Crisis Interventions In Mental Health Treatment

Your mental health describes your emotional, psychological, and social well-being. It is your internal state, influencing how you think, feel, and behave and how well you are able to cope with the challenges of day-to-day life. 

Unfortunately, many people in the United States live with poor mental health on a daily basis, with more than 20% of U.S. adults experiencing some form of mental illness each year and more than 4% living with a serious mental illness (SMI) like schizophrenia, bipolar disorder, major depression, PTSD, and others, according to the Centers for Disease Control and Prevention (CDC). These factors make it much more likely that a person may experience a mental health crisis or mental health emergency. However, mental health crises and emergencies can happen to anyone with little warning, even those who have never had a history of mental health problems in the past. 

When a situation does occur, mental health crisis intervention services are available to help, providing care and support to stabilize people and guide them towards long-term remission and recovery. 

What Is A Mental Health Crisis?

A mental health crisis, as defined by the National Alliance on Mental Illness (NAMI), is a situation in which a person’s mental health is severely compromised, putting them at risk of hurting themselves or others and being unable to function in normal life or take care of themselves or their dependents. Mental health crises are also sometimes referred to as mental breakdowns or nervous breakdowns in everyday speech, or as acute mental illness. 

A mental health crisis may be triggered by a variety of different experiences, often including sudden or prolonged personal stress, trauma or loss, relationship problems, physical health problems, medication problems, and other life challenges. Whatever the case, a mental health crisis is a medical emergency, and providing early and effective care is crucial to protect the person experiencing the crisis and to help them recover.

What Is A Mental Health Emergency?

A mental health emergency is similar to a mental health crisis, and the two terms are often used interchangeably. However, “mental health emergency” is often used in more urgently life-threatening situations, especially those in which the person experiencing a mental health crisis may be at risk of harming themselves or others. 

Mental Health Crisis Interventions

Mental health crisis interventions provide medical, psychological, emotional, and social treatments to people experiencing an acute mental illness. Depending on the situation, people may receive treatment after voluntarily admitting themselves to a hospital or mental health treatment facility, or after being involuntarily committed or placed in an emergency hold due to extreme symptoms like psychosis, violent behavior, or suicidal activity.

While receiving treatment in an inpatient setting, clients receiving mental health crisis intervention will be provided with a variety of different forms of care, including the following.

Evaluation And Diagnosis

It can be challenging for even trained mental health professionals to understand exactly what symptoms a person is experiencing and their root cause. This makes it extremely important that all people experiencing a mental health crisis be provided with an initial psychiatric evaluation and physical workup, giving treatment staff a clear understanding of the client’s condition and the diagnosis (including co-occurring conditions) underlying their symptoms. 

Medications

A wide variety of different medications may be used during the initial stabilization process or prescribed to clients to help manage a specific mental health condition on a long-term basis. Examples include anti-anxiety medications, antipsychotics, antidepressants, and others. 

1-On-1 Psychotherapy

Several different types of talk therapy may be used to help people experiencing a mental health crisis, including cognitive behavioral psychotherapy (CBT), dialectical behavior therapy (DBT), psychological first aid (PFA), and interpersonal therapy. In these sessions, clients work closely with trained mental health professionals, forging a relationship and talking through what they are thinking and feeling, the circumstances that led them to experience a mental health crisis, and specific ways that they can plan on managing their mental health in the future. 

Psychoeducation

Psychoeducational sessions focus on giving clients information about their mental health diagnosis and the symptoms and prognosis that come with it, as well as their future treatment options and recommendations. These sessions can help equip individuals who have experienced a mental health crisis to better understand their situation and make informed choices about their care in the future.

Treatment Planning/Discharge Planning

Crisis intervention services are rapid, short-term services. After a patient is initially stabilized, treatment staff will work with them to develop a personalized treatment plan in order to provide long-term support and recovery suited to their specific needs. This includes a discharge plan and referrals to inpatient or outpatient mental health treatment, substance abuse treatment programs, or other medical services. 

Self-Help And Peer Support Groups

Many crisis response services make an effort to connect people who have experienced a mental health crisis to others who have gone through similar experiences. These sessions, which can be one-on-one, group-based, or involve spouses or entire families, can be comforting and highly informative. 

Types Of Treatment Professionals Involved In Crisis Intervention

Many different types of healthcare providers may be involved in mental health crisis response, including:

• psychiatrists
• psychologists
• psychiatric nurse practitioners
• physician assistants
• registered nurses (RN)
• therapists (e.g., psychologists, licensed clinical social workers, licensed professional counselors, and marriage and family therapists)
• social workers
• assistants and technicians
• nutritionists
• case managers
• occupational therapists

Through flexible, multidisciplinary teams, hospitals and other treatment providers are better able to address the diverse physical, mental, and social factors contributing to the client’s mental illness and provide personalized care.  

Common Risk Factors & Triggers For Mental Health Crises

While anyone can experience a mental health crisis, regardless of their mental health history, there are a variety of different factors that make it more likely that a crisis will eventually occur. These contributing factors can include:

• genetic predisposition revealed through a family history of mental instability
• relationship problems (e.g., estrangement, affairs, divorce, breakups, etc.)
• unexpected death of a loved one
• loneliness and isolation
• trauma, such as that brought on by violence, abuse, victimization, discrimination, racial injustice, etc.
• physical health problems (e.g., disability, chronic pain, terminal illness, etc.)
• work or school stress and burnout
• recent job loss
• financial insecurity, poverty, and homelessness
• drug or alcohol abuse
• using or skipping medications (e.g., switching medications, changing dosages, loss of effectiveness, etc.)

