How to make a mental health crisis plan

What is a mental health crisis plan?

A crisis plan brings your experience and agreed support into a document that can be used when your mental health deteriorates. It may sit within a wider care plan. A joint crisis plan is developed together with professionals and, if you want, people who support you. NICE recommends joint planning that includes warning signs, coping support, practical needs and contacts for care.

You do not need to have every answer before beginning. Mental Health America encourages thinking ahead while you feel well enough to plan. You might start after discussing a recent difficult period, during a routine appointment or when moving to a new service.

These documents can inform one another, but are not interchangeable. NICE's self-harm guidance describes collaborative safety planning that includes warning signs, coping, support contacts and a safer environment. If suicidal distress is part of your experience, ask a health professional to help you develop that specific plan. The general worksheet below is not a substitute.

For care immediately after leaving hospital, use our separate psychiatric discharge follow-up guide. This article focuses on preparing a plan you can return to before and during future difficulties.

Write your mental health crisis plan in six parts

Use plain language that sounds like you. You can write, dictate or ask someone to help take notes. Leave unanswered questions for your care team rather than inventing a response. The prompts below are HopeStage preparation questions, not a clinical assessment.

1. Describe changes that matter for you

   Look back at your own experience: what did you notice first, and what did someone else notice? Record specific changes rather than a label such as “doing badly”. For example: “I stop replying to messages I usually answer” or “My daily routine changes in a way that worries me.” These examples are writing prompts, not diagnostic signs.

   If you live with bipolarity or depression, ask your clinician which patterns deserve early contact and which need urgent assessment. Your plan can distinguish what you want someone to notice from what you have agreed they should do.

2. Name support that helps, and approaches that do not

   Think about a difficult conversation that went better than expected. Was it helpful to have one person speak, receive written information, take a break or sit somewhere quieter? Record preferences in concrete terms. Mind suggests considering what has helped before, what has not, and what you would want during a crisis.

   An example: “Please explain what will happen next, then give me time to respond.” You can also note situations that make communication harder without having to describe every past experience.

3. Agree who can do what

   A list of names is more useful when each role is clear. Ask a trusted person whether they could help you contact the clinic, attend an appointment or check a practical task. Confirm their availability and the best way to reach them. Mental Health America's planning resource separates personal support from professional contacts.

   Do not assume that a friend can be available overnight or that a relative wants a particular role. If support is limited, tell your care team directly and ask for a plan that does not depend on family or friends being present.

4. Confirm professional contacts and an urgent backup

   Record the service, contact method, opening hours and who to ask for. Ask the team: “What should I do if this number is unanswered, if the clinic is closed, or if I need an urgent assessment?” Write the agreed route in the plan. A routine email or appointment portal may not be monitored for urgent messages.

   Ask which changes should prompt contact that day and when to seek emergency help. You do not need to wait for a friend to reply before using an urgent care route. If you are still waiting for a specialist, our guide to finding care when psychiatrist appointments are unavailable offers other starting points.

5. Keep treatment information accurate

   Note where your current medication list, allergies, relevant treatment history and prescribing contact can be found. Ask the clinician which information belongs in the short plan and which should remain in the medical record. If your plan refers to clinical instructions, have the responsible professional confirm them.

   NIMH advises working with a health professional before stopping prescribed medication. Do not use a general worksheet to decide dose changes, extra doses or a restart. For a supply gap, see our psychiatric medication refill guide.

6. Plan for everyday responsibilities

   Ask what would need attention if you needed an assessment or time away from home. This could include children or other dependants, pets, transport or contacting work. NICE includes these practical and social needs in crisis planning.

   Agree the task with the person involved and note only the access information they need. A planning sheet is not a secure place for passwords or unnecessary financial details. Leave a backup question for your team if a task has no agreed helper.

You can bring this to a regular appointment or use our first psychiatrist appointment worksheet to prepare wider questions.

Record your care preferences, then check their legal status

What would you want a team meeting you for the first time to understand? You might want an interpreter, a particular person involved, an explanation before decisions, or a record of previous treatment experiences. Write the request and the reason it matters. Ask the team what it can arrange and what it cannot promise.

An informal plan does not automatically authorise someone else to make healthcare decisions. NAMI describes psychiatric advance directives as legal documents for future treatment instructions or appointing someone to act when a person cannot make decisions. The available documents, formalities and limits depend on the jurisdiction.

