Crisis Planning: Preparing for Your Hardest Moments

Mental health crises can happen to anyone. A crisis is when you're in such acute distress that you're at risk of harming yourself or unable to function. While we hope you'll never need it, having a crisis plan prepared during stable times can quite literally save your life during your hardest moments. This isn't pessimism – it's compassionate preparation.

Understanding Mental Health Crisis

A mental health crisis might include thoughts of suicide or self-harm, severe panic attacks that feel unmanageable, experiencing psychosis (hallucinations, delusions, or extreme confusion), being overwhelmed by intense emotions to the point you can't function, or urges to harm yourself or others.

Crises often build over time, though they can also emerge suddenly. Warning signs might include increasingly dark or hopeless thoughts, withdrawal from people and activities, increased substance use, dramatic mood changes, talking about death or being a burden, giving away possessions, or feeling trapped with no way out.

If you're in immediate crisis right now, please reach out before continuing this article. Call 988 (Suicide and Crisis Lifeline in the US), text HOME to 741741 (Crisis Text Line), call emergency services, go to your nearest emergency room, or reach out to someone you trust. Your life matters, and help is available.

Why Create a Crisis Plan

During a crisis, your ability to think clearly, remember resources, and make decisions is significantly impaired. Having a plan created during a stable time provides a roadmap when you most need it.

A crisis plan reduces the time between recognizing you're in trouble and getting help. It provides concrete actions when everything feels overwhelming and abstract. It communicates your needs to others who might help. And it reminds your crisis self of reasons to stay safe and strategies that have helped before.

Creating Your Personal Crisis Plan

Your crisis plan should be personalized to you. While you can use templates, the most effective plans reflect your specific warning signs, triggers, helpful strategies, and resources.

Start by identifying your warning signs – the thoughts, feelings, and behaviors that indicate you're moving toward crisis. This might include things like 'thinking everyone would be better off without me,' 'stopped showering or eating,' 'feeling emotionally numb,' or 'withdrawing from all friends.' Be specific and honest.

Identify your triggers – situations or factors that increase crisis risk. This might include anniversaries of losses, specific stressful situations, relationship conflicts, substance use, or not taking medication. Understanding triggers helps you recognize when to increase support.

Include your reasons for living – things that matter to you and give you reasons to stay safe. This might include people you care about, pets who need you, goals you want to accomplish, experiences you want to have, or values you want to live by. During crisis, your brain will tell you none of these matter, but your stable self knows they do. Write them down clearly.

Coping Strategies That Help

List specific strategies that have helped you in the past or that you want to try during difficult times. Be concrete. Instead of 'relax,' write 'take ten deep breaths,' 'take a hot shower,' or 'wrap myself in a weighted blanket.'

Your list might include: calling a specific friend, using a grounding technique (like the 5-4-3-2-1 method), going for a walk, listening to a particular playlist, watching a comforting show, holding ice cubes, petting your dog, doing a puzzle, or reading affirmations you've written yourself.

Include both immediate coping strategies (things you can do right now when distress is high) and longer-term strategies (things that help over days and weeks, like scheduling a therapy appointment or reaching out to your doctor about medication).

Remember that what helps varies by person. Don't include things just because they're 'supposed' to help if they don't actually help you.

Your Support Network

Identify specific people you can reach out to during crisis, along with multiple ways to contact them. Include different people for different levels of need.

This might include: a close friend or family member who understands your mental health struggles (include their phone number and backup contacts), your therapist or psychiatrist with their emergency contact information, a crisis helpline number like 988, a trusted member of any support group you attend, or a spiritual leader if that's part of your support system.

For each person, note what they're good for. Some people are great listeners, others are good at practical help, some are available anytime, others only during certain hours. Knowing this helps you reach out effectively.

If you struggle to reach out during crisis, include permission statements in your plan: 'It's okay to call Sarah even if it's late,' 'People want to help me,' 'Reaching out isn't burdening others – it's letting them care for me.'

