Washington\u2019s Health Care Authority<\/a> describes WISe as an intensive, team-based behavioral health service that includes 24\/7 crisis support from people who are familiar with the family\u2019s situation.[1] Every family enrolled in WISe receives a crisis plan developed with the young person and family. When a young person experiences self-harm or suicidal ideation, the team also develops a separate safety plan as needed.<\/span><\/p>\nA crisis plan cannot prevent every hard day. But preparing important information, supports, and strategies ahead of time can give families and their WISe team a clearer starting point when things become difficult.<\/span>\u00a0<\/span><\/p>\nWhat Is a WISe Crisis Plan? How Is It Different From a Safety Plan?<\/span><\/b>\u00a0<\/span><\/h2>\nWashington\u2019s WISe manual uses the combined term \u201cCrisis\/Safety Plan\/Support Plan\u201d for a family-friendly planning document, generally one to two pages, developed with the youth and family.[2] For clarity, this article distinguishes between the two purposes: every WISe family receives a crisis plan, while a separate safety plan is created as needed when self-harm or suicidal ideation requires specific steps to protect the young person.<\/span><\/p>\nThe crisis plan\u2019s purpose is practical: identify potential behavioral health crises and help everyone involved know how to respond. A safety plan, when needed, focuses specifically on reducing risk and maintaining safety when self-harm or suicidal thoughts are present.<\/span><\/p>\nThe plan is meant to include information such as 24\/7 response options, formal and natural supports, back-up care, what tends to lead to a crisis, strategies that have worked before, and the young person\u2019s and family\u2019s strengths.[2]<\/span><\/p>\nThis is different from trying to predict exactly what will happen.<\/span><\/p>\nInstead, the family and team are preparing for situations that are reasonably possible based on what they already know about the young person.<\/span>\u00a0<\/span><\/p>\nStart by Defining What a Crisis Means for Your Family<\/span><\/b>\u00a0<\/span><\/h2>\nNot every family experiences a behavioral health crisis in the same way.<\/span><\/p>\nWashington\u2019s WISe Crisis and Safety Plan form specifically asks for the youth and family\u2019s definition of a crisis.[3]<\/span><\/p>\nThat matters because a crisis is not simply a clinical term on a form.<\/span><\/p>\nFor one young person, a crisis may involve leaving home unexpectedly. For another, it may involve escalating aggression, threats of self-harm, severe emotional dysregulation, or becoming unable to participate safely in everyday routines.<\/span><\/p>\nFamilies can begin by asking:<\/span><\/p>\nWhat does a hard day look like before it becomes a crisis?<\/span><\/p>\nWhat tells us that things are moving beyond what we can manage with our usual strategies?<\/span><\/p>\nBeing specific can help the team build a plan that reflects the young person rather than relying on a generic response.<\/span>\u00a0<\/span><\/p>\nIdentify Warning Signs Before the Situation Escalates<\/span><\/b>\u00a0<\/span><\/h2>\nA crisis may feel sudden, but families often recognize patterns once they have time to think about previous experiences. WISe crisis planning helps families identify these early warning signs so they can respond before a situation escalates.<\/p>\n
The Washington WISe planning form asks families and teams to identify warning signs and triggers across home, school, and community settings.[3]<\/span><\/p>\nYou might think about changes such as:<\/span>\u00a0<\/span><\/p>\n\n- Becoming unusually quiet or withdrawing from others<\/span><\/li>\n
- Escalating arguments or irritability<\/span><\/li>\n
- Difficulty sleeping<\/span><\/li>\n
- Refusing school or other normal activities<\/span><\/li>\n
- Pacing, yelling, or becoming increasingly restless<\/span><\/li>\n
- Talking about feeling hopeless or unsafe<\/span><\/li>\n
- Leaving a supervised area<\/span><\/li>\n
- Changes in behavior that your family recognizes as an early sign of distress<\/span><\/li>\n<\/ul>\n
