Crisis Plan

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Welcome to the step-by step guide. The Crisis Plan focuses on how other people can support you during a crisis.

Feeling Well

Write what you are like when you are feeling well. This section is copied from your Feeling Well Daily Plan. This important information can help educate people who might be trying to help you — whether that person knows you well or not at all. Select the Add Feeling Well Items Button to view and add examples for this category.

Symptoms/Issues

* This information has been copied from your "When Things Are Breaking Down" section but needs to be edited to reflect only the symptoms that are related to a crisis.

Describe symptoms that would indicate to others that they need to take over responsibility for your care and make decisions on your behalf. Select the Add Symptoms/Issues Items Button to view and add examples for this category.

Current Medications

List the medications you are currently using, the dosage, and why you are using them.

If Additional Medications Become Necessary

List the medications you would prefer to take if medication or additional medications became necessary. List those that have worked well for you in the past—and why you would choose them.

Medications to Avoid

List the medications that must be avoided. List those you are allergic to, that conflict with another medication, or cause undesirable side effects. Give the reasons they should be avoided.

Supporters

List the people (such as family members and friends) who you would like to take over for you when the symptoms you listed in the previous section arise. Before listing people in this part of your plan, talk with them about what you would like from them and make sure they understand and agree to be in the crisis plan. Select the Add Supporters Example Button to view and add example formats for this category.

What You Need From Supporters

Describe what your supporters can do for you that will help you feel better. Select the Add Items You Need From Supporters Button to view and add examples for this category.

Special Help You May Need From Supporters

Describe a plan for your care to help keep your life on track. Select the Add Special Help Items Button to view and add examples for this category.

Health Care Providers

Name your physician, pharmacist, and other health care providers, along with their phone numbers. Select the Add Health Care Providers Example Button to view and add examples for this category.

Preferred Treatment

List the treatments you are currently undergoing; treatments you prefer if additional treatments became necessary; and, treatments that would be acceptable to you if treatments were deemed necessary by your support team. Select the Add Preferred Treatments Button to view and add examples for this category.

Treatments to Avoid

List the treatments that must be avoided and why. The reason may be as simple as “this treatment has or has not worked in the past,” or you may have some concerns about the safety of this treatment. Maybe you just don’t like the way a particular treatment makes you feel. Select the Add Treatments to Avoid Button to view and add examples for this category.

Preferred Facilities/Providers

List the treatment facilities you would like to use if family members and friends cannot provide you with care, or if your condition requires hospital care. Select the Add Preferred Facilities/Providers Button to view and add examples for this category.

Facilities/Providers to Avoid

Describe the treatment facilities you would like to avoid if family members and friends cannot provide you with care, or if your condition requires hospital care. Select the Add Facilities/Providers to Avoid Button to view and add examples for this category.

Congratulations, you have completed the Crisis Plan.

Now decide how you would like to keep all of your information so you can access it when you need it. You can choose one method or all of them, it's up to you. For an explanation of each method, visit the Help Page.

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Select the Next Button to advance to the next section, Resources.

Symptoms/Issues

Current Medications

If Additional Medications Became Necessary

Medications to Avoid

Supporters

What You Need From Supporters

Staying In Place

Health Care Providers

Preferred Treatment

Treatments to Avoid

Preferred Facilities/Providers

Facilities/Providers to Avoid

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Feeling well Examples

Select any item to add it to your list.

I am happy to get out of bed in the morning.

I am talkative.

I am energetic.

I am humorous.

Symptoms/Issues Examples

Select any item to add it to your list.

Being unable to recognize or correctly identify family members and friends

Uncontrollable pacing, inability to stay still

Neglecting personal hygiene (for how many days?)

Not cooking or doing any housework (for how many days?)

Not understanding what people are saying

Thinking I am someone I am not

Thinking I have the ability to do something I don’t

Displaying abusive, destructive, or violent behavior, toward self, others, or property

Abusing alcohol and/or drugs

Not getting out of bed (for how long?)

Refusing to eat or drink

Current Medications Examples

Select any item to add it to your list.

Current Medications - XXXXXXXX

Current Medications - XXXXXXX

Current Medications - XXXX

If Additional Medications Become Necessary Examples

Select any item to add it to your list.

If Additional Medications Became Necessary - XXXXXX

If Additional Medications Became Necessary - XXXXXXX

If Additional Medications Became Necessary - XXXXXXXX

Medications to Avoid Examples

Select any item to add it to your list.

Medications to Avoid - XXXXXX

Medications to Avoid - XXXXXXX

Medications to Avoid - XXXXXXXX

Supporters Examples

Select an example to add it to your list. You can edit it from there.

Name: John Doe / Cell:555-123-4567 / Home:555-555-5555 / email:jdoe@gmail.com

Name: Jane Doe / Cell:555-555-5555 / Address: 123 Main St.

What You Need From Supporters Examples

Select any item to add it to your list.

Listen to me without giving me advice, judging me, or criticizing me.

Hold me (how? how firmly?).

Let me pace.

Encourage me to move, help me move.

Lead me through a relaxation or stress reduction technique.

Peer counsel with me.

Provide me with materials so I can draw or paint.

Give me the space to express my feelings.

Don’t talk to me (or do talk to me).

Encourage me and reassure me.

Feed me nutritious food.

Make sure I take my vitamins and other medications.

Play me comic videos.

Play me good music (list the kind).

Just let me rest.

Special Help You May Need From Supporters Examples

Select any item to add it to your list.

Buying groceries

Watering the plants

Feeding the pets

Taking care of the children

Paying the bills

Taking out the garbage or trash

Doing the laundry

Cleaning the house

Cooking meals

Helping with my medications

Doing yard work

Health Care Providers Examples

Select an example to add it to your list. You can edit it from there.

Peer Support (Add Name/Phone/Address/Email)

Psychologist (Add Name/Phone/Address/Email)

Psychiatrist (Add Name/Phone/Address/Email)

Primary Care Provider (Add Name/Phone/Address/Email)

Social Worker (Add Name/Phone/Address/Email)

Specialist (Add Name/Phone/Address/Email)

Preferred Treatment Examples

Select any item to add it to your list.

Tai Chi

Yoga

Chiropractic

Acupuncture

Peer Groups

Mindfulness Groups

Substance Abuse Groups

Sleep Therapy

Individual therapy sessions

Treatments to Avoid Examples

Select any item to add it to your list.

Prolonged Therapy

Group Therapy Sessions

Tai Chi

Yoga

Chiropractic

Acupuncture

Preferred Facilities/Providers Examples

Select any item to add it to your list.

VA Medical Facility (name and location)

VA Clinic (name and location)

Non-VA Hospital (name and location)

Non-VA Clinic (name and location)

Provider (location and number)

Facilities/Providers to Avoid Examples

Select an example to add it to your list. You can edit it from there.

VA Medical Facility (name and location)

VA Clinic (name and location)

Non-VA Hospital (name and location)

Non-VA Clinic (name and location)

Provider (location and number)

Crisis Plan

Feeling Well

Symptoms/Issues

Current Medications

If Additional Medications Became Necessary

Medications to Avoid

Supporters

What You Need From Supporters

Staying In Place

Health Care Providers

Preferred Treatment

Treatments to Avoid

Preferred Facilities/Providers

Facilities/Providers to Avoid

To talk to someone now call the Veteran Crisis Line; 988 then Press 1.