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Psychiatric Crisis

WHAT TO DO

*Disclaimer: This is a guide, not professional advice*

When a mental health crisis occurs, friends and family are often caught off-guard, unprepared and unsure of what to do. The behaviors of a person experiencing a crisis can be unpredictable and can change dramatically without warning.
If you’re worried that you or your loved one is in crisis or nearing a crisis, seek help. Make sure to assess the immediacy of the situation to help determine where to start or who to call.

  •  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?

A person experiencing a mental health crisis can’t always clearly communicate their thoughts, feelings, needs or emotions. They may also find it difficult to understand what others are saying. It’s important to empathize and connect with the person’s feelings, stay calm and try to de-escalate the crisis. If the following suggestions don’t help, seek outside assistance and resources.

Techniques that May Help De-escalate a Crisis:

  1. Keep your voice calm
  2. Avoid overreacting
  3. Listen to the person
  4. Express support and concern
  5. Avoid continuous eye contact
  6. Ask how you can help
  7. Keep stimulation level low
  8. Move slowly Offer options instead of trying to take control
  9. Avoid touching the person unless you ask permission 
  10. Be patient 
  11. Gently announce actions before initiating them
  12. Give them space, don’t make them feel trapped 
  13. Don’t make judgmental comments
  14. Don’t argue or try to reason with the person

If you can’t de-escalate the crisis yourself, you can seek additional help from mental health professionals who can assess the situation and determine the level of crisis intervention required. If you don’t believe there is an immediate danger, call a psychiatrist, clinic nurse, therapist, case manager or family physician that is familiar with the person’s history. This professional can help assess the situation and offer advice including obtaining an appointment or admitting the person to the hospital. If you can’t reach someone and the situation is worsening, consider calling your county mental health crisis unit, crisis response team or other similar contacts. If the situation is life-threatening or if serious property damage is occurring, don’t hesitate to call 911 and ask for immediate assistance.

When you call 911, tell them someone is experiencing a mental health crisis and explain the nature of the emergency, your relationship to the person in crisis and whether there are weapons involved. Ask the 911 operator to send someone trained to work with people with mental illnesses such as a Crisis Intervention Training officer, CIT for short. CIT officers are specially trained to recognize and de-escalate situations involving people who have a mental illness. They recognize that people with mental illnesses sometimes need a specialized response, and are familiar with the community-based mental health resources they can use in a crisis. You can always ask for a CIT officer when you call 911, although they are not available in all areas. 

When providing information about a person in a mental health crisis, be very specific about the behaviors you are observing. Describe what’s been going on lately and right now, not what happened a year ago. Be brief and to the point. For example, instead of saying “My sister is behaving strangely,” you might say, “My sister hasn’t slept in three days, hasn’t eaten anything in over five days and she believes that someone is talking to her through the television.” Report any active psychotic behavior, significant changes in behaviors (such as not leaving the house, not taking showers), threats to other people and increases in manic behaviors or agitation, (such as pacing, irritability). Once you call 911, there are two entities that may become involved—medical/first responders and law enforcement. You need to be prepared for both.

Medical Response/Emergency Department
If the situation can’t be resolved on site or it’s recommended by first responders or law enforcement, taking your loved one to the emergency department may be the best option. Be aware that if they are transported in a law
enforcement vehicle, usual policy is to use handcuffs. This can be upsetting for everyone involved, but may be the only option you have at the time. You may also be allowed to transport them in your vehicle, or they may be transported via ambulance. Remember, once first responders arrive, you are not in control of these decisions. The most important thing is to get to a medical facility for
evaluation and treatment as soon as possible.

A visit to the emergency department doesn’t guarantee admission. Admission criteria vary and depend on medical necessity as determined by a physician and insurance coverage. Be prepared for an emergency department visit
to be lengthy, likely several hours. Bring anything that may help the person who is in crisis stay calm, like books, music, games, etc. Some hospitals have separate psychiatric emergency units. They’re
typically quieter and are staffed by mental health professionals and practitioners. Make sure to bring any relevant medical information, including the names and doses of any medications and your crisis kit, if you have one.

