Creating a Crisis Plan

When do you use a crisis plan?

First, let’s define for ourselves what a ‘crisis’ means. I think the definition differs per individual, and each individual must find out what they consider to be a crisis. But for myself, a crisis begins after attempting my coping strategies on my own. It occurs when I find that despite my best efforts, I cannot control my own thoughts, actions, and/or behaviours to a level where I can positively and healthily cope with my current challenging situation. The degree of severity of a crisis will definitely vary, but the beauty of the crisis plan that I will help you complete is that it is a procedure that goes step by step until you feel you are no longer in crisis.

So take a moment to think on your own – what does a crisis mean for you? When is a specific time you were in crisis?

Why a crisis plan?

A social worker presented a worksheet to me and was working with me through my crisis plan, when I asked her, “I understand what a crisis is for me, but why exactly does this work?”. She simply told me, “You use a crisis plan to help control your behaviours when your thoughts are no longer in your control.” One of the most important lessons I learned from my first hospitalization was that when your mind converts to a state of despair and confusion, it will not find even the simplest of processing abilities to be possible. Therefore, in these times of crisis, it becomes of utmost importance to have an automated procedure ingrained into our heads – or at least in an accessible area in case we need it.

Your crisis plan outline: get out a piece of paper and a writing utensil! (Or, print out the template that I prepared and follow along. You can get it for free when you subscribe below!)

Let’s get started!

The first thing I recommend you do is to write the following on the top of the paper in bold letters:

NOTE: If you are currently in a severe crisis, you may need to skip straight to #4 or #5 for your safety.

1. Take any medications prescribed to you “as needed”.

I recommend that you write down your “as needed” medications in this section, including your prescribed dosages of each medication and perhaps in what situations you take them. “As needed” medications are those that you take when symptoms of your mental illness arrive (if they exist), including but not limited to medications you are prescribed to take when you are experiencing a panic or anxiety attack, or are notified by someone that you are exhibiting signs of escalation to mania.

    2. Talk to someone

Here, you will be writing down the names and telephone numbers/method of contact of 5 people who you can talk to about anything – but when you talk to them, you must avoid the topic of how you are currently feeling. This may be a friend you want to catch up with but are not very close to, or perhaps your best friend (as long as you are able to resist talking about how you are feeling). Talk to them for at least 10 minutes about anything but how you are feeling.

    3. Go to a place with people

Here, you will be removing yourself from isolation, and moving to a place with other people. This can be moving yourself downstairs to the vicinity of a family member, or going outside to the supermarket, or going out to a cafe or restaurant, or to a populated park. Any place with people. And your goal is still not to talk about your feelings with anyone – it is simply to remove yourself from your current physical environment and trying to process your thoughts and emotions in a safe area. Write down 3 different options for places to go (any more and you run the risk of deliberating too much about where you should go between your options).

   4. Talk to a mental health support

What is a mental health support? He or she is a person who is available and able to keep calm while actively listening to you (this means being able to tell how you are feeling from non-verbal cues and fully paying attention to you), and who is able to take you to the emergency department if needed. This is likely a close friend, a family member, or perhaps a trusted faculty member if you are in university. Write down 5 such people and their telephone numbers. If possible, it would be beneficial to meet in person to talk (i.e., if they can meet you where your safe space is).

You should now reach out to one of these people about how you are really feeling – trust that they can help you to feel better by listening to you and offering compassion. Trust that they will know if you are feeling so severely distressed that you may need to visit the emergency department, and that they will be right by your side when you go.

   5. Go to the emergency department

If all else fails, go to the emergency department. I can tell you from personal experience that the ER is not a frightening place. Every single human being working in a hospital studied their entire life to help those who are mentally and/or physically ill, and they will help you. If this step is too much for you right now, please call 1-800-273-8255 (National Suicide Prevention Lifeline) if you reside in the U.S., and 1-866-797-0000 (Telehealth Ontario) if you reside in Ontario, Canada.

Tips

I have now guided you through creating your own crisis plan, and I would now like to offer some tips when you are creating your own plan.

1. Keep it short and to the point. Again, when you are in crisis, you need to go into automated mode to keep yourself safe. The best way to do this is to have your plan in an accessible place, and keep the prompted procedure incredibly simple to read, with a brief writing style. Avoid writing long explanations of what to do at each step, because from personal experience I can say that oftentimes, certain normally innocuous phrases can actually be skewed negatively in interpretation in our minds when our minds are at their worst.
2. Keep multiple copies of your crisis plan around places you frequent around your home. A nice idea is to make a mini version of your crisis plan and put it in your wallet or somewhere you know you can find it easily when you are on the go. Or, keep it in your phone as a note!

I hope that this post will help you on your journey through life.

Always remember to BKTY (be kind to yourself),

Nicole (nicomochi)