A few weeks ago I received a call from a distraught mother, concerned about her 43-year-old son with bipolar disorder. He was in the manic phase of his bipolar disorder and displaying worrisome behavior. The last time she called emergency services, the police tasered him in her home, arrested him and dragged him away in handcuffs. It was a horrendous ordeal for both of them – one that she hoped never to repeat. The one good thing that came of it is that her son received the treatment he needed and resumed his life as a successful working professional.
During this latest crisis, the mother asked if there was an alternative to calling 911 which would hopefully not end with Tasers, handcuffs and arrest. After determining that he was not a risk to himself or others, I told her about the availability of skilled crisis intervention services in her community and offered some tips on how to use them.
Crisis intervention services, offer a form of intensive, short-term help for the purpose of stabilizing or preventing a mental health crisis or potentially dangerous mental health condition, episode or behavior. Many communities have a “Crisis Team” staffed by professionals trained to respond to crises and perform screening, triage, assessment, and counselling to stabilize or prevent a crisis situation. Sometimes these services are provided by phone or in a health care setting, but many towns and cities have mobile teams that to go outbound into the community, private homes and places of business. Crisis teams often work together with police and EMS, and can often arrange for a person’s transfer to an Emergency Department or inpatient unit, with or without his or her consent, depending on the situation.
During my 25 years with Laurel House in Stamford, CT, I had many opportunities to engage crisis services on behalf of clients. In the process I developed the following list of practices and tips for making the most effective use of those services.
Tips for Using Crisis Services
- Seek voluntary participation in treatment – research shows that voluntary treatment helps preserve self-respect and dignity, preserves family ties, and leads to better recovery outcomes.
- Write a crisis intervention plan – do this before an actual crisis occurs and include in the plan a written record of: current diagnosis; history of hospitalizations and other treatments; current medications and dosages; copies of service plans, assessments, including school IEPs and 504 plans; names and contact information for all mental health professionals and agencies working with the person; insurance information; a list of warning signs or triggers for the person, preferred treatment strategies and choices, coping mechanisms and strategies for managing behaviors.
- Enlist supporters – identify and recruit extended family members, friends or neighbors who can help out in a crisis by reinforcing messaging to the person in crisis, help make sure everyone is safe and other family members such as younger siblings are looked after, and provide a break for primary caregivers.
- Call ahead to reserve a bed – you may be able to avoid long wait times in uncomfortable emergency departments by calling ahead to the inpatient unit or hospital of choice to reserve a place.
- Be prepared – have information about the person’s diagnosis, the reasons for your concerns, medications and recent treatment history, risky or unusual behaviors, triggers, and any calming or soothing strategies that may work for him or her, ready at hand when you make the call.
- Take action early – place the call as early in the week and as early in the day as possible to help ensure a timely response.
- Ask for CIT-trained responders – you can often improve the emergency response and avoid escalation of a crisis by requesting police and other responders who have been trained and certified in CIT (Crisis Intervention Team training).
- Stay calm – a person in crisis might not be able to think or communicate clearly; you can help prevent an escalation of the crisis by empathizing with the person’s feelings and staying calm.
I shared these tips with the mother who called. A few days later, she called back, greatly relieved to report that her son was voluntarily escorted to the local Emergency Department, where he was evaluated and admitted for inpatient treatment: no Tasers, handcuffs, or arrests.
Thanks to the presence of a skilled clinician on the scene at the mother’s home and the CIT training of one of the police responders, an escalation of the crisis was avoided and her son was able to get the mental health care he needed with his dignity intact.
For more information on how to identify and use crisis intervention services, please visit the Crisis & Recognition and What To Do in a Crisis pages of our website.
In the event of a true emergency, always call 9-1-1. The tips in this article are for when you have the time to evaluate the situation and plan a response. In that case, it helps to have guidance from a qualified professional.
Our Resource Specialists can provide more information on crisis intervention services and are also available to help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.
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The best thing you can do for me is not remind me I hace an illness. Capische?
