Crisis Intervention for Mental Health Conditions: Principles, Practice, and Resources

Crisis Intervention

Crisis intervention is a short-term (usually single-session) technique used to address an immediate mental health emergency, stabilize the individual in crisis, and create and implement a safe, appropriate plan for next steps and future treatment (Caplan, 1964; Roberts, 1990). Crisis intervention can be used to help people who are experiencing a wide range of mental health problems, including suicidal ideation or attempts, self-harm, psychosis, mania, severe depression, anxiety attacks, and post-traumatic stress disorder (PTSD). It can also be used to help people who are coping with difficult life events, such as the death of a loved one, a divorce or breakup, a job loss, a natural disaster, or a traumatic experience.

Caplan’s four stages of a crisis reaction:

Four stages of a crisis reaction (Caplan, 1961):

1. Initial rise in tension: The person experiences a sudden increase in tension in response to a stressful event.
2. Disruption of daily living: The increased tension disrupts the person’s ability to function normally in their daily life.
3. Depression: If the tension remains unresolved, the person may experience depression.
4. Psychological breakdown: If the person is unable to resolve the crisis, they may experience a psychological breakdown.

It is important to note that not everyone who experiences a crisis will go through all four stages. Some people may be able to resolve the crisis at an earlier stage, while others may need more support.

Principles of Crisis Intervention

The principles of crisis intervention are based on the following assumptions (Caplan, 1964):

• A crisis is a time of opportunity for change and growth.
• People in crisis have the resources to cope and recover.
• Crisis intervention should be focused on the present moment and on the individual’s immediate needs.
• Crisis intervention should be collaborative, with the individual and the crisis worker working together to develop a plan for recovery.

Practice of Crisis Intervention

The practice of crisis intervention typically involves the following steps (Roberts, 1990):

1. Assessment: The crisis worker will assess the individual’s current situation, including their level of risk, their mental state, and their support system. This assessment will help the crisis worker determine how to best help the individual and develop a safety plan.
2. Stabilization: The crisis worker will help the individual to calm down and feel safe. This may involve using techniques such as relaxation exercises, grounding, and active listening.
3. Problem-solving: The crisis worker and the individual will work together to identify the problems that are contributing to the crisis and to develop a plan to address them. This plan may include referrals to other services, such as mental health treatment, substance abuse treatment, or housing assistance.
4. Follow-up: The crisis worker will follow up with the individual to ensure that they are staying safe and that they are connected to the resources they need.

Crisis intervention is a collaborative process. The crisis worker and the individual in crisis work together to assess the situation, develop a safety plan, address the underlying problems, and ensure that the individual is connected to the resources they need.

Crisis Intervention for Specific Mental Health Conditions

Crisis intervention can be tailored to the specific needs of individuals with different mental health conditions. For example, crisis intervention for suicidal individuals may focus on assessing suicide risk, developing a safety plan, and connecting the individual to mental health treatment (Stanley et al., 2020). Crisis intervention for individuals with psychosis may focus on helping the individual manage their symptoms and stay safe.

Crisis Intervention in Different Settings

Crisis intervention can be provided in a variety of settings, including mental health hospitals, crisis hotlines, community mental health centers, emergency rooms, schools, workplaces, and homes. The specific setting where crisis intervention is provided will depend on the individual’s needs and the resources available.

Outcomes of Crisis Intervention

Crisis intervention can have a number of positive outcomes, including reduced risk of suicide or self-harm, improved mental health symptoms, increased coping skills, reduced distress, and improved quality of life (World Health Organization, 2019).

The following are some additional positive outcomes of crisis intervention:

• Increased sense of hope and empowerment
• Improved relationships with family and friends
• Increased ability to function in daily life
• Reduced risk of re-hospitalization
• Improved overall quality of life

It is important to note that crisis intervention is not a cure for mental illness. However, it can be a valuable tool for helping people to manage their symptoms, cope with difficult life events, and develop coping skills.

When to seek crisis intervention

If you are experiencing a mental health crisis, or if you know someone who is, it is important to seek help immediately. Crisis intervention can be provided by a variety of professionals, including mental health counselors, social workers, psychologists, and psychiatrists.

There are also a number of crisis hotlines and websites that can provide support and resources.

In India, you can reach out to several crisis hotlines and helplines for different types of emergencies:

1. National Suicide Prevention Lifeline (Vandrevala Foundation): You can call 91-22-2772 6770 / 91-22-2772 6771 for help with suicidal thoughts or emotional distress.
2. Roshni: This helpline provides emotional support in multiple languages. You can call 91-40-6620 2000 between 11 a.m. and 9 p.m. IST.
3. iCall: A helpline run by the Tata Institute of Social Sciences (TISS) for emotional support. Call 022-2556-3291 between Monday to Saturday, from 8 Aa.m.to 10 PM.
4. Snehi: A helpline specifically for children and adolescents. Call 91-22-2772 6775 / 91-22-2772 6776 between 8 a.m. and 8 p.m.

For international crisis hotlines, consider these options:

1. International Suicide Prevention Hotlines: Websites like suicide.org provide a list of crisis hotlines worldwide. You can find a helpline that’s specific to your country or region.
2. Befrienders Worldwide: They offer emotional support through a network of helplines worldwide. Visit their website to find a helpline in your country.
3. International Crisis Helplines: In emergencies, you can also reach out to organizations like the Samaritans (116 123 in the UK and Ireland) or the National Suicide Prevention Lifeline (1-800-273-TALK(8255)) in the United States.
4. Crisis Text Line: Text HOME to 741741
5. The Trevor Project: 1-866-488-7386 (24/7 Crisis Support Services for LGBTQ Young People)
6. National Domestic Violence Hotline: 1-800-799-SAFE (7233)
7. National Sexual Assault Hotline: 1-800-656-HOPE (4673)

Please remember that if you or someone you know is in immediate danger or experiencing a life-threatening crisis, it’s essential to call emergency services in your country for immediate assistance.

Conclusion

Crisis intervention is an important part of mental health care. It can help people survive a crisis, recover from their symptoms, and return to their normal lives. If you or someone you know is in crisis, please reach out for help. There are people who care and want to help.

References

• Caplan, G. (1961). An approach to community mental health. New York: Grune & Stratton.
• Caplan, G. (1964). Principles of preventive psychiatry. New York: Basic Books.
• Roberts, A. R. (1990). Crisis intervention handbook. New York: Oxford University Press.
• Stanley, B., Brown, G. K., & Van Orden, K. (2020). Clinical practice guidelines for suicide prevention. American Psychologist, 75(2), 103.: https://zerosuicide.edc.org/resources/resource-database/american-psychiatric-association-practice-guideline-assessment-and
• World Health Organization. (2019). Mental Health: A State of Global Mind.: https://www.who.int/publications-detail-redirect/9789240049338

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