A mental health crisis plan is a written guide, made when you are well, that says what to do if your mental health gets worse. It records early warning signs, what helps, who to call, your care preferences and your medication. You write it with the people who would support you, keep copies where they can be found, and review it as your life changes.
This guide shows you how to build one step by step. It also covers who to contact in London, and how to adapt a plan for someone with dementia, a learning disability, autism, or for a child.
A crisis plan is a practical guide, created when someone is stable, to manage a deterioration in mental health. It means that in a hard moment, nobody has to guess. The person, their family, their carers and any professionals can all see what has helped before and what the person wants.
A crisis plan is often broader than a safety plan. A safety plan focuses on suicide and self-harm risk. In everyday use, the two terms are often used interchangeably, so you may see the same document under either name. What matters is that it fits the person and the risks they face.
One point on wording. A “safety contract”, where a person simply promises not to harm themselves, may feel coercive and is considered ineffective. A good plan is not a promise extracted from someone. It is a set of practical choices the person helps to make.
A plan can be useful for:
If you are a family member, you may be the one who starts the conversation. Keep it gentle, and make clear the plan belongs to the person, not to you.
Start by asking. Professionals are advised to ask the person whether they would agree to co-create a plan, check their understanding and acceptance, and involve trusted others where possible. The Royal College of General Practitioners stresses that plans should be co-created so that the person understands them, accepts them, and can rely on continuity of care.
Choose a quiet time when the person feels reasonably well. Keep the first session short. You can finish the plan over several conversations.
If the person is not ready, do not push. Offer to come back to it. A plan someone has been pressured into writing is unlikely to be used.
Warning signs are the changes that appear before a crisis. They can be emotional, physical, behavioural or social. Examples include:
Triggers are different. They are situations, events or internal states that push mental health towards crisis. A trigger might be a bereavement, a change of carer, noise, money worries, or an anniversary that is hard to face.
Write these in the person’s own words where you can. “I stop answering the phone” is more useful to a friend than “social withdrawal”. Ask the people who know the person well what they have noticed too, because others often spot changes first.
This is the heart of the plan. Make two lists.
What helps
What makes things worse
If the plan includes thoughts of suicide or self-harm, add the things that distract and keep the person safe. Some written plans include a section for anything that can take your mind away from distressing feelings and keep you busy, such as a playlist, a puzzle or calling a friend. Make the list specific to the person. Their own ideas will be used far more often than ones borrowed from a template.
A plan should record early warning signs, what helps, who to call, care preferences, medication and allergies, and any preferred hospital or service. Under “who to call”, write names and numbers in order:
Roles matter as much as numbers. The person and their supporters should agree what help is wanted, how concerns should be communicated, who will help, what they can do and how to reach them. Be practical. One person might take phone calls. Another might stay in the home. A third might look after children or a pet, or bring a bag to hospital.
Agree, too, how to raise a concern without causing offence. Some people prefer a text, others a set phrase such as “I’m worried, can we check the plan?” Settling this in advance makes it much easier to act early.
The way a call is handled also matters. Calm, unhurried phone contact helps anxious people say what is wrong, and this is why telephone reception for anxious patients is a topic in its own right. If you can, tell your GP surgery in advance how you prefer to be contacted.
A crisis can mean being seen by someone who does not know you. Put the essentials on one page:
NICE says a comprehensive assessment should cover social and living circumstances, functioning, symptoms, behaviour, diagnosis and current treatment. Having these facts already written down helps any professional build that picture quickly, and spares the person from repeating a painful history.
Put the right numbers on the plan, and say when to use each.
| Situation | What to do |
|---|---|
| Immediate danger to life | Call 999 or go to A&E |
| Urgent mental health help, not life-threatening | Call 111 |
| Someone to talk to, any time | Samaritans on 116 123 |
| Support in parts of south London | NHS 111 press 2 for 24/7 mental health support, and local Single Points of Access |
The south London service is run by South London and Maudsley NHS Foundation Trust. Other boroughs have their own NHS trusts and local crisis lines, so check which trust covers the person’s address and add that number to the plan. Your GP surgery can tell you.
