Crisis Planning
A Crisis Plan For People
Who
Experience Psychiatric Symptoms
I feel very
strongly that anyone who has ever experienced psychiatric symptoms needs to
develop for themselves, while they are well, a crisis plan such as the one that
follows. This plan allows those of us who experience
psychiatric symptoms to
maintain some degree of control over
our lives , even when it feels like everything is out of control.
Developing such a plan takes time-don't expect
to do it in one sitting. Work on it with family members or friends, your
counselor, case manager or psychiatrist-whoever feels comfortable to
you.
The hardest part for me was uncovering those
symptoms that indicate I need others to take over for me. It brought up
memories of very hard times in the past. I did it very slowly with lots of
support.
Once you have completed the plan, keep a copy
for yourself, and give copies to all your supporters.
Update it whenever you need to.
CRISIS PLAN
When I am feeling well, I am (describe yourself
when you are feeling well):
The following symptoms indicate that I am no
longer able to make decisions for myself, that I am no longer able to be
responsible for myself or to make appropriate decisions.
When I clearly have some of the above symptoms,
I want the following people to make decisions for me, see that I get
appropriate treatment and to give me care and support:
I do not want the following people
involved in any way in my care or treatment. List names and (optionally) why
you do not want them involved:
Preferred medications and why:
Acceptable medications and why:
Unacceptable medications and why:
Acceptable treatments and why:
Unacceptable treatments and why:
Preferred treatment facilities and why:
Unacceptable treatment facilities and
why:
What I want from my supporters when I am
experiencing these symptoms:
What I dont want from my supporters when
I experiencing these symptoms:
Things I need others to do for me and who I
want to do it:
How I want disagreements between my supporters
settled:
Things I can do for myself:
I (give, do not give) permission for my
supporters to talk with each other about my symptoms and to make plans on how
to assist me.
Indicators that supporters no longer need to
use this plan:
I developed this document myself with the help
and support of:
| Signed:
|
Date: |
| Attorney:
|
Date: |
| Witness:
|
Date: |
| Witness:
|
Date: |
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