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Crisis Guide and Resources

Why Rock Bottom in Serious Mental Illness Is Death
Psychology Today, By Julie Fast Feb 14, 2019
www.psychologytoday.com/us/blog/take-charge-bipolar-disorder/201902/why-rock-bottom-in-serious-mental-illness-is-death
​The idea that someone needs to hit rock bottom before getting help for a serious mental illness is a myth.  I often hear loving parents say, "He will get help when he’s ready! ” or, “Maybe a few days on the street will be good for him!” or ”She will finally say yes to meds when she realizes the damage bipolar is doing to her life!"

Serious Mental Illness, SMI, includes bipolar disorder, schizoaffective disorder, and schizophrenia. In SMI, there is no rock bottom.

Rock bottom is often death.
What is a mental health crisis?
A crisis is any situation in which a person's behaviors puts them at risk of hurting themselves or others and/or when they are not able to resolve the situation with the skills and resources available. If anyone is at risk of harm, ​call 911 immediately and request a mental health officer or Crisis Intervention Team member.
Remain calm, stay with them, don't argue, don't stare, don't touch.
Ask "what did you do last time that was helpful"?
​Listen, slow down, give them space.
Avoid quick movements.
One person talks - short and simple sentences. 
​Do not ask "Why" they are behaving the way that they are.
Psychiatric Advance Directives
You may also want to ask about a Psychiatric Advance Directive (PAD), which is a legal document that allows a second party to act on your loved one's behalf if he becomes acutely ill and unable to make decisions about treatment. The PAD is written by your loved one when they are currently ‘competent.’ It details the individual’s preferences for treatment should they become unable to make such decisions due to their mental health condition. Planning ahead can make a huge difference in your loved one’s treatment experience in the future.  
Mental Health Crisis Planning for Adults
Learn to Recognize, Manage, Prevent and Plan for Your Loved One’s Mental Health Crisis (NAMI Minnesota)
nami-mhcrisisplannforadultfeb2016.pdf
Mental Health Crisis Planning for Children
Learn to Recognize, Manage, Prevent and Plan for Your Child’s Mental Health Crisis (NAMI Minnesota)
nami-mhcrisisplanforchildrenfeb2016.pdf
Conservatorship & Adult Guardienship
In some cases, a person who is suicidal refuses to seek or accept treatment. They may engage in self-harm, risky behaviors and multiple suicide attempts. Oftentimes a person in this condition has a serious underlying mental illness that they refuse treatment for. Unfortunately, because they present such a significant danger to themselves, they may need someone else to make these decisions for them.

A conservatorship is a legal relationship granted by a court that allows one person (the conservator) to make personal decisions for another (the ward), who has shown themselves to be unable to fulfill the basic requirements needed to protect their own health and safety. Unless otherwise specified, the conservator has all of the powers that a parent has over a minor, which would allow the conservator to direct the ward’s mental health treatment and suicide prevention measures.
Wellness Recovery Plan
A Wellness Recovery Action Plan can also be very helpful for your loved one to plan his overall care, and how to avoid a crisis. If he will not work with you on a plan, you can make one on your own. Be sure to include the following information:
  • Phone numbers for your loved one’s therapist, psychiatrist and other healthcare providers
  • Family members and friends who would be helpful, and local crisis line number
  • Phone numbers of family members or friends who would be helpful in a crisis
  • Local crisis line number (you can usually find this by contacting your NAMI Affiliate, or by doing an internet search for “mental health crisis services” and the name of your county)
  • Addresses of walk-in crisis centers or emergency rooms
  • The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
  • Your address and phone number(s)
  • Your loved one’s diagnosis and medications
  • Previous psychosis or suicide attempts
  • History of drug use
  • Triggers
  • Things that have helped in the past
  • Mobile Crisis Unit phone number in the area (if there is one)
  • Determine if police officers in the community have Crisis Intervention Training (CIT)
Go over the plan with your loved one, and if he is comfortable doing so, with his doctor. Keep copies in several places. Store a copy in a drawer in your kitchen, your glove compartment, on your smartphone, your bedside table, or in your wallet. Also, keep a copy in a room in your home that has a lock and a phone.
The Wellness Recovery Action Plan® or WRAP®, is a self-designed prevention and wellness process that anyone can use to get well, stay well and make their life the way they want it to be. It was developed in 1997 by a group of people who were searching for ways to overcome their own mental health issues and move on to fulfilling their life dreams and goals.  It is now used extensively by people in all kinds of circumstances, and by health care and mental health systems all over the world to address all kinds of physical, mental health and life issues.

WRAP has been studied extensively in rigorous research projects and is listed in the National Registry of Evidence-based Programs and Practices.
mentalhealthrecovery.com/wrap-is/
“Navigating a Mental Health Crisis"
A NAMI Resource Guide for Those Experiencing a Mental Health Emergency.”

NAMI developed this guide to support people experiencing mental health crises and their loved ones. This potentially life-saving guide outlines what can contribute to a crisis, warning signs that a crisis is emerging, strategies to help de-escalate a crisis and resources available for those affected. Also included is information about advocating for a person in crisis along with a sample crisis plan
navigating-a-mental-health-crisis.pdf
File Size: 4111 kb
File Type: pdf
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