Preparing for a Crisis
Relapse and rehospitalization are, unfortunately, common in serious mental illnesses such as bipolar disorder and schizophrenia, especially among patients who don’t recognize they are ill (a condition known as anosognosia).
When a loved one is in an active psychiatric crisis, it can be hard to think clearly and quickly. Always having emergency contacts, personal data, prescription information and legal paperwork collected in a single source, at your fingertips, will make it faster and easier for you to respond effectively if a crisis develops. If your loved one is in a crisis, your goal in an emergency is to stabilize the situation and get the person to professional help as quickly as possible.
Make a list of items you may need for an emergency; what are the crisis essentials? Things like:
- The person’s name, age, physical description
- The person’s current location/living situation
- Whether the person has access to a weapon
- Mental health history, diagnosis(es)
- Psychiatrist, therapists, primary care physician
- Medications, current/discontinued
- Suicide attempts, current threats
- Prior violence, current threats
- Drug use
- Contributing factors (i.e. current stressors)
- What has helped in the past
- Clothing, material items, etc. that may help de-escalate
- Any delusions, hallucinations, loss of touch with reality, other common symptoms
You can include all these things in a Crisis Plan. Here are a few that may be helpful. Choose one that works best for you:
- Mental Health Recovery Crisis Plan (WRAP)
- Crisis Plan by the State of Maine
- Mental Health America Crisis Plan
Whether you keep your kit in a paper or digital file – or maybe both – be sure to review and update the information regularly (e.g., after a change in providers, diagnosis, prescriptions, address). Give a copy to anyone who might have to act if you are unavailable (e.g., other adult children, your siblings). Keep the information near you at all times (e.g., scanned onto your mobile devices, stored on a flash drive in the glove compartment of your car, organized in a file in your desk at the office).
It can also be helpful to enlist a stable and reliable third party in advance who is willing to back you up in an emergency by joining you on the scene, staying home with your children or providing other support you need in order to focus on getting help for your loved one.
Other Ways to Prepare
- Knowing the laws in your state;
- Knowing the procedures at the local emergency room or other facility where your loved one is likely to be taken by police or paramedics in an emergency and providing them with any forms or information that can be kept on file (e.g., an advance directive, a signed release for medical information);
- Identifying diversion options where your loved one lives (e.g., a hospital “safe room” where individuals in crisis can voluntarily shelter, a sub-acute group home that takes voluntary admissions, the local police department’s mobile crisis team); and
- Networking with other families through the local affiliate of the National Alliance on Mental Illness (NAMI).
If you are worried about a loved one, but there appears to be no immediate danger, alerting the person’s psychiatrist, caseworker, ACT team or other mental health professional can lead to help before crisis occurs and emergency intervention becomes necessary.
Learn more about Navigating a Mental Health Crisis.
Mental Health Advanced Directive
A mental health advance directive is a legal written document that describes what you want to happen if your mental health problems become so severe that you need help from others. This might be when your judgment is impaired and/or you are unable to communicate effectively.
It can inform others about what treatment you want or don’t want, and it can identify a person to whom you have given the authority to make decisions on your behalf.
For more information, please read the advance directives information for consumers pamphlet.
Where can I get a form?
Download and complete a mental health advance directive form. Your mental health provider may also have copies of the form.
Who should get my completed form?
If you name an agent to represent you, you must give them a copy. You may also want to give copies to your current mental health care providers, your lawyer, or trusted family members.
Read more about the WA laws surrounding Advanced Directives. RCW 71.32.
Guardianship and Power of Attorney may be other ways to help prepare for a crisis. Learn more on our Guardianship page.