending on where you live, there may not be professionals trained in handling mental health concerns. But if you do call, be sure to tell the operator that it’s a mental health crisis, so officers can know to come with de-escalation in mind.