A crisis intervention note, or crisis note, records an unplanned contact with a person in a mental health crisis: what set it off, the risk, what you did, where the person went next, and why. Copy the free template, see a phone call that ends in an emergency department visit and a teen who goes home after self-harm, and check what goes in each part.
Blank crisis intervention note template
FreeCRISIS INTERVENTION NOTE Client: [Name, age, pronouns, record number if known] Date: [Date] Times: [First contact, end of contact, and total minutes] Contact type: [Walk-in, phone, text or chat, mobile crisis visit, or unplanned session] Client's location: [Address confirmed at the start, and a callback number for phone, text, or video] Reached us through: [Self, family, friend, school, police, another clinician, or a crisis line] Others involved: [Name, relationship, and what each person did during the contact] Known to the service: [Current clinician, diagnosis, medications, and last contact, or new] Clinician: [Name, credentials, role] PRECIPITATING EVENT What happened: [The event behind the crisis, and when] Why now: [What made the client or others reach out today] Client's account: [A short quote] Collateral: [What family, friends, police, or records added, with consent or the reason for going ahead without it] PRESENTATION Appearance and behavior: [Dress, grooming, eye contact, agitation, cooperation; for a call, voice and pauses] Mood and affect: [Mood in the client's words; affect observed or heard] Thought and perception: [Process, hopelessness, guilt, voices, beliefs about death] Orientation and judgment: [Alert, oriented, able to take part in decisions] Intoxication: [Substance, amount, last use, and whether a full assessment is possible now] Injuries and medical needs: [Wounds, overdose, or illness, and how each was handled] RISK ASSESSMENT Suicide: [Thoughts, method, intent, plan, preparation, visits to the site, past attempts; screener and result, such as the C-SSRS] Self-harm: [Method, how often, most recent episode, and intent in the client's words] Harm to others: [Thoughts, threats, a named person, access to weapons] Self-neglect: [Eating, sleep, medications, shelter, ability to care for self] Lethal means: [Firearms asked about directly; medications at home; the method in any plan] Dependents and safety at home: [Children or others in the client's care; violence or abuse] PROTECTIVE FACTORS Reasons for living: [In the client's words] People available now: [Who can be with the client tonight, and whether they were reached] Engagement: [How the client took part, and their willingness to accept help] How much they hold: [Whether these factors are lowering the risk right now] INTERVENTIONS De-escalation: [What you did to lower distress and slow things down, and the effect] Safety planning: [Safety plan written, reviewed, or left for the next service, and where the client's copy is] Lethal means counseling: [What was agreed for each means, who will do it, and how it will be confirmed] Supports contacted: [Who was called, with consent, and what they agreed to do] Crisis contacts given: [988 by call or text, local crisis team, 911, nearest emergency department] Consultation: [Supervisor, psychiatrist, or on-call clinician, and their advice] DISPOSITION Decision: [Home with a safety plan and follow-up, crisis stabilization, voluntary emergency assessment, or involuntary emergency assessment under the law where you practice] Reasoning: [The facts that made this the safest option, and what would change it] Client's view: [Agreed, agreed with reservations, or declined, in the client's words] Transport and handoff: [How and with whom the client left, and the report given to the receiving team] If the plan fails: [What you would do if the client declined, left, or the contact dropped] CONSENT AND WHO WAS TOLD Shared with consent: [Who, what, and why] Shared without consent: [Who, what, and the legal or policy basis, or none] Young person or dependent: [Parent or guardian told, what was shared, and the young person's view] Kept private: [Anything the client asked to keep private, and whether it was kept] FOLLOW-UP Next contact: [Date and time, within a set number of hours, who makes it, and how] If no contact: [Who reaches out next, when, and the step after that] Tasks and plan changes: [Records, referrals, or messages to send, each with a due time; treatment plan, safety plan, or level of care updates] Signed: [Name, credentials, date and time]
Use it for
Each one follows the template. Use them to judge how much detail every part needs.
Community mental health clinic, same-day phone line, 49 minutes
Phone call to the clinic’s same-day line, 4:42 to 5:31 p.m. 27-year-old man, known to the clinic: intake 3 weeks ago for depression, PHQ-9 18 at intake, on the waitlist for therapy. Started an antidepressant from his family doctor 5 weeks ago. Called himself. Confirmed at the start: at his apartment, alone, with his cell number for a callback. His friend Marcus joined on a second line at 5:02 p.m., with consent, and arrived at the apartment at 5:16 p.m.