If you are supporting someone at home, our guide to mental health: 111 or 999 explains which to choose, and our page on emergency home care in the UK covers what to do right away.
A standard template may not suit someone who cannot easily say how they feel. For people with dementia or learning disabilities, plans should be person-centred, detailing routines, communication preferences, specific likes and dislikes, and sensory needs. These details help carers understand behaviour that might otherwise seem unusual.
A useful extra is a one-page profile. The Mental Welfare Commission for Scotland describes “Getting to Know Me”, which records a person’s needs, likes, dislikes, preferences and background. The same guide says plans must be accessible and meaningful to the individual, and that you can use different formats for the formal record and for personal use. That might mean pictures, large print or an easy-read version.
Things to add for these groups:
For a child with a learning disability, autism or challenging behaviour, the plan should lean on prevention. Government guidance promotes proactive, preventative, non-restrictive approaches for children and young people with learning disabilities or autism, and says positive approaches should be used to reduce the need for restraint and restrictive intervention.
In practice, share the plan with school, short-break providers and anyone else who looks after the child, so each adult responds the same way. Our guide to parenting tips for learning disabilities gives everyday strategies that support this.
In dementia, distress often comes from confusion, fear, pain or an unfamiliar setting. Write down what calms the person, such as a song, a photograph or a familiar voice. For ideas, see our guides on dementia behaviour management steps, how to handle dementia emergencies and home safety for dementia.
A plan nobody can find is no use. Keep:
Ask the person who may see it. Sharing needs their agreement wherever they are able to give it, so note that clearly in the plan.
A plan should be reviewed regularly and when circumstances or needs change. Good moments to look again include:
After a crisis, ask what worked and what did not. Cross out what failed and add what helped. A plan that grows from real experience becomes more useful each time.
We have supported people in their own homes across London for over 30 years, and we have seen how much easier a hard day is when the plan is already written down.
A crisis plan is not a form to complete. It is a record of who the person is: what calms them, what frightens them, and who they trust. Our carers are fully qualified, DBS checked and regulated by the CQC, and they work best when they know those details from the first visit.
We believe in independence, dignity and freedom of choice. That is why we encourage families to write the plan with the person, not for them. At home, familiar surroundings and a consistent carer can help someone feel safe, and a good plan lets every carer respond in the same, respectful way.
If a loved one has dementia, a learning disability, autism or a mental health condition, we can build the plan into their care. We can record routines and preferences, and keep it up to date as needs change.
Dan
If you want support putting a plan into practice, we provide call-in visits, live-in care, dementia care, support for adults and children with disabilities or mental health issues, and respite cover. You can see the full list on our home care services page. Our personal care assessments are a good place to start, because they set out the person’s needs and preferences in writing.
For a wider picture of the options, read our mental health support guide for London families or how to personalise home care. To talk it through, get in touch via kells-care.com and tell us about your situation.
Not exactly, though people often use the words interchangeably. A safety plan focuses on suicide and self-harm risk. A crisis plan is usually broader and covers any serious decline in mental health, including care preferences and practical arrangements.
Start with the person it is for, then add trusted family, friends or carers, and a professional such as a GP or care coordinator where possible. Everyone should agree their role and how to reach each other. The person should always be involved so that they understand and accept the plan.
If there is immediate danger to life, call 999 or go to A&E. For urgent help that is not life-threatening, call 111. You can also call Samaritans on 116 123 at any time to talk.
Focus on the person’s routines, communication preferences, likes and dislikes, and sensory needs. A one-page profile in an accessible format, such as pictures or large print, can help. Share it with everyone who provides care, so the response is consistent.
Review it regularly and whenever circumstances change, such as a new medication, a move or a change of carer. Always look at it again after a crisis, to record what helped.
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