Crisis services and planning for a crisis

A guide explaining what mental health crisis services are available, how they can help and when to access them. Also provides guidance on how you can plan for a crisis.

Your stories

Accessing NHS services in a crisis

Simon tells us about his experiences accessing NHS services in a crisis.

Simon
Posted on 05/07/2018

In crisis: my experience

In time for the release of the CQC's Mental Health Act report,Claire blogs about her experience of crisis care

Claire
Posted on 28/01/2014

How going to A&E helped me

Caroline blogs about how a visit to A&E helped her to realise she needed help.

Caroline
Posted on 27/11/2013

How can I plan for a possible crisis?

The idea of planning for a mental health crisis can feel difficult. You might not like the idea of planning for something you hope won't happen. But it could help to think about what you could do if you start to feel in crisis in the future, and what kind of support you think you might want.

This page has some suggestions for you to consider. Some people find these ideas useful, but remember that different things work for different people at different times.

You could:

Explore ideas for help and support

It could help to explore possible options for support when things are less difficult, so you have information ready for times when you might need it. For example, you could:

  • Talk to your GP – you could ask your GP about options for treatment and support. (For more about talking to your doctor, see our guide to seeking help for a mental health problem.)
  • Find your local Mind, and see if they offer support such as day services to help during a crisis.
  • Find details of helplines and listening services, including how to contact them and when they're open. It could help to write these details down.
  • Read our information on types of mental health problems, including ideas for self-care in a crisis and organisations that may be able to help.
  • Try peer support. Talking to people with similar experiences could help you find out about different services, or give you helpful tips to try.
  • Make a self-care box. Some people find it helpful to fill a box with things you find comforting or distracting. This means you can personalise what is helpful for you, and have this ready in advance, as it can be very difficult to come up with ideas when you're feeling in crisis. You could also do this using an app on your phone, such as the Stay Alive app.
  • Find a recovery college. Recovery colleges offer courses about mental health and recovery in a supportive environment. You can find local providers on the Mind Recovery Net website.

Social care services support people who struggle to manage day-to-day activities. To find out more, see our page on social care in our guide to health and social care rights.

Make informal plans with friends or family

Talking to people close to you about how you'd prefer to manage a crisis can be a good way to plan for the future. It could be helpful to write down what you've decided, so you both remember what you've said.

For example, you could let them know:

  • how they might help you spot the signs of a crisis
  • how you would like them to help you
  • who they could contact
  • what treatment you would prefer.

You could also discuss whether your friend or family member might feel able to act as your advocate. (See our pages on advocacy for more information).

Luckily I had fantastic support from friends and family.

Make an advance statement

In some situations, experiencing a mental health crisis might mean that you become unable to make decisions about your treatment (in legal terms, this is called losing capacity).

If you're worried about losing capacity, you might decide to make an advance statement. This is a written statement about what you would like to happen if you lose capacity, such as:

  • what treatment you would prefer
  • who you would like to be contacted in a crisis
  • any spiritual or religious views and requests
  • your food preferences.

You could ask your GP, care coordinator, psychiatrist or other health care professional to help you make an advance statement. For more about what you might include, see the Rethink Mental Illness website

Advance statements aren't legally binding, so health care professionals aren't required to follow them, but they should carry out your wishes wherever possible. (For more information about your rights if you lose capacity, see our pages on the Mental Capacity Act.)

Examples of advance statements include:

Joint crisis plans (JCPs)

Joint crisis plans (also known as JCPs) are a type of advance statement agreed between you and any health care professionals involved in your treatment. This could include:

  • signs that you might be experiencing a crisis
  • what support you might be offered in a crisis
  • practical help you might need if you go into hospital, such as childcare arrangements
  • who you would want to be contacted.

The National Institute of Health and Care Excellence (NICE) has published recommendations on what to include – you can read these on the NICE website. You might also decide to include other information, for example, details of medication you're taking or any allergies you have.

Crisis cards

A crisis card is a small card you carry in your wallet, purse or pocket with key details about how you'd prefer to be helped in a crisis, so you can easily find it or show it to other people. You might decide to tell people you know, such as friends or family, about the card and where you keep it.

Advance statements vs advanced decisions

Advance statements
 aren't legally binding, and can cover a wide range of issues related to your treatment in a crisis. They should be taken into account if a relevant decision is being made about you during a crisis.

Advance decisions are legally binding decisions to refuse certain types of health care in the future. (See our page on advance decisions in our guide to the Mental Capacity Act for more information.)

 


This information was published in October 2018 – to be revised in 2021. References are available on request. If you would like to reproduce any of this information see our page on permissions and licensing.


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