Over the course of April, I’ve produced a series of posts about the process involved in creating a Wellness Recovery Action Plan. Today is the final installment in which I look at Crisis Planning. As I stated in my last Monday Matters post, I did not complete this section of the booklet myself as my illness has never reached crisis point but I intend to go over what this part of the plan would look like and suggest some ideas of what you might include.
What constitutes crisis?
Although there is no set definition for a crisis, it can be described loosely as being a state of emergency that poses an immediate threat to your physical or emotional wellbeing. Therefore, in spite of your best planning and actions to keep yourself well, you find yourself in a situation where others need to take over your care.
This part of the W.R.A.P. has 9 sections and I will go over in in turn. Although the whole plan is very personal to the individual, I can offer suggestions on the kind of information you might record in each list.
Part 1: What I am like when I’m well
This can literally be copied from the second page of your plan and is simply placed in this part of the document for ease of access.
Part 2: Symptoms
This is a list of signs that tell others that they need to take over your care. Some examples include violent out of control behaviour, psychosis (loss of touch with reality), paranoia, abusive behaviour towards self or others, inability to perform basic tasks such as bathing, brushing teeth etc, showing signs of planning own suicide (Mind website information on this can be found here).
Part 3: Supporters
This is a list of people you want to care for you if the symptoms you listed in Part 2 occur. Include family members and health care professionals but make sure you seek their permission to me added to your list so that have advance warning in case something happens in the future. You can also include a list of people you do not want included in your supporters list too.
Part 4: Medication
In this section, you can write which medications are okay to be given and which are not. So, for example, you might have reacted in a bad way to a particular antipsychotic in the past and be worried that it might make you worse if administered again.
Part 5: Community Plan
In this section, you can list your preferences for your care so you can feel you have some say in what happens when you are unwell. So, for example, you might prefer to have the Crisis team visit you at home and come up with a plan for you in consultation with your partner or you might feel that you are best off being hospitalised.
Part 6: Treatment Facilities
Here, you would list where you would prefer to be treated or hospitalised if that becomes necessary. You can also add facilities that you would rather avoid if possible and why.
Part 7: Treatments
In this part, you can include treatments and therapies which you feel would be most beneficial and those which you wish to avoid and why. You may have tried alternative therapies that have worked in the past and wish them to be administered again.
Part 8: Help from others
Here, you can write down what you want from your supporters which will help make you feel most comfortable. Obviously, this list is very personal but might include the kind of things you would like people to say to you for encouragement or avoid saying as you know they will not help.
Part 9: When my supporters no longer need to use this plan
In this section, write a list of indicators that your supporters no longer need to take over your care. What are the signs that show you are once again in control of your life? This might include features of wellness that you display which show you are well on the path to recovery.
Remember that if you do reach crisis point, despite putting all of the elements of a W.R.A.P. in place, this is not the end of the world and it certainly does not mean that you won’t recover. After you have taken the time to get yourself feeling better and stronger, you might like to revisit your plan with one of your supporters and discuss any improvements you might be able to make to your plan and the action which goes with it. Maybe, on reflection, you didn’t do enough to keep yourself calm and relaxed in daily life and could benefit from putting more self soothing activities into place. Or perhaps a loved one recognised signs of deterioration but you chose to ignore it or go into a state of denial. Whatever happens, you can learn from the experience and try to make plans for the future.
And that, as they say in the filming industry, is a WRAP. I hope you have found my series helpful and can see the benefits of producing this kind of document to help with issues relating to mental health. If you would like support to write your WRAP, I suggest looking into if there is a Recovery College in your local area or if you are able to work with a mental health professional as part of therapy sessions to make one.
Wishing you a wonderful week,