Professional and Emergency Resources

Your plan should include concrete crisis resources with specific contact information:

988 - Suicide and Crisis Lifeline (call or text) Crisis Text Line: Text HOME to 741741 Your therapist's name and phone number, including after-hours emergency contact Your psychiatrist's contact information Local emergency room address and phone number Local crisis stabilization center if available Your insurance information and policy number Current medications and dosages List of medications you're allergic to Any medical conditions responders should know about

Keep this information easily accessible – saved in your phone, written on a card in your wallet, and given to trusted people who might help you during crisis.

Making Your Environment Safer

Part of crisis planning involves reducing access to means of self-harm during vulnerable times. This is called means restriction, and research shows it's highly effective at preventing suicide.

Consider limiting access to medications by giving someone you trust control of medications during high-risk periods, keeping only a few days of pills accessible, or using a timed medication lock box. Store or remove weapons if you have access to them. Some people arrange for a trusted person to keep these things during difficult periods.

Identify someone who can help make your environment safer if you're in crisis. This might include removing certain items, staying with you, or helping you get to a safe location.

Creating a Safety Plan vs. Suicide Prevention Plan

A general safety plan helps with various mental health crises. A suicide prevention plan specifically addresses suicidal thoughts and urges. If you experience suicidal thoughts, create a specific plan addressing this.

A suicide prevention plan typically follows this structure:

1. Warning signs that a crisis is developing
2. Internal coping strategies (things you can do without contacting anyone)
3. Social contacts and settings that provide distraction
4. People you can ask for help
5. Professional contacts and services
6. Making the environment safe (means restriction)

The Stanley-Brown Safety Planning Intervention is an evidence-based template available free online that follows this structure.

Sharing Your Plan

Once you've created your plan, share it with key people in your support network. Give copies to your therapist, a trusted friend or family member, and anyone else who might be in a position to help during crisis.

Walk them through the plan. Explain your warning signs so they can recognize when you might need help. Let them know how you want them to respond. Some people want to be asked directly if they're safe, others find that question triggering and prefer different approaches.

Authorize them to take action if you're in danger. This might include calling emergency services, taking you to the hospital, or implementing parts of your safety plan on your behalf if you're too impaired to do so.

Updating Your Plan

Crisis plans aren't static. Review and update your plan regularly – perhaps every few months or after any crisis, hospitalization, or major life change.

Add new resources as you discover them. Remove strategies that don't actually help. Update contact information. Revise your reasons for living as your life evolves. The plan should grow with you.

Set a reminder to review your plan quarterly, or ask your therapist to review it with you periodically.

Using Your Plan During Crisis

When you notice warning signs, pull out your plan before you're in full crisis. Start implementing coping strategies early. Reach out to supports proactively. Use crisis resources before things become desperate.

If you're in crisis and looking at your plan, start with the first action items. Don't try to do everything at once. Pick one thing – maybe taking deep breaths or calling one person – and do that. Then the next thing.

Remember that following your plan is acting with courage and wisdom. It's not weakness or failure – it's you taking care of yourself in the hardest moment.

If Your Plan Isn't Enough

Sometimes, despite having a plan, the crisis is too severe. That's when you need emergency intervention. If you're in immediate danger of harming yourself, go to an emergency room or call 911. This isn't overreacting – it's appropriate and necessary.

Hospitalization isn't failure. It's intensive support when you need it most. Short-term hospital stays can stabilize crisis and connect you with resources for ongoing care.

After Crisis

Once you're through a crisis, take time to recover. Be gentle with yourself. Crisis is exhausting.

Debrief what happened. What warning signs did you notice? What helped? What didn't? Update your plan with this information. Consider what additional support you might need going forward.

If you haven't been working with a mental health professional, please reach out for ongoing support. Crisis indicates that you need more consistent help to address underlying issues.

You Deserve to Stay Safe

If you're struggling with recurring crises or thoughts of self-harm, please know that this pain can change. Treatment works. Life can feel different than it does right now. You deserve support, safety, and a future where you want to be here.

Creating a crisis plan is an act of self-compassion and hope. It's your stable self caring for your crisis self. It's saying, 'You matter enough to prepare for hard times.' Because you do matter, and you deserve to be here.