Publications from ODSW Social Insights: Letters by DSW (Vol 2) | Page 72

Practice Issues

Giving the affected person assurance
While behaviours that represent an imminent danger certainly indicate the
need for a certain level of emergency response, the behaviours presented
may be responses to events that have been accumulating for some time.
Situations involving mental health crises may follow trajectories that include
intense feelings of personal distress (eg. anxiety, depression, anger, panic,
hopelessness), obvious changes in functioning (eg. neglect of personal
hygiene, unusual behaviour) or life events (eg. disruptions in personal
relationships, support systems or living arrangements, loss of autonomy or
personal rights, victimization).
Helping one to regain a sense of control over thoughts, feelings and events
that seem to be spinning out of control may be a priority for an individual
in a mental health crisis or a person who has been abused or neglected.
Staff interventions that occur without opportunities for the individual to
understand what is happening and to make choices among options may
reinforce feelings that control is being further wrested away. The individual’s
resistance to this may be inaccurately regarded as additional evidence of his
or her incapacity to understand the crisis situation.

Training for Crisis Intervention Work
Training for crisis intervention work should include being able to enable a
person to make choices, where reasonable, even when in a crisis situation.
Informed decision-making in this context is not simply a matter of apprising
the individual of the risks and benefits associated with various interventions.
It is also about having an understanding among staff that a sub-optimal
intervention that a person chooses may reinforce personal responsibility,
capability and engagement which can produce an even better outcome.
The choices are not just limited to the use of medication and may include
the individual’s preferences for other approaches that can be used when
crisis assistance is required. The urgency of a situation may also limit the
options available. Post-crisis recovery plans or advance directives developed
by the individual with assistance from crisis experts are important to avoid a
recurrence of a similar crisis.
Services provided should be congruent with the culture, gender, race, age,
health, literacy and communication needs of the individual being served.
Training for crisis intervention work should also include understanding of
how an individual experiences a crisis, how to engage the affected person in
the resolution process and how to work in a culturally sensitive way.
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