Law Enforcement Response
When the law enforcement officer arrives, provide them with as much relevant and concise information about the person as you can:

  • Diagnosis
  • Medications
  • Hospitalization history
  • Previous history of violence, suicide attempts or criminal charges

If the person has no history of violent acts, be sure to point this out. Share the facts efficiently and objectively, and let the officer decide the course of action. Remember that once 911 has been called and officers arrive on the scene, you don’t control the situation. Depending on the officers involved, and your community, they may actually take the person to jail instead of an emergency room. Law enforcement officers have broad discretion in deciding when to issue a warning, make an arrest or refer for evaluation and treatment. You can request and encourage the officers to view the situation as a mental health crisis. Be clear about what you want to have happen without disrespecting the officer’s authority. But remember, once 911 is called and law enforcement officers arrive, they determine if a possible crime has occurred, and they have the power to arrest and take a person into custody. Law enforcement can, and often will, call mental health resources in your community. Nearby supports and services may assist in deciding what options are available and appropriate. If you disagree with the officers don’t argue or interfere.

Once law enforcement has left, call a friend, mental health professional or advocate—like NAMI—for support and information. And if your loved one is not admitted to treatment and the situation worsens, don’t be afraid to call for help again. The situation can be reassessed and your loved one may meet the criteria for hospital admission later, even though they initially did not.

Family Reactions
Feelings, reactions, and responses to mental health emergencies vary from family to family and person to person within each family. Family members may feel:

  • Confusion and disorientation
  • Isolation, distancing or denial
  • Extreme fatigue
  • Guilt based on based on the mistaken assumption that the “parents are to blame”
  • Fear for the safety of the individual, the family, and society 

Remember to:

  1. Remain calm
  2. Explain that your loved one is having a mental health crisis and is not a criminal
  3. Ask for a Crisis Intervention Team (CIT) officer, if available

They will ask:

  1. Your name
  2. The person’s name, age, description
  3. The person’s current location
  4. Whether the person has access to a weapon

Information you may need to communicate:

  1. Mental health history, diagnosis(es)
  2. Medications, current/discontinued
  3. Suicide attempts, current threats
  4. Prior violence, current threats
  5. Drug use
  6. Contributing factors (i.e. current stressors)
  7. What has helped in the past
  8. Any delusions, hallucinations, loss of touch with reality

Tips for While You Wait for Help to Arrive:

  1. If you don’t feel safe at any time, leave the location immediately.
  2. If you feel safe staying with your loved one until help arrives:
  • Announce all of your actions in advance
  • Use short sentences
  • Be comfortable with silence
  • Allow your loved one to pace/move freely
  • Offer options (for example “do you want the lights off?)
  • Reduce stimulation from TV, bright lights, loud noises, etc.
  • Don’t disagree with the person’s experience 

This information is from Navigating a Mental Health Crisis: A NAMI resource guide for those experiencing a mental health emergency. If you would like to read the whole publication, you can find it here: Navigating A Mental Health Crisis.

IF YOU FEEL SUICIDAL, CALL 911 OR 1-800-273-TALK 1-800-273-8255
National Suicide Prevention Lifeline

Voluntary Treatment

Rosecrance Mulberry Center: Triage and Short-term Crisis 

605 Mulberry St.  Rockford, IL (N.W. CORNER)
Plenty of parking ~ Map and Directions –   Click here
Call ahead if possible 815-720-4960

Triage services are available to adults 18 years and older. Open from Noon – 11:00 p.m. 7 days a week. The Rosecrance Mulberry Center combines two current, closely linked programs – Triage and Short-term Crisis Residential – under one roof. The Triage Program and the Crisis Residential Unit are closely linked programs that are logically and efficiently offered under one roof. These programs are designed to provide an immediate response to individuals experiencing a psychiatric crisis. The goal of both programs is to avoid unnecessary hospitalization or incarceration of individuals in crisis by providing rapid assessment, stabilization and referral to the appropriate level of care. While many Triage clients go home with follow-up services at the Rosecrance Ware Center and others are referred for hospitalization, many are seamlessly moved to a short-term placement in the Rosecrance Crisis Residential Unit.

 


Non-Voluntary require you to go to the hospital Emergency Departments.

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NAMI Northern Illinois is dedicated to improving the quality of life of individuals with mental illness and their families through Support, Education and Advocacy.

 

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