What Causes a Crisis?

A mental health crisis can occur for many different reasons. By definition, we often do not know when a crisis may occur, and we might not be able to wait for a regularly-scheduled therapy appointment or standard business hours to address it.

Stressful and Traumatic Events May Lead to Crisis

When a person experiences a highly-stressful or traumatic event, they can go into crisis afterward because they cannot process what happened independently. Crisis intervention can help determine what they need to do to ensure their immediate safety, de-escalate their feelings, and make a plan for appropriate resources and ongoing treatment.

If someone experienced a traumatic event a long time ago, they can still go into crisis if they are triggered in the present moment. Crisis intervention can help them return to the present moment, process the trigger, and manage their symptoms until they can connect with their treatment team.

People with various mental health diagnoses, including mood disorders, psychotic disorders, or substance use disorders might experience a sudden, acute increase in their symptoms. They can benefit from crisis intervention to ensure immediate safety, utilize appropriate coping skills, and connect with ongoing treatment options.

Someone who experiences suicidal ideation can experience a crisis if they feel that they might act on these thoughts. Crisis intervention addresses any specific triggers for these thoughts and manages the individual’s safety.

How Crisis Intervention Works

Effective crisis intervention involves connecting to the person in crisis and talking them through specific steps to ensure their immediate safety as well as make appropriate plans for future care.

Many crisis resources utilize a six-step model developed by Dr. Richard James. This model includes the following six steps:

1. Define The Problem. In this stage, the responder establishes a connection with the person in crisis and helps them articulate their crisis as well as what caused it, using active listening and empathy.
2. Ensure Client Safety. This includes making sure that the client is in a safe place and is not at risk for immediate harm, both self-inflicted and abuse by another person.
3. Provide Support. Once the client is physically safe and the responder understands the nature of the problem, the responder helps determine appropriate options for both immediate and long-term support.
4. Examine Alternatives. The responder encourages the client to explore options for people who care for and want to help them, coping skills they can use at the moment, and appropriate re-frames or new ways of looking at the problem.
5. Make Plans. In this stage, the client and responder develop specific plans for how to implement the chosen alternatives, focusing on realistic and manageable steps that the client can take.
6. Obtain Commitment. Finally, the responder helps the client commit to these steps. This includes putting the plan in writing so that the client knows what they need to do and can remember what helped them during the crisis.