A study of 'crisis cards' in a community psychiatric service

Objective: 'Crisis cards' state patients' treatment details and preferences in anticipation of a later occasion when the patient might be too ill to e xpress them directly. We assessed the feasibility of introducing 'crisis ca rds', or a collaborative form of them, 'joint crisis plans', into a sectori zed community psychiatric service. Method: All patients with a psychosis and at high risk of crisis were invit ed to participate. Follow-up examined patients' satisfaction and how the ca rds were used. Results: In total, 106 eligible patients were identified and offered a card , and 40% agreed to participate. Patients with an affective psychosis, past suicide attempts and less frequent admissions were over-represented among these who agreed to take part. Patients chose to include a wide range of in formation. For participants, admissions fell by 30% in the follow-up year. Conclusion: Crisis cards serve both a 'manifest', practical function (to pr ovide important information when the patient is too ill to do so) and a 'la tent' psychological one (positive effects on the patient's attitude to self , their illness and treatment, and their relationship with the clinical tea m).