Guidelines: Responding to Mental Health Crises
People with mental illnesses are vulnerable to repeated clinical and life crises that can have profound effects on the individual, families, and communities.
“These crises are not the inevitable consequences of mental disability,” said Paolo del Vecchio, M.S.W., Associate Director for Consumer Affairs at SAMHSA’s Center for Mental Health Services. “Rather, they represent the combined impact of additional factors, such as lack of access to essential services and supports, poverty, unstable housing, coexisting substance use, other health problems, discrimination, and victimization.”
A new resource from SAMHSA, Practice Guidelines: Core Elements for Responding to Mental Health Crises, defines appropriate responses to mental health crises.
Developed by a diverse expert panel that includes individuals with and without serious mental illnesses, the crisis guidelines promote two essential goals:
- Ensure that standards consistent with recovery and resilience guide mental health crisis interventions.
- Replace today’s largely reactive and cyclical approach to mental health crises with one that works toward reducing the likelihood of future emergencies and that produces better outcomes.
Situations involving mental health crises may include intense feelings of personal distress (anxiety, depression, anger, panic, or hopelessness), obvious changes in functioning (neglect of personal hygiene), or catastrophic life events.
Individuals experiencing mental health crises may encounter an array of people who try to intervene and help, including family members, peers, health care personnel, police, advocates, clergy, educators, and others.
Several principles are key to ensuring that crisis intervention practices are enacted appropriately.
- Access to supports and services is timely, allowing for 24/7 availability and a capacity for outreach when an individual cannot come to a traditional service site.
- Services are provided in the least restrictive manner, which avoids the use of coercion, but also preserves the individual’s connectedness with his or her world.
- Peer support is available, affording opportunities for contact with others whose personal experiences with mental health crises allow them to convey a sense of hopefulness.
- Adequate time is spent with the individual in crisis.
- Plans are strengths-based, which helps to affirm the individual’s role as an active partner in the resolution of the crisis by marshalling his or her capabilities.
- Emergency interventions consider the context of the individual’s overall plan of services.
- Crisis services are provided by individuals with appropriate training.
- Individuals in a self-defined crisis are not turned away.
- Interveners have a comprehensive understanding of the crisis.
- Helping the individual to regain a sense of control is a priority.
- Services are congruent with the culture, gender, race, age, sexual orientation, health literacy, and communication needs of the individual being served.
- Rights are respected.
- Services are trauma-informed.
- Recurring crises signal problems in assessment or care.
- Meaningful measures are taken to reduce the likelihood of future emergencies.
Download Practice Guidelines: Core Elements in Responding to Mental Health Crises.