Learn about mental illness
Know the laws in your state
Identify community resources
Develop an emergency contacts list
Compile a psychiatric and medical history
Get a signed Release of Information form
Keep it all together
- LEARN ABOUT mental illness and its treatment. Our Media Library contains links to a number of informative videos on the subject.
- ATTEND meetings or classes about mental illness offered in your community. Your public library, community college and local NAMI (National Alliance on Mental Illness) affiliate are typical sponsors.
- ENROLL in NAMI’s 12-week “Family-to-Family” course for families of people with severe mental illness. The course is free, and the information is practical and useful. Your local NAMI affiliate will hve information.
- ASK TO MEET with your loved one’s mental health provider(s) to get specific information about triggers and effective interventions in your own loved one.
- READ the family advocate issue of our Catalyst newsletter devoted to tools and strategies for family members and caregivers.
- DOWNLOAD AND PRINT "Eliminating Barriers: Tips for Advocates on Busting Through."
Know the laws in your state.
Several forms of psychiatric intervention exist to address mental health crises, but they differ from state to state. You must know the ones that apply where your loved one resides in order to use them. Separate laws apply to each of the following.
- Emergency hospitalization (sometimes called "psychiatric hold" or "pick-up")
- Civil inpatient and outpatient commitment (outpatient statutes do not exist in Connecticut, Maryland, Massachusetts, Nevada, New Mexico and Tennessee)
- Initiating court-ordered treatment
- HIPAA (the federal Health Insurance Portability and Accountability Act and its "privacy rule")
- LOCATE the NAMI chapter nearest you. NAMI (National Alliance on Mental Illness) is a family support and advocacy organization for people with psychiatric disorders and their families. Local chapters hold regular meetings. Local and state leaders are usually knowledgeable and willing to advise on the treatment options and procedures. Find your chapter online or via the national hotline at 1-800-950-NAMI (6264).
- NETWORK with other families you can identify who have loved ones with severe mental illness. Ask them what strategies worked – or didn’t – in getting intervention for their loved ones in your community. Ask for the names of caring and effective service providers they know and other resources they have used with success. Your experience may be different, but it’s good to know what others’ have been.
- IDENTIFY the local facility or emergency room that performs emergency psychiatric evaluations. Call or visit and find out what procedures are followed when someone in a mental illness crisis presents there. Request copies of any relevant handouts they have outlining procedures.
- IDENTIFY any resources in your community for averting crisis or preventing one from escalating. One example is a hospital “safe room” where families or law enforcement may take someone who is becoming symptomatic, but not yet ill enough to be committed, and get temporary supervision or medication. A mobile crisis team is another.
Develop an emergency contacts list
Having an up-to-date and complete list of key people, agencies and organizations to contact makes it faster and easier to get appropriate help if and when an emergency develops. These are typical contacts in an emergency:
- Your standby support person(s) – the stable and reliable third party or parties willing to back you up in an emergency
- Mobile crisis team
- Psychiatric case manager
- Program of Assertive Community Treatment (PACT or ACT) team
- Local mental health center or county mental health department
- Telephone hotline numbers for different crises: mental illness, suicide, domestic violence
- Local hospital/emergency room
- Non-911 police/paramedic numbers that are answered 24/7 (e.g., local precinct)
- Crisis Intervention Team (CIT), if local law enforcement has one
- Local advocates who can advise or support you
- Sympathetic public official/elected official with whom you’ve established a relationship
- Homeless shelter(s)
- Friends of your loved one
- Employers or others who will need to be notified immediately if your loved one is hospitalized
- Legal Aid Services, public defender or private attorney familiar with mental health law
PROVIDE copies of this list to your standby support person and anyone who might be called upon to act in your absence.
MAKE multiple copies of the list. Keep a copy at home, at work, in your car, in the briefcase you carry on trips – anywhere you might be when a crisis arises. Store it in your portable electronic device. Wherever you are or wherever you go, never leave home without it
REVISIT and revise your list regularly to make sure numbers and names are up to date.
A brief, easy-to-read summary of vital statistics, psychiatric history and medication records may help medical providers make informed choices during a crisis. Limit this page to key facts.
- Full name and date of birth
- Full address
- Psychiatric diagnosis (e.g., schizophrenia, schizoaffective disorder, bipolar disorder)
- Age at diagnosis
- Any other pertinent medical conditions (e.g., diabetes, allergies)
- Current symptoms
- Current condition (e.g., suicidal, homeless, missing, vulnerable, violent, abusing substances, other)
- Treating psychiatrist’s name and number
- Local service provider’s name and provider (e.g., mental health clinic, therapist)
- Current medication(s) including names and dosages
- Dates and locations of previous hospitalizations
- Any medication(s) that has/have helped in the past
- Any medication(s) that has/have not helped in the past
- History of symptomatic behaviors (e.g., running up huge debt, getting into car accidents, threatening family members, failing to care for basic needs)
- Date(s) and charge(s) of previous arrest(s)/incarceration(s)
- Current photograph
- Key physical characteristics: height, race, age, weight, hair color
- Full name, contact numbers and address for person(s) to be contacted in an emergency
Leave space to add a description of clothing last worn in case that information is needed.
Get a signed release of information form.
If possible, have your loved one sign an authorization/release of information form so that health care providers can talk with you in a crisis. Your local hospital, mental health department, medial provider or similar should be able to supply you with the form. File a copy with any local facility where your loved one might be treated in a crisis and keep the original in your CARE Kit (below).
Keep it all together.
We suggest storing all your key documents in a three-ring binder, a file box, or some other easy-to-carry system you can take with you easily in an emergency. Keep it in a place where you can find it quickly even in the confusion of a crisis. Using letter-sized, one-sided paper that can easily be faxed or emailed to police, hospitals and medical providers, mental health agencies and others will save time later. In addition to your emergency contacts and psychiatric/medical history, you may want to include handouts, forms and other informational materials like these:
- Copies of your state’s standards for emergency hospitalization for evaluation and civil commitment laws (both inpatient and outpatient)
- Petition forms for civil commitment – multiple blank copies. Complete any fixed information ahead of time.
- A "What to Do in a Psychiatric Crisis" brochure with local resources and their contact information if an organization in your community has prepared one.
- Other handouts, brochures, other materials supplied to you previously by hospitals, law enforcement, mental health agencies, others.
- Authorization for release of information, already signed by your loved one, if applicable
- Advance directive, if applicable.