The warning signs that matter most are the ones that are meaningful for your child.<\/span><\/p>\nThe goal is not to create a long list of every behavior that could possibly occur. It is to identify the signs that tell your family and team, \u201cWe may need to respond differently now.\u201d<\/span>\u00a0<\/span><\/p>\nThink About Triggers and Anticipated Stressors<\/span><\/b>\u00a0<\/span><\/h2>\nThe state WISe form also asks teams to consider anticipated crises and potential events that could lead to one, including situations at home, school, and in the community.[3]<\/span><\/p>\nSome stressors can be anticipated.<\/span><\/p>\nA change in school placement, conflict with a peer, a family transition, a difficult anniversary, a court date, a change in visitation, or another major disruption may increase stress for a young person.<\/span><\/p>\nKnowing that a stressful event is coming does not mean a crisis will happen.<\/span><\/p>\nIt does mean the team can talk ahead of time about additional support, schedule changes, coping strategies, or people who may need to be available.<\/span><\/p>\nPreparation can be especially useful when a family already knows that certain situations have been difficult in the past.<\/span>\u00a0<\/span><\/p>\nWrite Down What Actually Helps<\/span><\/b>\u00a0<\/span><\/h2>\nWhen a young person is escalating, well-intended adults may try many things at once.<\/span><\/p>\nSometimes that makes the situation harder.<\/span><\/p>\nA useful crisis plan identifies strategies that have worked before. Washington\u2019s WISe manual specifically includes successful past strategies as information that should be part of the plan.[2]<\/span><\/p>\nThink beyond formal treatment techniques.<\/span><\/p>\nWhat helps your child feel safer or regain control?<\/span><\/p>\nIt might be:<\/span>\u00a0<\/span><\/p>\n\n- Having fewer people talking at once<\/span><\/li>\n
- Moving to a quieter space<\/span><\/li>\n
- Calling a trusted family member<\/span><\/li>\n
- Taking a walk with a safe adult<\/span><\/li>\n
- Using music, movement, sensory tools, or another familiar coping strategy<\/span><\/li>\n
- Having clear choices instead of open-ended questions<\/span><\/li>\n
- Giving the young person appropriate time and space<\/span><\/li>\n
- Connecting with a WISe team member who already knows the family<\/span><\/li>\n<\/ul>\n
Also consider what tends not to help.<\/span><\/p>\nIf repeated questioning, raised voices, physical proximity, or too many adults entering the situation typically increases distress, that is useful information for the team to know.<\/span><\/p>\nA strong plan is not only about what professionals can do. It captures what the family has already learned about the young person.<\/span>\u00a0<\/span><\/p>\nKnow Who You Can Call<\/span><\/b>\u00a0<\/span><\/h2>\nAn important part of WISe crisis planning is identifying who families can turn to for support before a crisis occurs. Knowing who to contact ahead of time can help families respond more confidently during difficult situations.<\/p>\n
WISe is designed to include both formal supports and natural supports. Washington HCA describes natural supports as trusted people such as family, friends, and community members, while professional team members may include therapists, school staff, and others involved in the young person\u2019s care.[1]<\/span><\/p>\nYour crisis plan can clarify who should be contacted, under what circumstances, and who may be available as a back-up.<\/span><\/p>\nThat may include members of the WISe team as well as trusted people in the young person\u2019s life.<\/span><\/p>\nWashington requires WISe providers to have 24\/7 crisis services available to WISe participants from people who are familiar with the youth\u2019s safety plan, preferably members of the WISe team.[4]<\/span><\/p>\nFamilies should know how to access that support before they need it. Ask your WISe team which number to call after hours and what to expect when you call.<\/span>\u00a0<\/span><\/p>\nKeep Important Information Easy to Find<\/span><\/b>\u00a0<\/span><\/h2>\nDuring a crisis, families should not have to search through emails or paperwork for basic information.<\/span><\/p>\nThe Washington WISe Crisis and Safety Plan form includes medical information such as diagnoses, medications, allergies, primary care information, and psychiatric provider information.[3]<\/span><\/p>\nDepending on your child\u2019s situation, it may be helpful to keep an updated copy of the plan somewhere accessible.<\/span><\/p>\nMake sure the information your team needs is current, especially after medication changes, provider changes, or other significant updates.<\/span><\/p>\nFamilies can also ask who should have a copy of the plan and how updates will be shared with relevant team members.<\/span>\u00a0<\/span><\/p>\nPlan for Home, School, and the Community<\/span><\/b>\u00a0<\/span><\/h2>\nWISe crisis planning considers how a young person’s needs may differ across home, school, and community settings. Preparing for these different environments helps families and their support teams respond more effectively when challenges arise.<\/p>\n
