Fight-or-flight worksheet
Developing a reliable mental health crisis plan worksheet with your clients is one of the most effective ways to manage risk and provide structure during acute distress.
In this guide, we cover the core components of effective crisis plan development and how to introduce them in session.
You can also download our free mental health crisis plan template PDF to customize and save directly to your electronic health record (EHR).
What is a mental health crisis plan?
A crisis plan is a short-term intervention with clear and actionable steps to reduce the effects of a mental health crisis. Crises include overwhelming events, recurrence of a severe mental health condition, or the experience of other types of traumatic stress that may put the person at risk to themselves or others.
The goal of a mental health crisis plan worksheet is to maintain the individual's safety, connect them with support, and seek professional help as needed.
Crisis plans are most beneficial when developed in collaboration with the person and, depending on their mental health condition(s), may include information about:
How to prevent a crisis
What to do when mental health symptoms escalate
Steps to take when experiencing a mental health crisis
Clinicians may suggest that the client share the crisis plan with their support network so they know what to do in the event of a mental health crisis.
Who needs a mental health crisis plan?
Not everyone with a mental health condition needs a crisis plan. However, certain conditions and situations may increase the risk of someone experiencing a crisis, such as:
Specific mental health conditions: Certain conditions, like depression, anxiety disorders, bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD), and borderline personality disorder, may lead to an increased risk of suicidal ideation, self-harm, or emotional distress that can warrant creation of a crisis plan if untreated or without adequate support.
Suicide or self-harm: People with a recent history of self-harm behaviors or active suicidal thoughts may be at increased risk of harm during times of stress or traumatic events.
Major life transitions: Clients experiencing the psychological distress of significant life events, such as divorce, separation, job loss, economic hardship, health issues, or relocation, may experience an increased risk of harm if they do not receive treatment.
People in recovery: Those in recovery from previous crises may experience a further trigger, or setback, that can increase the risk of another crisis.
Key components of a mental health crisis plan
Mental health crisis plans generally include two key components:
Planning section
The planning section of the mental health crisis plan template PDF includes:
Triggers and escalation factors: Behaviors, symptoms, and triggers that might lead to an escalation of mental health symptoms, such as relational difficulties, loss, social difficulties, conflicts, and facing socioeconomic barriers.
Coping strategies: This includes developing distress tolerance skills, using emotional regulation techniques, utilizing distractions, and seeking support from others.
Support contacts: Contact details for at least three reliable and supportive contacts, such as friends, family, or a therapist.
Crisis plan
The crisis planning section should include:
Crisis symptoms: A list of symptoms that warrant emergency or crisis contact, such as mania, psychosis, suicidal ideation, social isolation, feeling on edge, or wanting to engage in self-harm.
De-escalation techniques: Immediate steps to de-escalate, such as distress tolerance skills, anxiety medication, avoiding substances, calling a friend, or reaching out to a therapist.
Emergency contacts: Names and telephone numbers of crisis response centers and local emergency departments, as well as a list of current providers, including primary care physicians and mental health clinicians.
How to use the mental health crisis plan worksheet
You can download and use the mental health crisis plan template PDF in several ways:
Use the mental health crisis plan worksheet prompts in session with the client.
Provide the client with a copy of the crisis planning worksheet to take home.
Upload the mental health crisis plan worksheet to your EHR and email a version to the client.
Combine this worksheet with other mental health worksheets, such as our safety plan template for therapists, substance use assessment form, mental status exam example, or our psychosocial assessment template.
Share the worksheet with coworkers.
Use the mental health crisis plan template PDF as a training prompt for interns or supervisees.
Sources
Lequin, P., Ferrari, P., Suter, C., Milovan, M., Besse, C., et al. (2021). The Joint Crisis Plan: A Powerful Tool to Promote Mental Health. Frontiers in Psychiatry.
National Alliance on Mental Illness. (n.d.). Navigating a Mental Health Crisis.
Rosenberg, C. R. (2017). Crisis Plan Template for Individuals with Neurodevelopmental and Behavioral Dual Diagnoses. University of Colorado Anschutz Medical Campus.
University Health Services. (2016). Mental health crisis intervention plan. University of Wisconsin–Madison.
Wang D, Gupta V. (2023). Crisis Intervention. StatPearls Publishing.
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