A variety of protective factors are also known to help reduce the likelihood that a person will experience a mental health crisis, even in the face of serious life challenges and stressors. These factors include having a healthy support system, well-developed problem-solving and coping skills, good physical health, and a strong personal and cultural identity. 

However, experiencing a period of poor mental health should never be seen as a moral failure or personal weakness. 

How To Recognize And Respond To A Mental Health Crisis

It can sometimes be difficult to recognize when someone is experiencing a mental health crisis and even harder to know how to respond. The American Psychiatric Association (APA) recommends watching for the following warning signs of mental illness, especially in those you know well:

• changes in sleep, appetite, and personal self-care
• mood changes, especially dramatic emotional shifts, depression, and irritability
• social withdrawal 
• unusual problems functioning or performing familiar tasks
• unusual problems with thinking, concentration, memory, or speech
• increased sensitivity to sights, sounds, smells, or touch
• apathy and lack of interest in activities
• feelings of disconnection from oneself or one’s surroundings
• illogical or “magical” thinking and belief
• feelings of nervousness or paranoia
• uncharacteristic or peculiar behaviors
• changes in performance at school or work and problems with one’s relationships
• engaging in self-harm
• thinking or talking about dying or suicide

If you notice these signs in a loved one, talk to them and share your concerns. Use specific examples and encourage them to share their own perspective and to be seen by a doctor or a mental health professional, especially if you think they may be at risk of escalating issues. 

The earlier you talk to someone about your concerns and the earlier they get help, the better the outcome is likely to be. Let the person know that they are loved and that you want the best for them, which means having a healthy mental and emotional state. 

When Should You Call Emergency Services?

There are situations in which emergency services are required to get your loved one the help that they need. For instance, you should call 911 or 988, the Suicide and Crisis Lifeline, if someone around you is:

• out of touch with reality (psychosis)
• harming or threatening to harm themselves or others
• damaging property
• an active suicide threat
• injured (including self-injury)
• severely intoxicated or overdosed
• unable to care for themselves

Mental health crises are sometimes life-threatening situations, and it is best to err on the side of caution. Once you are connected with a trained response professional over the phone, they will provide further instructions and send help to your location as needed or recommend local treatment options. This may include transferring the person experiencing the mental health crisis to a stabilization facility. 

What Comes After Crisis Intervention?

Mental health crisis interventions are designed to be short-term services that stabilize clients and prepare them to participate in other forms of mental health treatment. Depending on the client’s condition, this means that they may transition from inpatient stabilization to a variety of other settings or even back home. 

Common follow-up treatments recommended after mental health crisis stabilization programs include the following.

Inpatient Psychiatric Units

Often compared to intensive care units (ICUs), inpatient psychiatric units are places where people with severe mental illnesses are provided with treatment in a highly secure hospital environment with a variety of different restrictions put in place for their own safety. These restrictions may include locked doors and strict rules pertaining to clothing, gifts, visitors, and the use of electronics. 

While often viewed in a negative light in popular media, inpatient psychiatric care provides the most intensive level of care for those experiencing severe mental health issues and is an important part of mental health treatment in the U.S. 

Short-Term Residential Mental Health Treatment

Short-term residential/inpatient mental health programs provide clients with a secure, structured environment and 24/7 care and support. This intensive treatment environment can be ideal for laying the foundation for lasting recovery, helping clients to make as much progress as possible in a short period of time. 

Also referred to as community crisis stabilization (CCS) in some areas, short-term residential programs are often used as a step-down treatment option after a mental health crisis, giving clients access to experienced mental health professionals, in-depth psychotherapy, peer support meetings, medication management, and much more. 

Outpatient Therapy

Outpatient mental health treatment is less-intensive and more flexible than other treatment services, making it best for clients who are medically and psychologically stable but may need ongoing, long-term care and support. 

Treatment may be provided in either a one-on-one or group setting and include counseling, various forms of therapy, peer support, and more. 

Community Support Services

People may also be referred to mental health support groups like AA or NA, NAMI Connection and NAMI Family Support groups, and social services provided by local county and nonprofit organizations. Community-based resources may also be available to help address financial barriers, transportation needs, housing needs, language or translation needs, and more.

Residential Mental Health Treatment At ORC

If you or someone close to you has recently experienced a mental health crisis, it can be hard to know who to trust or where to go for a treatment program that fits. At Ohio Recovery Center, you will find highly qualified and compassionate mental health professionals serving at a peaceful, forested 50-acre campus, providing the perfect setting for long-term healing and recovery. 

Our welcoming, short-term residential treatment program in northwest Ohio provides client-centered mental health services for Ohioans and people across the U.S.

Personalized treatment plans may include:

• psychoeducation
• psychotherapy
• medication management
• daily living skills training
• wellness activities
• family involvement
• dual diagnosis care for co-occurring substance use disorders
• aftercare coordination

Our treatment programs are available for people facing mental health disorders including anxiety disorders, ADHD, bipolar disorder, borderline personality disorder, depression, OCD, PTSD, schizophrenia, and more. If you have any questions or would like to learn more, please reach out today.