Crisis Prevention Interventions
Crisis Prevention Interventions
Everyone experiences problems or emergencies now and then. Typical life stressors can cause temporary setbacks, but most times individuals and their families can find a resolution and overcome their problems. In some instances, however, problems may arise that are well beyond a person’s ability to cope using their existing support system. In these cases, the individual’s situation is considered a mental health crisis, and the external assistance obtained is called a crisis prevention intervention.
What is a Mental Health Crisis?
Most people think of crises in terms of an emergency event, like a heart attack or a natural disaster. However, a mental health emergency can also be a crisis. A mental health crisis is an overwhelming event — like a mental breakdown, violence, or the loss of a loved one— that a person or family cannot manage on their own.
These situations can develop after any stressful event. Sometimes, they may occur after prolonged drug use or because of a psychiatric condition. Other times, however, the cause of a mental health crisis might remain unknown. (1)
Although an individual might try their best to deal with a crisis on their own, outside help in the form of a crisis prevention intervention becomes necessary. A mental health crisis reduces a person’s ability to respond appropriately, preventing them from utilizing their coping skills to manage the situation. (2)
Signs of a Mental Health Crisis
The following are common signs that indicate a person is in a mental health crisis:(1)
- The inability to perform daily tasks like bathing, brushing teeth, brushing hair, changing clothes.
- Irritability, violent outbursts, property destruction, and bouts of extreme agitation.
- Harmful injurious actions against the self or others, including cutting or self-mutilation.
- Isolation from friends and family members.
- Extreme mood swings and rapid energy changes.
- Loss of touch with reality, paranoia, or delusions. Hearing or seeing things that are not there.
- Inability to articulate themselves well or get their thoughts communicated.
When a person is in a mental health crisis, they may potentially injure themselves or others. Although they may not intend to hurt others, their inability to think clearly can increase the risk of harm, which is why crisis intervention is necessary for these situations. (2)(3)
Crisis Intervention and Addiction
According to the Agency for Healthcare Research and Quality (AHRQ), emergency rooms have experienced a 41% increase since 2006 in visits from people with either a mental or substance abuse disorder (4). People with either a mental or substance abuse disorder now account for about 16% of all emergency room visits. (4)
Because mental health conditions and substance abuse disorders are often interrelated, many mental health crises have substance abuse or addiction component. Additionally, addiction can lead to drug overdoses, which can cause permanent injury or even death. In many cases, an addiction necessitates a crisis intervention. Unfortunately, friends and family members might be hesitant to seek help due to the stigma that surrounds addiction. (5)
Crisis prevention interventions are typically performed by professionals. However, friends and family can also familiarize themselves with crisis prevention intervention models and receive training. The following are some examples of crisis intervention models.
The Seven Stage Crisis Intervention Model
To find a resolution to a crisis, mental health and substance abuse professionals use the Seven Stage Crisis Intervention Model. The seven stages are as follows: (6)
- Develop and execute a thorough crisis assessment.
- Establish a rapport with the person.
- Identify the most significant problems and, if possible, what precipitated the crisis.
- Encourage the exploration of emotions and feelings.
- Create and investigate alternatives.
- Restore a person’s ability to function.
- Follow-up and provide support.
When initiating a crisis intervention, the first and most important step is to assess safety. A mental health crisis may impair a person’s judgment and heighten emotions, making them more likely to harm themselves or others. Deciding regarding how safe a person is allowed professionals to make decisions regarding how to progress and offer intervention.
The focus of the SAFER-R Model is to enable the individual to return to their way of life before the crisis occurred. The stages for the SAFE-R Model include: (7)
- Stabilize the individual.
- Acknowledge their situation and their concerns.
- Facilitate understanding between you and the individuals.
- Encourage adaptive and healthy coping skills.
- Restore functioning to their previous levels, or better.
- Refer the individual to support systems that can ensure their safety.
The 10 Stages of Acute Traumatic Stress Management (ATSM)
The 10 Stages of ATSM include: (8)
- Assess the person for dangerousness, both to themselves and to others.
- Consider how they would go about hurting themselves or others.
- Assess how open and responsive they are towards an intervention.
- Assess and address any medical needs they may have.
- Make observations and identify their problems.
- Connect and establish a rapport with the person.
- Provide a safe space for the person to calm down.
- Provide support and reassurance.
- Normalize the experience to help the person feel less isolated.
- Prepare the person for a healthy life in the future.
Although the Seven Stage Crisis Intervention Model and the 10 Stages of Acute Traumatic Stress Management have differences, the approach and core principles are the same. First and foremost, assess the safety and — if unsafe — take measures to ensure that safety is established. Then foster a rapport and assess their medical and psychological needs. Provide assistance and support, giving them enough skills to move towards the future.
Crisis Prevention Training
Crisis prevention intervention (CPI) training allows professionals to intervene non-violently in crisis situations. Although there are many types of CPI training available, they all incorporate the same principles of the three intervention models previously listed.
Along with the CPI intervention models, trainees learn nonverbal and verbal techniques to defuse tension. Rather than relying on violence as a first response, CPI encourages others to use non-coercive and lesser restrictive methods. The goal is to stabilize the individual, remove them from the crisis, and move them forward towards healing.
One major CPI training program available at the Crisis Prevention Institute. (9) This world-renowned program provides education on how to intervene in behavioral and mental health crises. CPI certification is available for professionals and caregivers. For those interested in training others, CPI training and CPI certification as a trainer are offered. Most importantly, giving people a safe space to decompress and ensure their well-being is vital to CPI.