HOPESTAGE — MENTAL HEALTH CRISIS PLAN: PREPARATION WORKSHEET
Published 14 October 2026
Guide: https://www.hopestage.com/research/mental-health-crisis-plan

Use these original prompts to prepare a conversation with your care team.
This is not an official advance directive, a suicide safety plan or an
individual treatment plan. Agree clinical actions with a health professional.
You can leave questions unanswered until you discuss them.

If you are in immediate danger, might act on thoughts of harming yourself
or cannot stay safe, seek urgent local medical help or contact emergency
services. Do not wait to finish this worksheet or try every contact first.

Keep your completed copy privately. This download does not send your
answers to HopeStage or a care service. Avoid unnecessary sensitive details,
passwords or financial information.

My name / name I want people to use:
Version date:
Prepared with (if anyone):
Items agreed with my care team / date:
Items still to discuss:

1. WHAT I WANT PEOPLE TO UNDERSTAND
What matters to me about how I receive support:
How I prefer to communicate:
Language, interpreter or accessibility needs:

2. CHANGES I WANT TO DISCUSS WITH MY CLINICIAN
Changes I have noticed in my own experience:
Changes someone I trust has noticed (if I want to include them):
What I want someone to do if they notice these changes:
Clinical advice about when to contact the team / date confirmed:
Clinical advice about when urgent assessment is needed / date confirmed:

3. SUPPORT THAT HELPS ME
Ways of communicating or offering support that help:
Approaches I would like people to avoid, and why:
What I want to ask my care team about:
If suicidal distress is part of my experience, who can help me make a
specific suicide safety plan, and where is the current plan kept?

4. CONTACTS AND AGREED ROLES
Repeat this block for each person or service you choose to include.
Person / service:
How to contact them:
Hours / availability:
What help they have agreed to provide:
When and with whom the role was confirmed:
Information I agree can be shared with them:
Backup if unavailable:

Professional contact responsible for ongoing care:
Agreed local route if the service is closed or cannot be reached:
Where to seek urgent assessment (confirm locally):
Questions about available support if I do not have family or friends to help:

5. TREATMENT INFORMATION AND PREFERENCES
Where my current medication list and allergy information are held:
Prescribing clinician / service contact:
Relevant treatment experiences I want to discuss:
Care preferences and reasons they matter to me:
Questions or arrangements that still need clinical agreement:

Do not use this worksheet to decide a dose change, extra dose, stopping
or restarting medication. Ask the prescribing clinician for any instructions.

6. EVERYDAY RESPONSIBILITIES
Task that may need attention (dependants, pets, transport, work or other):
Person / service who has agreed to help:
What they have agreed to do and when:
Only the practical information they need:
Backup or unresolved question:

7. FORMAL DOCUMENTS TO DISCUSS LOCALLY
Do I want advice about recording future treatment decisions or appointing
a decision-maker under local law?
Local professional / advocate / legal adviser to ask:
Which document applies in my jurisdiction:
Requirements and limits still to confirm:
Where any completed formal document is held:
Who knows how to find the current signed version:

Naming someone above does not appoint a legal healthcare decision-maker.
This worksheet does not replace the required local forms or legal steps.

8. SHARING AND REVIEW
Where I keep my current copy:
Which people have agreed to hold a copy:
Where my care team stores it / which services can access it:
Information-sharing preferences and questions about confidentiality:
How an urgent service can find the plan:
Next review date agreed with the care team:
Changes that mean I should review it earlier:
How outdated copies will be replaced:
What worked / what needs changing after using the plan:

SMALL FIRST STEP
The next question I want to bring to my care team: