2020-winter-recognizing-a-person-in-crisis

Recognizing and Responding to a Person in Crisis

When working in the mental health field, it is not uncommon to interact with an individual in a crisis state.  For those who do not work in the mental health field, it is also likely at some point, you may come across someone in your personal life who is struggling to cope with the stressors […]

When working in the mental health field, it is not uncommon to interact with an individual in a crisis state.  For those who do not work in the mental health field, it is also likely at some point, you may come across someone in your personal life who is struggling to cope with the stressors of everyday life.  When these stressors become unmanageable, a person could go into a crisis state.  So, what is a crisis state?  A crisis state is defined as a temporary state of disorganization, characterized by an individual’s inability to cope with internal or external stressors using common methods of problem-solving.  There are 3 stages of the cycle to achieve a crisis state: the emotional trigger, the escalation, and the crisis state.  A person begins the crisis cycle by first being exposed to an emotional trigger.  The death of a loved one, a divorce, or losing one’s job are all some common examples of emotional triggers that we see in everyday life that may be very difficult for someone to cope with.  When an individual is unable to cope with these emotional triggers, the situation begins to escalate.

Some common reasons an emotional trigger can escalate into a crisis are because the individual may not understand “why” the trigger is happening to them; they may misperceive a situation, have not yet developed healthy coping skills, or are easily overwhelmed.  What does this escalation stage look like in terms of a person’s behavior?  They may become loud or threatening, refuse to cooperate, defiant, aggressive, withdrawn/run away, and talk about self-harm or suicide.  There are not only behavioral signs that a person is in the escalation stage of a crisis cycle but also physical warning signs as well.  These physical changes may include dilated pupils and direct stares, clenched fists and muscle constriction, flushed and angry appearance, invasion of other’s personal space, and rapid, deep breathing.  These are all warning signs that an individual is entering a crisis state and will need either intervention or professional support.  Once the trigger has occurred, and the emotional response escalates to the inability to manage that trigger effectively, the crisis state is realized.   

How do we respond to a person who is now in a crisis state? 

There are both physical and behavioral ways that we can respond to a person in crisis in the hopes to deescalate the situation.  In terms of your physical response, first, begin by using a calm and soothing voice.  Manage your volume not further to escalate the situation.  Use a relaxed and open body posture to appear non-threatening. Maintain soft gestures and facial expressions.  Finally, keep a safe distance from the person to not endanger yourself.  Behaviorally, we want to attempt to verbally deescalate the individual to prevent any physical harm to them or anyone else present.  Use empathy statements to validate the feelings of the individual.  Reflect on the emotion that you hear.  Use encouraging and soothing words.  Don’t lead with the rules or consequences of the individual’s behavior.  Also, do not use critical language or express your own negative emotions.

In summary, whether you are a professional in the mental health field or just a normal person in everyday life, you will most likely encounter a person in a crisis state at some point.  The number one priority is to maintain the safety of everyone involved, including the individual in crisis.  If you find yourself in such a situation and the above suggestions are not useful in deescalating the individual please, reach out to the authorities or dial 911.  We always want everyone to remain safe in a crisis situation.

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