When Someone you Support is in an Acute Psychiatric Crisis
When Someone you Support is in an Acute Psychiatric Crisis
As mentioned above, an acute psychiatric crisis is very serious and is different from a situational struggle. When we discuss an acute psychiatric crisis, we are talking about a situation when someone is behaving in a way that seems out of their control. If we know them, this behaviour might seem out of character for them. When someone is in a state like this, they most likely need professional support. Some types of behaviours you might see in an acute psychiatric crisis are:
- Acute psychosis; hearing voices, hallucinations, delusions. These symptoms can be normal for some people, for example someone with schizophrenia. It’s a crisis if their behaviour is elevated, and they can’t be calmed down with the usual things that support them
- Suicidal with a plan
- Exhibiting volatile behaviour
- Extreme out of control panic
The way we support someone depends on their unique situation and experience. Sometimes, a crisis can be experienced as persistent, lower intensity and spanning several months or even years in length. At other times, a crisis can be experienced as immediate, intense, and sometimes episodic (occasional and irregular) in nature. This is what we mean by an acute crisis. An acute crisis may present itself as a very intense, one-time, or a possibly aggressive, or violent situation.
In this section, we look at how you can support someone you’re working with when they experience an acute crisis. This can include many different types of situations.
The following are some potential acute crisis situations:
- Psychosis
- Panic attack
- Potential overdose
- Delusional state because of alcohol withdrawal
- Physical health crisis
- Re-traumatization
- Suicidal ideation, a plan, or is in process (we will cover this further on in the module)
- Severe depressive episode
- Episode of mania
If there is a way to avoid intervention from law enforcement, that is ideal, as not all officers are trained in mental health best practices. An altercation with law enforcement can cause trauma for someone in an acute psychiatric crisis. However, there might be times when calling 911 is the only option. If that is the case, the immediate safety of the person and everyone around them must be considered.
Each of the situations listed will require a different approach. Being prepared for anything is important. Have a phone close-by. Naloxone training is essential.
A Note About a Non-Acute Crisis
We mentioned that the word crisis means different things to different people. It is also a term that can be used often in casual conversation. This can add to potential misunderstandings of what the word crisis means within a mental health context.
For example, though the following situation is certainly stressful, and definitely a crisis of sorts, it is not an acute psychiatric crisis: “I had a huge crisis the other day when I spilled water on my laptop and lost the whole paper I was working on. I had to start fro