His partner of 6 years ended the relationship 2 weeks ago and moved out. This afternoon she came back with her brother for the last of her things and left her key. He has been alone in the apartment since, drinking. Why now: “There’s nothing left here. I’ve been looking at the bridge on my phone. Part of me wants someone to stop me.” No collateral before the call; Marcus later confirmed he has barely left the apartment in a week.
By phone. Voice flat and slow, with long pauses; cried at times. Speech clear, not slurred. Mood “empty”; affect, as far as could be heard, flat. Thought process logical; content hopeless, sees no future without her, “I wrecked it.” Denies hearing voices. Knew the date, the time, and his address. Alcohol: 3 beers since 2 p.m., the last about 30 minutes before the call; no drugs. Not intoxicated enough to stop the assessment, but tonight’s drinking lowers his restraint. Has not eaten since morning. No injuries.
Suicide: thoughts of killing himself several times a day since the breakup, nearly constant since this afternoon. Plan: to jump from the Harbor Street bridge, a 10-minute drive away. Last night he drove there, parked, and sat for 20 minutes thinking about jumping, then drove home. Looked up the height of the bridge today. Intent: “If I’m on my own tonight, I think I’ll do it.” No note or goodbyes. No past attempts or self-harm. C-SSRS screener: high risk, with active thoughts, a method, intent, a plan, and suicidal behavior last night. Harm to others: no thoughts of hurting his ex-partner, her brother, or anyone else; no threats. Self-neglect: off work for 2 days, barely eating. Firearms: asked directly; none at home and none he could get. Medications: his antidepressant, about 3 weeks’ supply, and ibuprofen. Main means: his car and the bridge. No children or others in his care; one dog.
His dog, Juno. His older sister, who he is close to. Marcus, who answered on the first ring. He called for help himself and says part of him wants to live. These matter to him, but tonight they are not lowering his intent.
Stayed on the line throughout. Slowed the pace, reflected the loss, and told him that calling took courage. Asked him to pour the rest of the beer down the sink; he did. Lethal means: he agreed not to drive tonight and to give his car keys to Marcus. With his consent, called Marcus on a second line; Marcus agreed to come over, drive him to the emergency department, and stay with him there. Went over his reasons for living. A full safety plan was left for the emergency team or his first clinic visit, since he was going for emergency assessment. Gave 988 by call or text, and 911. Messaged the on-call psychiatrist at 5:05 p.m. while he stayed on the line; she agreed he needs an emergency assessment tonight.
Voluntary emergency department assessment tonight at St. Luke’s Hospital, 12 minutes away. Reasoning: active thoughts with a specific, lethal plan, stated intent for tonight, a visit to the bridge last night, an acute loss today, alcohol, and being alone. His protective factors are not holding tonight, so home with a safety plan and a next-day call is not safe enough. Options discussed: an ambulance, or Marcus driving him. He chose Marcus. Agreed because Marcus arrived within 15 minutes, holds the car keys, will drive straight there and stay, and will call 911 if he refuses or tries to leave on the way. Gave a verbal report to the emergency department charge nurse at 5:24 p.m. In his words: “Okay. I don’t want to be alone tonight.” If he had declined, the plan was to stay on the line and call 911 for an emergency assessment under the local mental health law.
With his consent, Marcus was told he is having thoughts of suicide and needs an emergency assessment tonight, and the charge nurse was given the risk details and the clinic’s number. He asked that his sister not be told tonight; respected, since Marcus is with him. Internal message to his intake clinician and the clinic psychiatrist. Nothing shared without consent.
6:30 p.m.: call the emergency department to confirm he arrived. If he hasn’t, call Marcus, then 911 for a welfare check at the apartment. Next business day by noon: call him, or the inpatient unit if he is admitted. Taken off the waitlist: first therapy appointment within 7 days of his emergency department discharge, booked by the clinic. At that visit, write or review his safety plan and check his means steps, including the car keys.
Youth crisis walk-in service, with a parent, 85 minutes
Walk-in to the youth crisis service, 6:10 to 7:35 p.m. 15-year-old girl in grade 10, brought by her father after he found cuts on her arm at dinner. Not known to the service; no past mental health care. Seen alone for the first 40 minutes, then with her father. The clinic nurse checked her wounds.
