How to Create a Mental Health Crisis Plan: A Guide for Young People (Youth Generated Content)

Author: Stellan Knowles, YE4C Editorial Board Member

Warning: This blog post discusses mental health crises, including feelings of hopelessness, anger, and thoughts of self-harm. If you or someone you know is in need of support, please call, text, or chat with the 988 Lifeline (www.988lifeline.org/) or reach out to a trusted individual for support.

Why You Need a Mental Health Crisis Response Plan

Imagine some scenarios in which you might be struggling with your mental health:

	You’re in a school bathroom, anxiously biting your nails as you wait for a text reply from a crisis hotline counselor. You’ve reached out for help three times this week, yet you still are distressed by a growing sense of hopelessness.
	After many sleepless nights, you groggily open your instrument case in band class when you hear someone whispering your name. You don’t recognize the voice, and no one else is in the room yet. What’s going on?
	You usually love skateboarding with your friends on the weekend. Today, however, you snapped your skateboard in half over your knee as you screamed at your younger sibling. You’ve never felt so enraged.

Each scenario mentioned above could be examples of warning signs for an impending mental health crisis. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act, and helps determine how we handle stress, relate to others, and make choices.” 

The experience of a mental health crisis is deeply personal and subjective, so there isn’t a singular federal definition. What one person considers a crisis may not be perceived the same way by someone else. Although a mental health crisis can affect anyone at any time, there are often warning signs. Think of these signs like a traffic light: 

• Green is your baseline—it is the “good to fair” range. 
• Yellow is “fair to poor.” If you’re in this range, you might be aware of heightened anger or more stomachaches. 
• Red is “very poor to highly alarming.” It likely requires external support from behavioral health services.

If you are in distress, it might be challenging to find resources and information quickly. Creating a crisis response plan well in advance equips you with knowledge of what to do and peace of mind. So, how do you create such a plan? 

How to Create Your Mental Health Crisis Response Plan

Building an effective crisis response plan takes reflection, self-understanding, and a willingness to do some information gathering. To start, you can answer five questions:

1. What are some signs that my mental health is declining?
2. What are some coping strategies I can try after noticing them?
3. Who can I reach out to for support before a crisis starts? 
4. What destructive items need to be removed or restricted to make my environment safe?
5. What services are available in my area and which ones do I feel comfortable connecting with while in crisis?

Notice the bold words: signs, strategies, support, safety, and services. These are the five building blocks of a crisis plan. Let’s review each one.

Signs (thoughts, feelings, mood, behaviors): Write down the warning signs that apply to you. Mental health warning signs often include the following:

• Anger, feeling edgy, or lashing out at others
• Eating too much or too little
• Having unexplained aches and pains, such as constant stomachaches or headaches 
• Excessive sadness
• Feeling helpless or hopeless 
• Thinking of hurting yourself or someone else

If you’re unsure whether you’ve experienced these signs before, don’t worry! If you want to track your warning signs, try journaling or using an app. 

Strategies: Internal coping strategies are activities that you can do independently after noticing that your mental health is moving deeper into fair/poor or “yellow” territory. Examples may include the following:

• Mindful activities: yoga, coloring, meditation
• Grounding exercises, like deep breathing or visualization, to help you relax 
• Saying a special prayer or mantra
• Listening to uplifting music (favorite songs)
• Going for a walk or spending time at the park
• Engaging with items that remind you to stay positive 

It can be powerful to have a personal collection of items that remind you of reasons why you matter and why your life is important. This collection can include notes from loved ones, article clippings, affirmations, faith-based messages, audio recordings, and photographs.

Many apps are available to help you develop positive coping strategies. Some focus on mindfulness, positive affirmations, and mental health support.

Be as specific as possible about your preferred coping strategies so that you don’t have to think too hard about them later. It’s okay to give yourself options! 

Support: Now think of the supportive people in your life. There are two sets; try to choose three people for each.

• The first set is social distractions. Consider people you could contact or places you could go to take your mind off problems or help you feel better. This could be anyone—from a friendly acquaintance to a close friend—and anywhere—from your school library to a local coffee shop. Folks you can talk to about everyday things are best here. 
• The second set is “serious” supports. Make note of people you can expect support from in a time of crisis, such as close friends or family. These should be people you would feel comfortable confiding to in a very difficult moment. Make sure you write down names and telephone numbers (or the best way to reach them).

Safety: Do any objects in your environment pose a risk to your safety? Possibilities include medications, drugs, alcohol, firearms, weapons, and so forth. Think about ways you can make your environment safer and protect yourself from harm until a crisis passes. Identify a person you can trust to keep your home safe, and if possible, show them where these items are stored in your home. Decide if you need limited access or to completely remove them or if monitoring would be enough.

Services: What medical or mental health professionals can you contact in a time of crisis? If you need to go to a behavioral health urgent care center or emergency room, identify the one nearest to you. Add full details, including telephone number, hours of operation, and address. Be sure to add them to your contacts as well. The Suicide and Crisis Lifeline is 988. You can call, text, or chat  988 anytime–even if you are just having a bad day. And if you prefer to text, you can text “HOME” to 741741, which is the 24/7 Crisis Text Line.

Your completed mental health crisis plan may look something like this: 

Congratulations on creating your mental health crisis plan! You’ve taken a powerful step toward protecting your well-being and equipping yourself for tough moments. Your next step is to share your plan with those involved, especially anyone you’d like to help you in an emergency. Place the plan somewhere visible, such as your refrigerator, or save it in your phone. Remember, your crisis plan is a living document. Update it as your needs change. 

Resources

• Mental Health: Causes, Symptoms, Treatment, and Help 
• Safety Plans Work
• Build a Safety Plan (Video) 
• Identifying a Crisis 
• Safety Plan