13 Tips to De-Escalate a Mental Health Crisis

Jun. 25, 2019
Friend comforting another in a time of crisis

13 Ways a MET Team Officer (And You!) Can De-Escalate a Mental Health Crisis

MET Team Deputy Miranda and Tina Webb, a licensed LCSW from the Department of Mental Health, imparted the techniques they use when de-escalating a mental health crisis. It can be incredibly bewildering, confusing, and terrifying for an individual at first, and you don’t know what’s going to happen next.

Here are their main points.

1.   Be a jack of all trades, master of none.

When engaging in a high-risk, high-uncertainty situation, it’s important to think on your toes and outside of the box. You need to be able to hold a conversation about different topics with different people, to follow the conversation where they take it and stay engaged.

2.   Engage them in conversation. Be persistent.

Try to positively redirect their thought process and become their ally. “The longer you keep someone engaged, the more rapport you build. When I see them start to go silent, I know that I’ve lost them.”  

3.   Adapt and adjust your game plan as you go.

“You’re always changing your approach based on what’s going on,” Miranda said. For example, in the case of a relationship break-up, he said he often tries to boost their ego and bring out their good qualities. If for example, they start talking about their bad financial situation, Miranda says to redirect the conversation and talk about a sport they like.

4.   Identify and avoid triggers.

While the situation is constantly changing, your goal is to create calm and get their mind off of whatever is pushing them over the edge. Try to find out what that trigger is and direct the conversation to something else more positive, ambivalent, or distracting.

5.   Talk to everyone around them to get a full picture.

Webb said that friends and family members can share important info that the client may not express. “We also assess their background and previous mental hospitalizations,” said Webb.

 6.   Use active listening.

It’s so important to give a person going through the crisis a safe space to express themselves and let them know they’re being heard.

Repeat back what they say, and don’t add anything.

- Webb.

7.   Don’t take anything personally.

People may swear, curse, or insult you. It’s important to recognize that they have their own reasons for how they feel, and you know you’re there to help.

8.   Be sincere.

“People in crisis can sense a canned script instantly. It’s important to let them know that you actually care. If someone tells me I’m faking it, I say, ‘Hey, I chose to be here, because I want to help people. I want to know what I can do for you,’ ” said Miranda. 

9.   Empower them by giving them choices.

It helps add to a sense of urgency and hope if you can offer more choices than jumping.

10.  Never say, “I understand what you’re going through.”

Instead say, “I see you’re going through a rough time.”

Everyone has their own story and way of coping with tough situations. Unless you’ve gone through the same exact struggle, trying to suggest that you got through it de-legitimizes their struggle and their experience. People feel more heard and recognized if you simply acknowledge their words and feelings.

11.  Connect clients to those with similar backgrounds.

At the same time, it helps if the person helping you is similar to you. Both Miranda and Johnson spoke of the culture of respect between veterans that civilians don’t always understand.

Veterans respond better if you’re also a veteran. If you don’t know the lingo, then you’ve lost them.

- Miranda

12. Don’t give in to their commands.

Your job is to somehow coax them off the ledge, so you need to try and be in control of the situation. “We can talk and go around in circles all day, but the more we talk on that bridge, the more time they have to convince themselves to jump,” - Miranda. 

13. Practice Self-Care.

People who have worked with people in crisis know that they have to make a conscious effort to engage in self-care and separate their work and personal life as much as they can. 
“Eventually you just have to actively engage in self-care and you get better at blocking it out when you need to,” - Webb.
“I don’t take my work home with me. I have fun,” - Miranda. Playing games, watching sports, and taking regular trips is a regular part of his relaxed life outside of work. 

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