Crisis Management Plan:
Support at Home for Children and Youth With Mental Health Needs

Most of us experience a time when events happen that make us feel anxious, stressed, or needing support. For parents of children and youth with mental health needs, an experience that produces distress may quickly escalate into a crisis if we do not know how to help reduce the intensity of the situation. Parents may also feel embarrassment when caught in a situation they can’t stop. Developing a written crisis management plan to use at home is one way to be proactive in attempting to handle crisis situations.

A written crisis management plan should address positive ways to prevent the escalation of your child or youth’s behavior problems, and identify next steps to take if it does intensify. Remember during interactions with your son or daughter to use as few words as possible, have a neutral facial expression, and maintain a calm voice. The written plan may also help to stabilize the situation.

Who Writes the Plan?

A crisis management plan designed for situations arising at home should be written by the parent with their child or youth. It can also include information and suggestions from others who know or work with the child and family (e.g., a family therapist or other mental health provider). It can also be written as part of an individual service plan with the child’s mental health provider. The intent of an individualized crisis management plan is to decrease the likelihood of escalating behavior problems, provide early intervention and supports, and offer your child help that does not feel threatening.

What Does a Crisis Management Plan Include?

A crisis management plan should include the following key elements:

1. A statement about how your child or youth looks and acts when he or she is feeling calm and happy. It is important to have a baseline of positive behavior so that you can recognize when your child is not coping well and your youth’s behavior problem is starting to escalate.
2. A list of triggers such as words, gestures, or situations that could increase the behavior problem. This list should be developed with input from your child or youth. Consider including the impact of sudden transitions, noise, medication non-compliance, or disrupted sleep. Each child has his or her own level of tolerance, so identifying triggers with your child will give a better picture of what impacts his or her behavior.
3. Information about how the child or youth starts to look when he or she is increasing the behavior. Some children have physically observable signs when they are upset such as a flushed face, tense body, or tantrums, which can signal loss of control. Older youth may be less likely to demonstrate obvious signs. For youth, changes in personal hygiene, excessive sleep or sleep deprivation, or changes in social behavior may signal a growing crisis. One of the most frequent signs of an increasing mental health need may be unprovoked, angry, or disruptive behavior that is out of the ordinary. Describing any observable behavior helps individuals be proactive.
4. A list of specific actions that have helped calm behavior problems in the past. Identify previous actions that you have taken to help slow a mounting crisis. If your child loves hugs, a long hug is likely to make him or her feel loved, signal your understanding, and calm the situation. If, despite the use of an agreed-upon strategy, your youth escalates his or her problem behavior, a ‘time out’ in a predetermined space for your child may calm the situation.
5. A list of specific strategies that your child feels may help prevent a crisis from occurring, and a corresponding plan of when and how to use the strategies. Over time, your child or youth may have given you clues about what helps in regaining his or her composure. Prearrange a signal for you to use to prompt your child or youth to use a strategy that has worked before. Sometimes simply offering the chance to do an alternate activity helps to change the situation from negative to positive. Examples may include taking a walk or listening to music.
6. A list of specific ways others can help and when they should be asked. Sometimes certain inappropriate behavior does not stop even with well-planned interventions in place. When that happens, have a predetermined list of people who can help. For example, a call to the county mobile crisis team by you or your child or youth, to the mental health provider working with your family, or to an informed friend or relative. Make sure you have a clear statement about how they can help.

Stay positive and focused on the crisis plan activities. When a child or youth with a mental health challenge demonstrates difficult or escalating behavior, the written crisis management plan may help. If a crisis management plan is created ahead of time that is positive and specific to your child or youth, the situation can improve.