How To Support People Who Are In A Mental Health Crisis

December 7, 2021

FIRST of all… Take a deep breath, breathe in, breathe out. Ground yourself, and prepare to listen carefully. I want to share with you a few helpful practices on “How To Support People Who Are In a Mental Health Crisis” from my years of experience of being a Health/Patient Advocate whose practice includes Mental Health, Substance Abuse, and Crisis Management as well as Medical issues.


Who 

Suppose you are a Health or Patient Advocate, part of a support system, or find yourself in a situation where someone you know is experiencing a mental health crisis, this article will help you de-escalate the crisis, get the individual to appropriate resources, and identify some do’s and don’ts when managing the situation during and after the fact.


Let’s start by defining what is a “mental health crisis?”

PsychiatricTimes describes a mental health crisis as “a situation in which a person’s thoughts, emotions, and behaviors can put them in jeopardy of harming themselves or others and/or put them at risk of being unable to care for themselves or access food, clothing, and shelter. Crises also include acute conditions that could quickly deteriorate into dangerousness or inability to care for self, even if those issues do not currently pose a problem. A mental health crisis can surface anywhere—in public, in the home or work environment, or in any number of clinical settings.”


With this being said, for someone who is not having a mental health crisis and is dealing with the individual in crisis, this type of situation can be overwhelming, but you can still help. I have outlined some suggested steps and approaches that you can adopt to take action, de-escalate the crisis, and get the individual the appropriate help as quickly as possible:

  • Use active listening skills – repeat back what the person says without adding additional information. This helps to confirm your understanding of the situation as that individual has expressed it and provides feedback that the individual has been heard.


  • Identify who has the mental health crisis…the person you are speaking with, or another individual. If you are on the phone, try to get call-back numbers in case you are disconnected, but don’t be pushy about it. Sometimes the caller may be very anxious about what is happening with someone else so it may take a little bit to figure out who is having the actual crisis.


  • Use a very calm voice…it is extremely important to remain calm. If you need to, breathe in slowly to a count of 4 and out to a count of 6 multiple times to help calm yourself.


  • Do not be judgmental. Make sure the person feels heard by using phrases like “It sounds like things have been tough for you,” but don’t say “I understand” because that may set the person off…you couldn’t possibly understand exactly what that person is  going through.


  • Do NOT try to solve the problem yourself. Instead, use positive, helpful statements like “I want to try to help you. Let me see if I can get [this organization] on the line and see if they might be able to help you”…or give them contact names and phone numbers if they won’t allow you to do a 3-way call.


  • If you can, try to ascertain if the individual is considering suicide, is in danger of hurting themselves or others. There are differing opinions on whether to involve the authorities, but at this point, I would because  it is unlikely that you are equipped to help someone who is suicidal. Try to get a location if you can. If you have the phone number, that is a start. Contact 911 and let them know. They can triangulate the number and get the appropriate authorities involved. Often those authorities are already familiar with this individual.


  • Remember, do the best you can and leave your own predisposed thoughts and feelings at the door. Do NOT make assumptions unless you have the training to do so.


Self-care

As an advocate or support system, it is crucial to take care of yourself first, or to borrow a phrase, “Put your own oxygen mask on first.” Self-care, defined in more ways than one, is essential to sustainably care for or support someone else and have a sense of clarity when dealing with an overwhelming, intense situation. 


Who | Where

I am here to reassure you that you are not alone, and resources have developed within the last few years to provide the appropriate care for someone with a mental health crisis. 


For example, CAHOOTS (Crisis Assistance Helping Out On The Streets), is a mobile crisis intervention program taking on social service calls for crisis counseling. CAHOOTS was first developed in Eugene, OR and similar programs based on its model have now been rolled out in several other locations around the country. In those locations where it is offered, this program is an excellent resource to be familiar with that “often provide[s] initial contact and transport for people who are intoxicated, mentally ill, or disoriented, as well as transport for necessary non-emergency medical care.” Each van is staffed with a medic (nurse or EMT) and an experienced crisis worker. An interesting stat is that CAHOOTS in Eugene diverts 5-8% of calls from Police as they are qualified and equipped with the knowledge to get the individual the care they need. 


Other great models which exist as resources in some communities include Crisis Intervention Team (CIT) Programs, Assertive Community Treatment (ACT) teams, EmPATH emergency room setups, and the Living Room model


The Living Room model and EmPATH are a couple of examples of where you can take someone who is having a mental health crisis instead of bringing them to a typical hospital emergency room where they will be unlikely to receive care oriented towards those with mental health issues. In fact, a typical ER setting often exacerbates mental health situations. SMI Adviser, A Clinical Support System for Serious Mental Illness, explains that the “Living Rooms embrace the Recovery Model and offer people experiencing mental health crises a calm and safe environment. The community outpatient centers are open 24 hours a day, 7 days a week, and people receive care immediately.”


Do’s and Don’ts

Above, I mention some suggested steps and approaches when dealing with someone in a mental health crisis. Below you can find a few more:

Do’s

  • Have a plan from the beginning
  • Set reasonable expectations upfront
  • Name your needs and boundaries clearly
  • Practice rigorous self-care
  • Kindly step back when you need to

Don’ts

  • Make decisions without their consent
  • Blame or shame
  • Personalize their behavior
  • Wait until your resentment builds up
  • Ghost, ignore or avoid them
  • Overreact 


Consult With a Professional

I hope you found this information and the suggested practices helpful on “How To Support People Who Are In a Mental Health Crisis.” It is critical to know that you are not alone, and consulting with a professional like myself or through the resources I have provided will hopefully give you the support and direction you need. 


Be well during this holiday season!

-Lee

Sources
https://www.huffingtonpost.ca/entry/deescalate-mental-health-crisis-tips_ca_5ef67d60c5b6ca97090fa2b1

https://www.crisisprevention.com/Blog/CPI-s-Top-10-De-Escalation-Tips-Revisited

http://www.ceicmh.org/component/docman/doc_view/452-de-escalation-skills?Itemid=144

https://www.psychiatrictimes.com/view/understanding-crisis-services-what-they-are-when-access-them

https://www.psychiatrictimes.com/view/cahoots-model-prehospital-mental-health-crisis-intervention

https://www.healthline.com/health/mental-health/supporting-someone-in-a-mental-health-crisis

https://mhealthfairview.org/blog/minnesotas-first-empath-opens-march-29-at-m-health-fairview-southdale-hospital


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