Crisis Planning

It is understandable if you do not want to think about becoming unwell again.

You may want to move on.

You may feel superstitious, as though writing a plan makes relapse more likely.

You may feel angry that you even have to think about this.

You may feel sad that this is part of your life now.

All of that makes sense.

But planning for crisis does not mean crisis will happen.

People have fire alarms without expecting their house to burn down.

People wear seatbelts without expecting a crash.

People write emergency contacts without assuming an emergency will happen.

A crisis plan is similar.

It is not fear.

It is preparation.

And preparation can sometimes make life feel safer.

Your crisis plan can be simple.

It can be a page in a notebook, a note on your phone, a printable worksheet, a document shared with someone you trust, or something you create with a professional.

You might include:

• my name and basic information

• my diagnoses, if relevant

• my medication

• allergies or medical conditions

• my GP

• my psychiatrist or care coordinator

• my crisis team or local urgent support number

• my emergency contacts

• my early warning signs

• my red flags

• what helps me calm down

• what makes things worse

• what I may say or believe when unwell

• how I prefer people to speak to me

• what practical responsibilities need covering

• what I want to happen if I am unsafe

• what I want people to know if I cannot explain myself

It does not need to be dramatic.

It just needs to be useful.

Your crisis plan should connect with your warning signs.

You might divide them into stages:

Green: I am mostly well

What helps me stay well?

This might include sleep, medication, meals, routine, connection, creativity, quiet, movement, therapy, appointments, or avoiding substances that make things worse.

Amber: I may be starting to struggle

What changes should I take seriously?

This might include sleep changes, racing thoughts, withdrawing, feeling watched, feeling unusually powerful or chosen, seeing special meaning in things, spending more, using more substances, missing medication, becoming very low, or feeling unable to cope.

Red: I need urgent support

What means this is no longer safe to manage alone?

This might include feeling unsafe, wanting to harm yourself, not wanting to be alive, not sleeping for a long time, losing touch with reality, hearing or seeing things others do not, feeling extremely paranoid, or being unable to care for yourself.

The aim is not to panic at every mood change.

The aim is to recognise when something is becoming a pattern, and to act earlier.

In a crisis, searching for numbers can feel impossible.

Write them down somewhere easy to find.

You might include:

• GP surgery

• community mental health team

• care coordinator

• psychiatrist

• therapist

• crisis team

• NHS 111

• trusted family member

• trusted friend

• neighbour

• Samaritans

• Shout text service

• emergency services

In England, NHS 111 can provide 24/7 access to mental health crisis support; NHS guidance says to call 111 and select the mental health option if you need urgent mental health help but it is not an emergency. Samaritans can be called free any time on 116 123, and Shout offers free 24/7 text support in the UK by texting SHOUT to 85258.

If there is immediate danger, call 999 or go to A&E.

You do not have to wait until you are at absolute breaking point to ask for help.

A crisis plan can include the people you trust to be contacted if things become difficult.

These might be people who:

• stay calm

• do not shame you

• respect your boundaries

• understand your warning signs

• can help you contact services

• can sit with you if you are unsafe

• can help with practical responsibilities

• can speak to professionals if needed

• know how to support you without taking over completely

You may want to write down:

• who should be contacted first

• who should not be contacted

• what each person can help with

• whether they have a spare key

• whether they know your care team

• whether they know your preferences

• whether they can help with pets, children, work, or home responsibilities

Not everyone who loves you is the right person in a crisis.

That is okay.

Choose people who are safe, steady, and helpful.

This part can be very practical.

When you are in crisis, what helps you feel even slightly safer?

It might be:

• calm voices

• simple sentences

• dimmer lights

• less noise

• being offered water

• being reminded where you are

• being given space

• not being left alone

• having someone sit nearby

• being helped to call a professional

• being spoken to like an adult

• being reminded to take medication as prescribed

• being taken somewhere quieter

• having sensory items nearby

• having pets cared for

• having social media paused

• being helped to sleep or rest

• having one person speak at a time

You might write:

When I am distressed, it helps when people speak slowly, use my name, keep things simple, and remind me that I am safe.

Or:

If I am paranoid, please do not argue with every belief. Stay calm, focus on safety, and help me contact professional support.

Or:

If I am very low, please do not leave me alone if there is a risk I might harm myself.

These details matter.

They help people support you with more care and less panic.

This is just as important.

You might know from experience that certain things make crisis worse.

