Perhaps the most important challenge for any community behavioral health clinic is to diagnose and treat acute mental health crises. These are situations that are more intense and upsetting for people than usual. Our staff and therapists go through extensive training to understand mental health emergencies and provide the compassionate care that patients experiencing a crisis need.
It’s not an easy task but with a little bit of education, anyone can spot the warning signs and help others (or yourself) receive proper treatment in an emergency.
Defining a Mental Health Crisis
According to the National Alliance on Mental Illness (NAMI), a mental health crisis is “any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community”.
Anyone can experience a mental health crisis. They can even occur in people without a diagnosed mental health condition. So, it’s important for everyone in a community to be on the lookout for friends, family, and acquaintances who need help.
We use the words “mental health crisis” and “mental health emergency” interchangeably to refer to any of these situations. You may also hear them referred to as a “mental breakdown”, a “nervous breakdown”, or other similar terms. The important thing to note is that if a person’s behavior is causing them to be a danger to themselves or others, they need immediate help.
Recognizing the Signs
Just like the people experiencing them, every crisis presents itself differently. Crises may develop over time or occur rather suddenly. Warning signs can be difficult to spot or even nonexistent.
To the person experiencing the crisis, the feeling may be totally overwhelming. They may feel that they’re losing control. They may have difficulty finding ways to handle these feelings. In this state, it is difficult to identify their own options for getting help. And their inability to cope can make it difficult to reach out on their own. Before this level of crisis develops, early intervention can make a world of difference.
According to the American Psychological Association (APA), the most common indication is “a clear and abrupt change in behavior”. If someone is acting very differently from normal, they may be struggling with their mental health.
Common Behaviors of a Person in Crisis
Here are some common signs that a person is experiencing a mental health crisis:
- Dramatic changes in personality, mood, and/or behavior
- Drug or alcohol use
- Inability to perform daily tasks (getting out of bed, brushing teeth, bathing, etc.)
- Rapid mood swings
- Self-harm or self-medicating
- Psychosis (experiencing hallucinations or delusions)
- Increased agitation, abusive or violent behavior
- Thoughts or talk of suicide
This is not a comprehensive list, and a person in crisis may present different or multiple warning signs at once.
Understanding the Causes
Mental health emergencies have a lot of potential causes. The most obvious causes are sudden, life-changing events such as a natural disaster, the loss of a loved one, or a traumatic experience. However, behavior changes often develop gradually over time.
It’s possible that the person experiencing the emergency has an underlying mental health condition, but that’s not always the case. We all have different ways of coping with stressors, and we all have different thresholds before we feel that we are in crisis. It’s possible for anyone to become overwhelmed when faced with a novel or difficult situation.
Common stressors include:
- Relationship changes
- Loss of loved ones
- Trauma or exposure to violence
- Job loss or academic struggles
- Natural disasters, terrorism
- Drug or alcohol use
- Changing or stopping mental health treatment
What to Do
Observe and Assess
Responding to a mental health crisis can be stressful. The first thing to do is determine the seriousness and immediacy of the situation. The crisis may bring out more extreme feelings and actions in a person. As well, the person experiencing a crisis may exhibit unpredictable and even violent behavior.
NAMI recommends asking yourself these questions to determine where to start:
- Is the person in danger of hurting themselves, others, or property?
- Do you need emergency assistance?
- Do you have time to start with a phone call for guidance and support from a mental health professional?
Helping a person to reduce their intense feelings or behaviors is key. The person experiencing a mental health crisis may not be able to clearly communicate their thoughts to you. It’s important to empathize with their feelings, stay calm, and try to de-escalate the situation.
De-escalation techniques include:
- Speaking in a calm voice
- Listening to what the person has to say
- Expressing support and concern
- Moving slowly
- Avoiding prolonged eye contact
- Avoiding physical contact without permission
- Calmly announcing actions before initiating them
- Providing the person space so they don’t feel trapped
If you’re unable to de-escalate or fully resolve the crisis yourself, you’ll need to reach out for help. Mental health professionals like those at our Walk-In Crisis Clinic are specially trained to assess situations like these and determine the appropriate level of crisis intervention.
If the situation is life-threatening or if serious property damage is occurring, you shouldn’t hesitate to call 911. You should do your best to fully explain the nature of the emergency: tell them that someone is experiencing a mental health crisis, let them know if weapons are involved, explain your relationship to the person in crisis, and any other important details. It’s also beneficial to ask if they’re able to send someone specifically trained in mental health such as a Crisis Intervention Training (CIT) officer.
If you don’t believe there is immediate danger, it’s helpful to call a psychiatrist, therapist, case manager, or another professional who is familiar with the person’s history for advice. They may be able to help talk them down, schedule an appointment, and/or get them admitted to the hospital if necessary.
You can’t be prepared for everything. If you feel unsafe for any reason, leave immediately. Once you are safe and secure, call emergency services and provide the detailed information they will need to help.
Your safety comes first. Remember, a person in crisis may not be in control of or aware of their own actions. Removing yourself from the situation may be the best thing for you and them. It’s easier to care for others when we’ve taken care of ourselves first.
A safe and healthy community is one where people look after each other. If you or someone you know is struggling with mental health, we’re here to help.