Crisis Planning After Discharge: Staying Safe After Hospital or ER Care

Mental Health Discharge Planning: Creating a Safety Plan 

Staying safe after a mental health crisis often means planning for times when mental health can dip. We can’t always avoid the factors that trigger poor well-being, but we can consider the steps to take to protect our well-being when we do. This is where an after-psychiatric-hospitalization care plan can help. 

In moments when someone feels emotionally overwhelmed or distressed, it’s not easy to think clearly or make good decisions. But having a practical guide to follow, whether that’s in a notebook or even on your phone, can help relieve cognitive overload. 

In fact, studies show that a personalized crisis safety plan is one of the most valuable tools for staying safe after a mental health crisis.^[7]

A good post-hospital mental health recovery plan usually includes: 

A List of Personal Warning Signs

Preventing relapse after a crisis means recognizing the thoughts, feelings, or behaviors that suggest someone’s mental health may be declining again. Examples might include: 

• Hopelessness.
• Extreme anxiety.
• Isolation. 
• Panic attacks.
• Racing thoughts.
• Thoughts of self-harm.

A List of Personal Triggers

What triggered or led to any previous declines in mental health? Having an awareness of these factors can help people better plan for when they encounter them again. Possible triggers may include:

• Work burnout.
• Conflict with loved ones.
• Financial stressors. 

Effective Coping Strategies

When someone encounters a trigger, they can use coping strategies to help return their physiological stress response to baseline. This way, they can calm themselves before mental health issues start to worsen. A few of these coping strategies include: 

• Breathing exercises.
• Journaling.
• Calming music.
• Calling a trusted person. 

When staying safe after a mental health crisis, someone could try a few different strategies to figure out which ones work best for them.

Support Contacts

This part of an after psychiatric hospitalization care plan involves considering who you can count on during times of need. For instance, could you contact trusted friends, family members, a therapist, or a support worker during difficult moments? Make sure their contact details are included in your plan.

Professional Resources

As an extension of support contact, it’s also important to have crisis resources that you can contact in a mental health emergency. A go-to for many in the U.S. is the 988 suicide and crisis lifeline. This lifeline is available 24 hours a day, so you can reach out at any time of need. Emergency services, a therapist or psychiatrist, or a local crisis team are also good options. 

Ways of Making the Environment Safer

If the symptoms of a mental health crisis are escalating, it’s important to consider how to make your own or someone else’s environment safer. If the environment itself is a trigger, you might need to consider making an exit plan. For example, by planning ahead to say something like “I’ve just received a call that I need to be at an appointment.”  

However, if harm to the self or another person is a risk, then reducing access to items such as medication or weapons may be necessary. This can be a crucial means of ensuring safety.^[8]

While each of these steps can ensure post-crisis support planning, one of the best ways to prevent a future crisis after discharge is through aftercare mental health programs – such as outpatient support. 

Outpatient Support Options After Hospitalization

Outpatient care after inpatient treatment aims to ensure that once someone leaves the hospital, their care doesn’t just stop there. So while they make the transition to living at home again, they can recognize that their mental health is still being looked after and they don’t have to cope alone. 

What’s more, attending follow-up care as part of post-hospital mental health recovery is proven by research to help identify problems early before they become another crisis.^[3] 

Typically, outpatient support options include: 

• Talk therapy: Depending on the person’s symptoms, there are different forms of therapy that can help them process what happened during the crisis, build coping skills, and work through underlying issues contributing to emotional distress.^[6] Some examples of evidence-based therapy include cognitive behavioral therapy, dialectical behavioral therapy, and mindfulness-based cognitive therapy. 
• Psychiatry Services: Alongside therapy, medication management appointments help monitor side effects, adjust dosages if needed, and ensure medications are working effectively.
• Peer Support Groups: Talking with others who have experienced mental health challenges can make people feel less alone in their recovery.^[9]
• Case Management: Some people benefit from practical support services that help with housing, transportation, employment, or accessing healthcare resources after being discharged from the hospital. This may especially be the case if any of these factors contributed to poor mental health in the first place. 

Additionally, each of these outpatient support options can be included in partial hospitalization programs (PHPs) or intensive outpatient programs (IOPs). Both PHPs and IOPs provide more structured treatment several days per week without needing to stay overnight in a hospital setting. These programs can be especially helpful during the transition after psychiatric hospitalization care discharge.^[10]

Building Healthy Daily Routines for Recovery

We’ve covered the essentials when it comes to crisis planning after discharge from the hospital. But preventing relapse after a crisis isn’t just about safety planning. It also involves thinking about how to create more balanced, healthy day-to-day routines. 

For some people, returning to “normal” life means also encountering habits that contributed to poor mental health in the first place. This might mean:^[11] 

• Disrupted sleep.
• Poor eating habits or hygiene.
• A difficult-to-manage work environment.
• Challenges with family or friend groups. 

While many of these issues can be addressed through resources like therapy, there are practical things you can do to protect your well-being after being discharged from the hospital. These may include:^[9]

• Keeping regular sleep and wake times.
• Taking medications consistently.
• Eating balanced meals.
• Attending appointments.
• Limiting alcohol or substance use.
• Getting regular movement or exercise.
• Staying socially connected.
• Practicing stress management techniques.

The Role of Family and Loved Ones in Safety Planning After Discharge

While you’re not responsible for someone else’s mental health, we all want the best for those we care about. And family members and loved ones can play a valuable role in creating an after-psychiatric-hospitalization care plan. 

The following are some key points to be mindful of when it comes to supporting someone you care about and preventing relapse after a crisis:

• Be collaborative: Work with your loved one on an effective care plan that suits their needs.
• Consider their triggers: Help them identify what tends to set off their declines in well-being. For instance, you may have more clarity around how certain social groups or situations tend to lead to distressing emotions. 
• Keep a copy of their personalized safety plan: You can also help them review and update this plan accordingly.
• Be an emergency contact: Remain available to them in the event of an emergency. This might mean ensuring they can access you in “Do Not Disturb” mode by making them an emergency contact. And you can also verbally reassure them that you’ll be available to them. 

While you can do your best to support someone you care about, it’s important to note that caregivers also need support for their own emotional well-being. If you feel like it’s ever “too much” and you’re finding it hard to cope emotionally as a result, it’s a good idea to practice self-care. If you feel the need, you can also reach out to your healthcare provider for a referral to mental health resources.