At dinner her father saw blood on her sleeve and found fresh cuts on her left forearm. She has cut her forearm and thighs with a blade taken from a pencil sharpener about twice a week for 6 weeks, most recently this afternoon. It began after her friend group removed her from their group chat and posted an edited photo mocking her. In her words: “It’s the only thing that makes the noise in my head stop.” Her father adds: more time in her room, grades down from Bs to Cs, and she quit volleyball practice 3 weeks ago.
Sleeves pulled over her hands; little eye contact at first, more by the end. Speech quiet, normal rate. Mood “numb”; affect constricted, tearful about the photo. Thought process logical; content self-critical, “I’m the problem”; no hallucinations. Alert and oriented. Denies alcohol, cannabis, and other drugs. Injuries, by the nurse: 5 superficial straight cuts on the left forearm, 2 to 4 cm, edges together, no gaping, no signs of infection; older healed marks on both thighs. Cleaned and dressed; no stitches needed. Tetanus up to date, per her father.
Self-harm: about twice a week for 6 weeks, to relieve distress, not to die; today’s cuts were the most in one day. Suicide: a wish to be dead a few times in the past month, last 4 days ago after she saw the photo again; no thoughts of killing herself, and no method, intent, plan, or preparation. No past attempts. C-SSRS screener: low risk, with a wish to be dead and no suicidal behavior; the cutting was confirmed as without intent to die. PHQ-A 14. Harm to others: none. Self-neglect: eating less, sleeping 5 to 6 hours. Lethal means: no firearms at home, her father confirmed; his prescription medications and over-the-counter painkillers in an unlocked bathroom cabinet; razors in the bathroom; 2 more sharpener blades in her desk. Safety at home: feels safe with her father; her parents are separated, and she stays with her mother every second weekend.
Close to her father and her grandmother. Her dog. Wants to go to volleyball camp in July. Told the truth about the cutting, and took part in her safety plan. Her father is calm, believes her, and can be home with her tonight and tomorrow. These are holding: they lower her risk now.
At the start, alone with her, explained what stays private and what her father must know if her safety is at risk. Validated how much it hurts to be shut out. Asked about the cutting plainly and without judgment, including what it does for her. Practiced two ways through an urge: holding ice, and 5 minutes of hard exercise. Wrote a safety plan with her, in her words, on the service’s form: her grandmother and her cousin as people to text, and 988 by text, which she said she would use before a call. Lethal means counseling with her and her father: all medications, including over-the-counter, into a lockbox tonight with her father holding the key; razors and sharpener blades out of the house; she will hand over the 2 blades in her desk when they get home. Wound care shown to both. Discussed with the on-call psychiatrist, who agreed with the plan.
Home with her father tonight, with a safety plan, means locked up or removed, and an appointment tomorrow. Reasoning: self-harm without suicidal intent; a passive wish to be dead, with no thoughts of acting on it, no plan, preparation, or past attempts; and wounds that needed no stitches. To watch: more frequent cutting, depressive symptoms, exclusion by peers, and 6 weeks of hiding it. She engaged, made her own plan, and rated herself 7 out of 10 likely to use it; her father can supervise and has agreed to the means steps. An emergency assessment isn’t needed tonight. That would change with thoughts of killing herself, a plan, a cut that needs stitches, or if she couldn’t agree to the plan: then the emergency department or 911. In her words: “I don’t want Dad watching me all the time, but okay.”
She agreed that her father is told about the cutting, her safety plan, and the means steps. She asked that the photo not be described to him; he was told only that friends had shut her out online, and the details stayed private. With her agreement, her father will tell her mother tonight, so medications and blades are locked away at her mother’s home before the next weekend visit. School not contacted; to discuss with her at tomorrow’s appointment.
Tomorrow at 4 p.m. with the service’s youth therapist, in person; her father will bring her, and the nurse will check the wounds. If they haven’t arrived by 4:30 p.m., the service calls her father. Tonight: her father calls 988 or takes her to the emergency department if she talks about suicide, or if she cuts again and the wound gapes or bleeds through the dressing. She keeps her safety plan on her phone; her father has the contacts and the means steps.
When the contact began and ended, how it reached you, and where the client was.