The state crisis-planning form asks teams to think about warning signs, triggers, and anticipated crises across settings such as home, school, and the community.[3]<\/span><\/p>\nThat can help families move beyond a plan that only works in the living room.<\/span><\/p>\nIf a crisis begins at school, who should the school contact?<\/span><\/p>\nIf your child becomes overwhelmed in the community, what helps?<\/span><\/p>\nIf a trusted caregiver is unavailable, who is the back-up?<\/span><\/p>\nThese are useful questions to work through with the Child and Family Team.<\/span><\/p>\nThe answers may change over time, which is why the plan should be treated as a working document rather than something completed once and forgotten.<\/span>\u00a0<\/span><\/p>\nMake Sure Your Child\u2019s Strengths Are in the Plan<\/span><\/b>\u00a0<\/span><\/h2>\nCrisis planning can easily become focused on risk.<\/span><\/p>\nBut WISe intentionally includes strengths.<\/span><\/p>\nThe state WISe manual says the planning document should include strengths alongside triggers, supports, and strategies.[2]<\/span><\/p>\nThat might include your child\u2019s ability to ask for a particular person, willingness to use a coping skill when prompted, connection with a sibling, sense of humor, interest in music or sports, relationship with a teacher, or ability to recognize when they need space.<\/span><\/p>\nStrengths are not included to minimize the seriousness of a crisis.<\/span><\/p>\nThey help the team remember what can be built on when the young person is struggling.<\/span>\u00a0<\/span><\/p>\nTalk About When the Plan Is Not Enough<\/span><\/b>\u00a0<\/span><\/h2>\nA crisis plan should also make it clear when additional help is needed.<\/span><\/p>\nWashington HCA provides 24-hour crisis resources statewide. For a suicide or behavioral health crisis, people can call or text 988. HCA advises calling 911 for a life-threatening emergency.[5]<\/span><\/p>\nFamilies enrolled in WISe should also follow the crisis instructions provided by their WISe team.<\/span><\/p>\nTalk about these thresholds before a hard day.<\/span><\/p>\nAsk the team what situations should prompt a call to WISe crisis support, when other crisis resources may be appropriate, and what the family should do if there is an immediate safety emergency.<\/span><\/p>\nHaving that conversation in advance can reduce uncertainty when quick decisions are needed.<\/span>\u00a0<\/span><\/p>\nReview the Plan After Things Change<\/span><\/b>\u00a0<\/span><\/h2>\nWISe crisis planning is an ongoing process that should reflect the young person’s current needs. As circumstances change, families and their WISe teams should revisit the crisis plan to ensure it remains useful and relevant.<\/p>\n
If a strategy stops working, update it.<\/span><\/p>\nIf a new school staff member becomes an important support, add that information.<\/span><\/p>\nIf medication changes, contact information changes, or the family learns something new after a difficult event, bring it back to the team.<\/span><\/p>\nA hard day can reveal useful information.<\/span><\/p>\nWhat helped the situation settle? What made it worse? Who was available? Was there confusion about whom to call? Did the plan match what the family actually needed?<\/span><\/p>\nThose observations can help the Child and Family Team make the plan more useful for the future.<\/span>\u00a0<\/span><\/p>\nPrepare Before You Need the Plan<\/span><\/b>\u00a0<\/span><\/h2>\nFamilies do not need to wait for a crisis to start thinking through these questions.<\/span><\/p>\nBefore the next difficult day, consider whether you can answer:<\/span>\u00a0<\/span><\/p>\n\n- What does a crisis look like for my child?<\/span><\/li>\n
- What are the early warning signs?<\/span><\/li>\n
- What situations commonly increase stress?<\/span><\/li>\n