Bring these questions to a clinician, patient advocate or local legal adviser: Which document fits my wishes? Does it need a particular form, witness or other step? When does it apply? How can I change it? What happens under compulsory treatment rules? Keep any completed formal document alongside the plan, with clear information about where the signed version is held.

Crisis planning and advance care preferences, by country

Start with your own care team and the resources below. These are starting points, not a complete account of local law. Tell the team whether you want practical support planning, a formal record of treatment wishes, or both.

Go to: United States · United Kingdom · Australia · Canada · New Zealand.

United States: ask about a psychiatric advance directive

SAMHSA's practical guide to psychiatric advance directives is a starting point for discussing future treatment preferences. Ask your clinician or a patient advocate which current state rules and forms apply. Confirm any witnessing requirements, how an appointed decision-maker's authority works and how services will find the document.

Keep a practical contact plan as well. Ask the service which local urgent route applies to you and whether the plan can be added to your record. Completing the HopeStage worksheet alone does not complete a legal psychiatric advance directive.

United Kingdom: check the guidance for your nation

England and Wales: Mind explains advance statements and advance decisions. An advance statement records wishes and preferences and is not legally binding; an advance decision to refuse treatment has a different legal role and requirements. Ask for help choosing the appropriate document and understanding its limits. Do not assume that writing a treatment preference prevents compulsory treatment.

Scotland: the Mental Welfare Commission provides guidance on advance statements, including witnessing by an eligible health or social care professional. A statement must be considered but does not guarantee every preference will be followed. Use the Scottish guidance rather than an England and Wales form.

For Northern Ireland, ask your local mental health team or patient advocacy service which current arrangements apply. Across the UK, confirm the practical out-of-hours contact route with the service caring for you.

Australia: use your state or territory's arrangements

Ask your mental health service about crisis plans and documents for recording future preferences in your state or territory. Terminology and legal requirements differ.

Victoria example: the Department of Health explains advance statements of preferences under the Mental Health and Wellbeing Act 2022. These record treatment, care and support preferences for compulsory assessment or treatment. There are signing, dating and witnessing requirements. Services must make reasonable efforts to give effect to preferences, but the Act allows them to be overridden in specified circumstances. Ask your team how to prepare, store and review one; do not apply Victoria's rules to the rest of Australia.

Canada: check provincial or territorial requirements

Ask your care team or patient relations office which local documents cover care preferences and substitute decision-making. Confirm the rules for your province or territory, including how the document is made available during an urgent assessment.

Ontario example: the province's mental capacity guidance explains planning ahead and substitute decision-making when someone cannot make a healthcare decision. Ask who would be consulted in your circumstances and how any formal appointment should be recorded. A person's name in your emergency contacts list does not, by itself, appoint them as your legal decision-maker.

New Zealand: distinguish a directive from appointing someone

The Health and Disability Commissioner explains advance directives and enduring powers of attorney. Its guidance recommends writing, signing and dating a directive and discussing it with a health professional. Appointing someone to make decisions requires a separate legal arrangement; naming them in a planning worksheet is not enough.

Ask how the document applies to your circumstances and how the team can access it. HDC explains that an advance directive is not always followed and that compulsory mental health treatment rules can override it. Get help understanding those limits before relying on a document for a particular treatment decision.

Elsewhere: ask your local mental health service, health ministry or recognised patient rights organisation about crisis planning and future treatment preferences. Confirm the relevant law and local service routes before using another country's form.

Make the plan easy to find, and keep it current

A plan is more useful when the people involved know it exists. NHS England's improvement guidance emphasises accessible, up-to-date joint crisis plans, including availability to primary care and out-of-hours services. Ask your team where yours will be stored and which services can actually see it.

Choose how to keep your own copy: a clearly named file, a paper copy or both. You might keep a short card that says where the fuller plan is held and gives the agreed clinical contact. Protect sensitive information if other people can access your phone or papers.

• Confirm each role: has the person agreed, and do they have the current contact details?
• Agree information sharing: which parts may be shared with whom? Ask the service to explain confidentiality and any exceptions.
• Try one practical question: if the clinic is closed, can you find the agreed route quickly?
• Date changes: after a move, treatment change or difficult period, review what still fits and replace outdated copies.

If you change services, ask how the plan will transfer. Our psychiatrist handover guide covers the wider transfer of care. If part of the plan did not work, that is information to discuss, not a personal failure.