Avoid: Leaving the location unconfirmed on a call. If the line drops or the risk rises, you need to know where to send help.
What set off the crisis, and why the client or someone else reached out today rather than last week.
Avoid: “Client in crisis.” Name the event: a partner moving out today, cuts found at dinner, an eviction notice. The trigger often shapes the plan.
How the client was during the contact: a brief mental status, focused on what bears on risk and on the decision.
Avoid: Writing up a phone call as if you saw the client. Say what you heard, and what you couldn’t judge.
Risk in every direction, not only suicide: self-harm, harm to others, self-neglect, intoxication, and anyone in the client’s care.
Avoid: Stopping at a denial of suicidal thoughts. A client in crisis over a partner can still be at risk of hurting that partner, or of not eating for days.
What may hold the client back, and an honest view of whether it is holding now.
Avoid: Listing supports as if they settle the question. A sister the client loves may not lower intent tonight; say so.
What you did during the contact, in order, so the next clinician knows what has been tried and agreed.
Avoid: “Crisis counseling provided.” Name each step, so a colleague sees what is in place.
Where the client went next, and why. This is the heart of the note: the decision, the reasoning, and the backup plan.
Avoid: “Discharged home with safety plan” and no reasons. Write why home was safe enough, or why it wasn’t.
What was shared, with whom, and on what basis. Crisis contacts often bring in family, friends, and other services within minutes.
Avoid: Telling a parent or friend more than they need. Agree with the client on what is shared, and record it.
The next contact, set to a time, and who acts if it doesn’t happen.
Avoid: “Follow up next week.” The days after a crisis carry the most risk. Book the contact before the client leaves.
“Sent home with a safety plan” tells the next clinician what happened, not why. Write the facts that made home safe enough, or the emergency department necessary, and what would have changed the decision.
Write down what you would have done if the client declined, left, or hung up, and what you did if it happened. It shows the decision was thought through.
Ask about intent and record the answer in the client’s words. Self-harm without intent to die is not an attempt, but it still raises later risk and needs a plan.
A breakup, an eviction, or a night of drinking can bring risk to others, or self-neglect, as well as suicide. Ask about each, and about children or others in the client’s care.
“Will follow up” is not a time. Name the hour, who calls, and what happens if no one answers.
Vero Scribe writes the crisis intervention note in your template from your dictation after the contact, or from the session itself, with the client’s consent. You review and edit every section, including the disposition and its reasons, then copy it into your record or export it to Word or PDF. Vero works in 60+ languages.
Record when and how the contact began, and where the client was. Name the event behind the crisis, describe how the client presented, and assess risk to self and others, self-neglect, and intoxication. List what you did, then the disposition with its reasons and a backup plan, who was told, and a follow-up time. Write it the same day.
Contact details and the client’s location, the precipitating event, a brief mental status, a risk assessment covering suicide, self-harm, harm to others, and self-neglect, access to lethal means, protective factors, your interventions, the disposition and why, consent and who was told, and the next contact with a time.
A progress note records a planned session against treatment goals. A suicide risk assessment is a full, structured look at suicide risk. A crisis note records an unplanned contact from start to finish: the trigger, a risk check that covers self-harm, harm to others, and self-neglect as well as suicide, what you did, and the disposition decision.
When the client goes home, yes: write or review it before they leave, and give them a copy. When they go to an emergency department or a stabilization unit, the plan is often written there or at the first follow-up; record who will write it and when. A no-suicide contract is no substitute.
Yes. Copy it, or download it as a Word or text file. No account needed.
One psychotherapy session: focus, interventions, client response, risk, and progress toward goals.
A CBT session in its own order: mood check, agenda, homework review, thought or exposure work, new homework, and feedback.
An EMDR session by phase: target, negative and positive cognitions, SUD and VOC, bilateral sets, closure, and reevaluation.
Data, Assessment, Plan: the three-part session note, with the line between facts and judgment made clear.
Goal, Intervention, Response, Plan: a progress note that opens with the treatment plan goal.
What each question covers, the risk levels, and how to record the result.
Notes drafted from your sessions or dictation, for you to review.
Note drafts and care plans from your conversations, for you to review.
Notes, documents, and follow-up in one workspace.
Vero writes your notes and letters in the templates you choose, so you review instead of type.
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