So you’ve probably heard of a crisis plan. You’re wondering what they are, what the need for them and for any extra information about them.
That’s what today’s topic is going to be. It’s a little more informative than some of my others but I believe it will be worthwhile knowledge.
So what are crisis plans?
A crisis plan (sometimes called a safety plan) is exactly what it says on the tin, it’s a plan for interventions during a mental health crisis. Whilst, no, we don’t want these crises to happen, they can and we’re better off being prepared for if they do.
Some information on them can be found here.
What types of crisis plans are there?
There are different ways you can organise a crisis plan such as:
Planning one for yourself
Planning one with family/friends
A joint crisis plan with a health professional
Each of these have slightly different uses, are made in a slightly different way and will be implemented for varying reasons. Next we will explore each of these in a little more detail.
Plan for yourself / with family and friends
So, the first two are pretty much the same and I’d highly advise talking with a family member/friend you could trust if you were to plan one so they’d be fully aware of what support you may need.
These can include anything such as:
Things you can do when you feel in crisis.
Things you can do to prevent a crisis.
People you can contact in a crisis.
Helplines you may call.
Safe alternatives to what you would do.
Details of any advance statements/decisions.
Early warning signs that you’re in a crisis state.
Resources and Support that you can look at and reach out for.
They’re something that you and the people who know about it can work on together and if you’re alone you have a list of support you can reach out to or things you can try to do instead.
A good template of one can be found here.
Joint crisis plan with a health care professional
Joint crisis plans are also known as JCP’s. These are kind of agreed statements between yourself and your health care professional who is involved in your treatment.
The statement will include some details like:
How you’d exhibit that you’re in a crisis state.
Safe coping mechanisms.
What support you would receive in a crisis to avoid having to go to hospital.
Where you’d like to be admitted if you had to go to hospital.
Any help you may need if you’d have to go to the hospital, such as childcare if you have children, support for family members you may be caring for, your pets etc.
Details of any advance statements and decisions.
Where to and how much they get family and carers involved.
Information about 24 hour services.
What is an advanced statement?
An advanced statement is a written or verbal statement that you can prepare before a crisis state if you were worried about losing capacity to make decisions about your care. (This to me sounds exactly like a JCP)
These are generally a statement of your general wishes and care preferences.
There isn’t a set template for them however it is worth checking up on what information the mental health code of practice says to include on them
These usually have information on them such as:
What happens when you become unwell.
What treatment you would prefer.
Who you’d prefer to be contacted in a crisis.
Any religious/spiritual views that you have.
Your food preferences/dietary requirements.
How you like to do things, ie; shower or bath.
Who will look after your family or pets.
Who will deal with your money and bills.
Health care professionals do need to know about these so you could tell your GP about it or your mental health team. Ensuring they have a copy can be very helpful.
You can update these as time goes on, good times to change them would be if your condition changes, if your treatment changes or if any big life changes happen
You can also cancel these at any time as long as you have the capacity to do so. You can do this verbally or in writing. There isn’t a process to follow.
An important thing to remember though is that these aren’t legally binding, this means that healthcare professionals aren’t legally required to follow them. However, they should follow your wishes where possible. If you’re worried about your money and bills in an event of this, it is worth talking to a solicitor about naming someone who will have the lasting power of attorney.
What is an advanced decision?
An advanced statement is a written or verbal statement that you can prepare before a crisis state if you were worried about losing the capacity to make decisions about your care. However, this differs to the statements because it is about your refusals of treatment.
An example of this is stating that you don’t want to be resuscitated if you were to develop certain medical conditions.
You can only make these if you have the mental capacity and if you’re over 18 years old. You also need to follow the procedures set out in the mental capacity act.
You need to make these with a health care professional, however, having it in writing would be the best option.
These can be changed as long as you have capacity just like the advance statements.
These are legally binding and so doctors will need to follow these. There are certain exceptions to if doctors need to follow these, however, such as:
If you’re asking for a certain type of treatment as this will fall under the advanced statement rather than decision.
If you cancelled your advanced decision.
If it is not made entirely clear what type of treatment you wish to refuse in it.