We have a 27 year old daughter she has sever mental illness. Plus MS let me start at the beginning she was diagnosed when she was 10. Plus she got her period that same year. Bipolar. Then came persinality defect . We worked on a cocktail she would use me as a punching bag go back and forth to hospitals up and down the eastern seaboard . The whole time my husband is in a wheelchair he is disabled. Back when she was diagnosed with bipolar she blamed it on pot that she smoked that had been laced with lsd. I dont buy it she continued to smoke and drink back then would be hospitalized for the maximum rate of time I believe it was 90 days back then . An she would come home all changed for about 3; to 4 mthys then some thing would click in her brain or she would stop her meds and go right back. At one point my oldest son and his then girl friend had gotten pregnant I was so happy so was every one my dad was alive back then my mom every body was so happy. My husband kept saying what should the baby call me paw paw or gramps I was and is grammie and my husband is grandpa and when my grandson wants something hes pawpaw.My daughter got so upset she but a statement on facebook that my son was not my grandsons father and his girlfriend was a whore. Then about 2 weeks before my sons girlfreind was to go into labor angela my daughter said out loud in front of my family she wished she could kill the baby . I was so shook up my sons girlfriend didn’t think she heard it right so know one repeated it. Now my son and his girl friend are married. To my suggestion my daughter does not see my grandson at all. What mad my daughter go into the hospital this last time on Dec 14. Was it started at my moms house my dad passed away on June 13 2013 so I being the oldest asked my mom if we can have Christmas at there house for the last time she is trying to sell her house so she said fine so my siblings and there kids went to my parents house to put up her tree. My husband didn’t go he wasn’t felling well my youngest so didn’t go he worked late. But my oldest son my daughter in law and my grandson went I went and angela also my sister who is 3 years younger then me other sister who is 6 years younger then me there husband’s and my youngest sisters children went. So im in the kitchen talking to my brother in law talking to him about his sister who has or had breast cancer and I was telling him from my experience that some things will bother him . My daughter in law is a five year survivor I had a tumor in my uterus. That they gave me some kind of pills to shrink it and did a hysterectomy and they gave me a clean bill of health. So tell his sister we are praying for her. Well my daughter go up and ran out side. Not saying a word. As the little ons ate putting up the tree I had to go out side cause me and my daughter in law had gone shopping and I had Matix christmas gifts from his parents and jamie had stuff for me we went out the garage door after we saw her sitting on the drive way she scared us 1/2 to death. So she started using foul laungnwitch and this kept going on for awhile me and jamie moved the stuff. As we got to the door to go into the house she stepped in front of me and blocked us from going in and did this for a while as she did this she was yelling dirty words. At the point in the garage angela turned to me and jamie and she said stay away from me you b if you dont I will beat the s-/& out of you I hate you f=”:&*,^ b^#@! I will beat the S&*$ out of the both of you so get the F#&”* away ftom me. And as she was blocking the door way she was yelling F@/^ YOU at the top of her lungs. At this point I didn’t know what to do. So my oldest son went out side to talk to her I went with him I needed to know what the problem was so we went out to the front porch she said the reason she did the whole thing with me and jamie was because she heard me talk to my brother in law and she heard me call her a whore. I almost passed out. I never called her a name or any thing I would never call my daughter a whore. First of all she was about 60 feet away from were me and my brother and law were sitting. But I should have remembered that she hears things that aren’t there the day before she said our neighbors were fighting over her. Plus she still hears knuckles cracking and twigs snapping .On the date 1/22/15 me and my husband went out left her home I get a call from home mom had to call the police why what happened . I heard noise up stairs and the ladder was gone so I tell her stay still be right there we get home in like 15 min and no sign of break in the police never left a card or anything. We really need help she also has ms diagnosed on July 5 2013.Please help us .
Susan,
It sounds like you and your family have been through a lot.
The behavior you describe could be the result of your daughter’s bipolar disorder. Crisis intervention services might be of help. Please call our Resource Line at 203-724-9070 if you would like help identifying crisis resources in your community… Contact a Resource Specialist
Jay
i have a 11 year old with adhd autisum {pdd} and epilepsy, weve been thru cirsis intervention and have been severly let down by the whole system,he has become very violent,we are affraid to take him anywhere for fear he may hurt someone or even us,he cant spend a whole day in school without being restrained. the system has failed us badley
Gus,
It sounds like you have a very difficult situation on your hands. RtoR.org focuses on the psychiatric side of mental health, so I don’t have much information on Autism Spectrum Disorders or the other conditions you mention.
Having a violent child at home and in school is one of the hardest things any parent ever has to face. It’s very important to seek and get support, before it overwhelms you. Maybe this list of Internet resources for ASDs will help… Top Ten Autism Websites Recommended by Parents
Best wishes, Jay