Mental Health Emergencies: Preparing for the Five Types of Mental Health Crises

• More effectively assess and intervene in mental health emergencies
• Conduct a quick, but thorough and accurate, mental status exam
• DSM-5® and crisis situations
• The rising heroin and synthetic drug epidemic
• Maximize client safety while minimizing your risk

Times are changing. We are flooded by media reports of violence and suicide on a nearly daily basis, with many of the perpetrators being labeled as “mentally ill.” The public wants mental health providers who are equipped and confident to handle crisis situations. Here’s an example:

“Ana” was a new client sitting in the waiting room of my clinic one morning when I arrived for work.

“I came here because I went to the Emergency Room last night after I’d had a panic attack. The doctor said I should come here today,” she explained. Ana said that she had been diagnosed with bipolar disorder in the past. Her speech was pressured and her thoughts seemed to wander. She admitted to three previous suicide attempts, two of which required hospitalization.

As the interview progressed, Ana continued to open up, but she required a lot of re-direction from me. Ana admitted to current heroin and bath salts use. A former counselor, whom Ana trusted, had been able to get Ana to talk about the sexual abuse from her step-father when she was a child.

“I also sometimes think I can hear things that no one else can,” she continues. “And I’m afraid,” she shudders as she whispers, “He’s out there and he’s coming for me.”

Ana starts to loudly cry and gets up to leave the room.

Now what? A crisis is never scheduled, neat, or easy. What types of crises are going with Ana? What should you do next?

This seminar will prepare you to respond to the five types of crisis situations regardless of your setting. You will leave the seminar more confident in your abilities to meet the needs of your clients. You will also improve your ability to assess, respond and treat people in crisis.

OUTLINE

Client Assessment

• Lethality Assessment
• Mental status exam
  • Mood & affect
  • Thought content & thought process
  • Perceptions & judgment
  • Memory & Somatic complaints
  • Psychosocial stressors & supports
  • Environmental & Spiritual stressors & supports
• DSM-5® changes regarding major mental illness diagnosis

The Suicidal Client

• Higher risk populations
• Suicide assessment
• Disposition
• Safety planning

The Violent/Homicidal Client

• Ethical duty to protect
• Physical ways to keep yourself safe
• Approaching a potentially violent client
• Developing a good safety plan

Medical vs. Mental Problems

• Neuroleptic Malignant Syndrome
• Stevens-Johnson Syndrome
• Serotonin Syndrome
• Dementia vs. Delirium
• Urinary Tract Infections—often missed
• Organic issues—“Stephen and the Zombies”
• Medication reactions

Trauma

• Recognizing trauma
• Trauma and the triune brain
• Trauma and emotional response
• The role of memory
• Trauma and pre-existing mental illness
• Immediate intervention for trauma: safety
• Identifying recovery capital

Substance Abuse

• Intoxication syndromes
• The Heroin “revival”
• Synthetic drugs
  • JWH-018: K2/Spice
  • Methylenedioxymethamphetamine: Ecstasy to Molly
  • Methylenedioxypyrovalerone: “Bath Salts”
  • Alcohol Vaporizers
• Other street drugs
  • Cocaine vs. methamphetamine
  • Khat (Cathinone)
  • Dextromethorphan
  • Ayahousca (Yage)

Taking Care of Ourselves

• Debriefing and documentation
• Peer supervision
• Stopping compassion fatigue
• Addressing burn-out

OBJECTIVES

1. Complete a client safety assessment, specifically addressing suicidal or homicidal ideations and behaviors.
2. Critique how a brief yet thorough mental health interview can determine the nature of the crisis. 
3. Specify effective diagnostic skills for utilizing DSM-5 criteria. 
4. Evaluate medical problems that I initially appear as mental health symptoms. 
5. Explore how victims of trauma can present in crisis.
6. Develop a deeper knowledge of the variety of inebriants and intoxicants that can propel a person into a crisis.
7. Substantiate how we, as clinicians, are a part of the crisis process and how this may continue  to impact us beyond the actual event.

ADA Needs
We would be happy to accommodate your ADA needs; please call our Customer Service Department for more information at 1-800-844-8260.

Satisfaction Guarantee
Your satisfaction is our goal and our guarantee. Concerns should be addressed to: PO Box 1000, Eau Claire, WI 54702-1000 or call 1-800-844-8260.