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Suicide is a significant public health issue in the United States, with notable trends and disparities. Between 2000 and 2018, the suicide rate increased by 35%, contributing to a decrease in life expectancy [1]. Creating a mental health crisis plan is essential for ensuring safety and effective response during a mental health emergency. Below is a step-by-step guide on how to create a crisis plan, along with the actions to take during a crisis:

1. Identify Warning Signs:

• Recognize Triggers and Symptoms: List the specific signs that indicate a mental health crisis may be developing. These could include changes in mood, behavior, or thoughts, such as increased anxiety, withdrawal from social situations, severe agitation, or suicidal thoughts.

• Physical Symptoms: Recognize any physical symptoms like changes in sleep, appetite, or energy levels.

2. Develop Coping Strategies:

• List Effective Coping Mechanisms: Write down strategies that have previously helped manage stress or distress, such as deep breathing exercises, listening to music, taking a walk, or practicing mindfulness.

• Create a Safe Space: Identify a place where you feel safe and can go to if you need to calm down.

3. Create a Support Network:

• Emergency Contacts: List the names and phone numbers of people you can contact in an emergency, such as close friends, family members, or a therapist.

• Crisis Support Services: Include the contact information for crisis hotlines, such as the National Suicide Prevention Lifeline (988) or the Crisis Text Line (text HOME to 741741).

4. Outline Steps to Take During a Crisis:

• Immediate Action: If feeling unsafe or experiencing thoughts of self-harm, the first step is to contact a trusted person or call a crisis hotline.

• Use Grounding Techniques: Engage in grounding techniques, such as focusing on your surroundings, naming objects in the room, or touching something comforting, to help reduce anxiety.

• Avoid Harmful Situations: Remove yourself from situations that could lead to harm, and avoid substances like drugs or alcohol.

5. Know When to Seek Professional Help:

• Emergency Services: If the situation escalates and you or someone else is in immediate danger, call 911 or go to the nearest emergency room.

• Reach Out to a Mental Health Professional: If you recognize the signs of a crisis but it is not an immediate emergency, contact your therapist, psychiatrist, or counselor for guidance.

6. Prepare an Emergency Bag:

• Pack Essentials: Include items that may be needed in case of a crisis, such as medications, a phone charger, comfort items (e.g., a favorite book or blanket), and a list of important contacts and information.

7. Document Your Plan:

• Write It Down: Keep a written copy of your crisis plan in a place that is easily accessible. Share it with your support network so they know how to help if needed.

• Update Regularly: Review and update the plan regularly, especially after any significant changes in your mental health or life circumstances.

8. After the Crisis:

• Debrief and Reflect: After a crisis, take time to reflect on what happened and what could be done differently in the future. Discuss with your therapist or support network to adjust the crisis plan if necessary.

• Self-Care: Engage in self-care activities to recover from the crisis, such as getting adequate rest, eating well, and spending time with loved ones.

Key Resources:

• National Suicide Prevention Lifeline: 988

• Crisis Text Line: Text HOME to 741741

• Local Emergency Services: 911

• Mental Health America (MHA) Crisis Planning Guide: MHA

• National Alliance on Mental Illness (NAMI): NAMI Helpline

This plan helps ensure you’re prepared to handle a mental health crisis and have the necessary support and actions in place to stay safe.

Reference:

1. The Recent Rise of Suicide Mortality in the United States.

   Martínez-Alés G, Jiang T, Keyes KM, Gradus JL.

   Annual Review of Public Health. 2022;43:99-116. doi:10.1146/annurev-publhealth-051920-123206.

Creating a Mental Crisis Plan, Avoiding Suicide