For example:

• being shouted at

• being mocked

• being touched without warning

• being crowded by too many people

• being told you are being dramatic

• being told to calm down

• having people argue aggressively with delusions

• having people panic

• being filmed or photographed

• being threatened

• being given too many choices

• being left alone when unsafe

• having your phone taken without explanation

• being spoken about instead of spoken to

• being treated like a problem rather than a person

You are allowed to write these things down.

Your dignity matters in crisis.

A plan can help remind other people that even when you are very unwell, you are still a person.

Crisis is not only emotional or medical.

Life still exists.

You may have responsibilities that need covering if you become unwell or need hospital care.

Your plan might include:

• pets

• children

• caring responsibilities

• work

• study

• rent or bills

• medication collection

• house keys

• plants

• appointments

• urgent emails

• who can access important documents

• who knows where essential things are

This might feel very practical, even boring.

But practical planning can reduce fear.

It can help you know that if you need urgent care, the rest of your life will not completely collapse.

Your crisis plan may include:

• current medication

• dose and timing

• medication you have reacted badly to before

• allergies

• physical health conditions

• pharmacy details

• diagnosis or working diagnosis

• names of professionals involved

• hospital or service you are under

• past admissions, if relevant

• what treatment has helped before

• what treatment has not helped before

This can be useful if you need to speak to urgent services, especially when you are distressed and may not be able to explain everything clearly.

You might also want to keep a photo of your medication list on your phone.

Some people choose to make an advance statement.

This is a way of writing down your wishes and preferences for treatment and support if you become unwell in the future. Mind includes advance statements as part of crisis planning and notes that they can help professionals, family, and friends understand what kind of support you would want.

An advance statement might include things like:

• who you want contacted

• who you do not want contacted

• where you would prefer to be treated

• what helps you feel safe

• what medication has helped or not helped before

• cultural, spiritual, religious, or identity-related needs

• food, communication, sensory, or accessibility needs

• responsibilities that need covering

• what you would like people to remember about you if you are very unwell

You may want to ask a professional, advocate, or mental health charity about how advance statements work where you live.

You do not need to do this all at once.

Even a simple written preference is a start.

This is important.

Some people have had frightening, traumatic, dismissive, racist, homophobic, transphobic, ableist, coercive, confusing, or dehumanising experiences with mental health services.

Some people have been restrained, ignored, misdiagnosed, overmedicated, discharged too early, or treated without enough dignity.

So being told “just contact services” can feel too simple.

If you do not fully trust services, your crisis plan can still matter.

It might include:

• a trusted person who can advocate for you

• what you want professionals to know

• what has harmed you before

• what helps you cooperate with care

• what makes you feel unsafe

• what language feels respectful

• what you need around identity, culture, gender, sexuality, disability, religion, or trauma

• how people can help you access support earlier, before things escalate

A crisis plan cannot guarantee perfect care.

But it can give your voice a better chance of being heard.

Especially at a time when speaking for yourself may be harder.

A crisis plan is only useful if the right people can find it.

You might:

• keep a copy on your phone

• print a copy

• give one to a trusted person

• share it with your care coordinator, therapist, GP, or psychiatrist

• keep a copy with medication

• save it somewhere obvious with emergency contacts

• update it after appointments

• review it when things change

You do not have to share it with everyone.

Choose people who will respect it.

You can also write a shorter version for emergencies and keep the more detailed version private.

A crisis plan is not a one-time document.

It can change as your life changes.

You may want to review it:

• after hospital discharge

• after a medication change

• after moving house

• after changing services

• after a relapse

• after a new diagnosis

• after a difficult period

• when you notice new warning signs

• when a trusted person changes

• when your work, study, pets, children, or responsibilities change

You are allowed to update your plan.

You are allowed to learn.

You are allowed to say:

This is what I thought would help, but now I know something different.

That is not failure.

That is recovery knowledge.

If you have close friends, family, partners, or chosen family involved in your care, they may also need guidance.

They may not know what to do if you become unwell.

They may panic.

They may argue.

They may freeze.

They may minimise it.

They may overreact.

A crisis plan can help them too.

You might tell them:

• what early signs to look for

• what language helps

• who to call

• when to seek urgent help

• what not to do

• how to support you without taking over

• how to look after themselves too

Loved ones are not professionals, and they should not have to carry everything alone.

A good crisis plan helps spread the responsibility.