If you have named someone as an attorney under a lasting power of attorney and if you’ve given them any power to make the same decisions or refusals that you have in your advanced decision since you have made it.
If you have capacity in making decisions at the time that the treatment is offered.
If there’s any change of circumstances so it’s unclear if you would make the same decision now, such as improvements in treatments and medications.
Crisis cards are simply small cards that you can carry that will have the key details of how you’d like to be helped in a crisis situation. They’re easy to carry so you can show them to other people if you need to or to find and read yourself.
It might be helpful to tell family or friends what they are and where they are so they are easy to find in such a situation.
Why do we need them?
We need crisis plans in order to help us when we are nearing a crisis state and to try to prevent it from getting any further. However, if we are in the crisis state, it’s there to help pinpoint where to go, what to do and what support to get in the said situation.
Personally, after my last really bad relapse with the self-harm. My husband and I sat down and made our own crisis plan together.
My crisis plan
So yeah, like I previously stated. I made my own crisis plan with my husband.
This took us a while because we had no clue what to put on it. How to set it up or what good it would even be. So, we did a bit of research together and found the basics of what should be put on them and worked around that.
First off, we thought about what my support circle is. So, we started listing names of people and support that I could reach out for. The primary being him, then mental health care professionals and then support networks.
After that, we thought what could I do to help myself? One idea was distraction techniques. So we started listing off things that I could do to try and distract myself such as gaming, videos, reading etc. We even thought it would be helpful to list things to live for, so things that I love, things that I’m looking forward to and what not.
We considered what if I was adamant I needed to get out or needed to seriously vent? So as stupid as it sounds we listed on it that I would go out with him be it to the pub, or for a walk… or even just to the shop. We even added the most obvious thing on that list which was talking to my husband. It may be obvious but when you’re in crisis, it’s kind of not. (honestly, I’ve ignored him for HOURS when I’ve been in crisis)
However, the last thing we considered was what if the need was too much. What if I had to do it? Well, then we discussed safe alternatives to it. It would be the same action but with something far safer. Even stating that it should be done in the house preferably in order to ensure my safety.
The last bit was added because even the crisis team said if I was adamant I was going to do it, even though they don’t advocate it. I should do it safely. I should do it minorly. Which we both have taken it to heart because I know if I am going to do something there is sometimes absolutely no chance of stopping me.
Here is a photo of it below:
We will actually be revising this soon and probably add some new things to it.
Why did I make one?
Ideally, we needed it. I had been pretty bad with my self-harm and in a crisis state a lot where nothing and nobody could help me. My husband wanted some structure, some sort of safety plan in place in order to help me.
It came around after an attempt which I took pretty far and needed treatment in hospital for.
It’s pretty basic at the moment and there’s so much more that I could put on to this myself. To be honest, whilst I’ve been pretty calm lately, I might edit it because there’s so much more crisis me needs as options. I know the difference between ‘me’ me and crisis me. I expect a load of people do too. Crisis me feels like a completely different person and this why we’ve put this in place.
If you’re not aware of my story so far, go check out this post which is about my struggle and how I’ve ended up here.
Has it helped me?
I’d say it’s been useful. We have been doing other things alongside this which will be discussed in later posts.
Its nice having a structure. A plan in place in case things go wrong, in case my mind goes a little bit off of the rails. I like plans. (I guess you’ve probably figured that out by now) I like lists, I’m always making lists so this was kind of therapeutic to do in the first place. It’s also the most important list that I’ve ever made because it’s about my wellbeing.
At the time of making it I thought it would be a load of rubbish. However, we showed it to my CPN and he thought it was good and approved of the alternatives on it.
However, now? I’d say it’s a wonderful tool. I always turn to it and it gets kept in my ‘lovely’ journal. I say lovely because that’s generally where my negative thoughts get released. Where crisis/not coping me gets to let loose and scream the feelings out onto paper…
So has it helped? In short, kind of yeah. It’s a beneficial tool and worth looking in to and creating one for yourself. Even if you’re not struggling now, it’s worth doing it just in case because you never know what could happen. I broke and I thought everything was fine.
Just a heads up!
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