Crisis Checklist

 NAMI San Fernando Valley continues to respond to cries for help, to offer comfort and crucial information to families in crisis and meaningful support to individuals living in recovery. If your loved one is experiencing a mental health crisis, NAMI San Fernando Valley is here to help with information and resources but we are not a crisis service organization. These pages will provide important guidelines on how to get help for your loved one now and in the future.

 

What should I do or say to my loved one during a crisis?

How do I handle this crisis?

(This article appeared in our Newsletter January, 1999 and has helped many families and individuals)

There are some actions that can diminish or avoid disaster. You need to reverse any escalation of the psychotic symptoms and provide immediate protection and support to the person with the mental illness (as well as yourself in some cases).  Remember that things always go better if you speak softly and in simple sentences.

 

Your task is to help the person regain control. Do nothing to agitate the situation. The person is probably terrified by the subjective experience of loss of control over thoughts and feelings. The “voices” may be giving life-threatening commands; messages may be coming from light fixtures; the room may be filled with poisonous fumes; snakes may be crawling on the window. Accept the fact that the person is in an “altered reality state” and may “act out” the hallucination. For example, they may shatter the window to destroy the snakes. It is imperative that you remain calm. If you are alone, call someone to stay with you until professional help arrives.

How should I prepare for a crisis?

How should I prepare for a crisis? Should I have a plan? What should it look like?

 

Emergencies that have happened over the last two years with your mentally ill loved one will probably be the same ones that will happen over the next two years. Review what was done in the past and how it could be improved. Then you will have a plan that can guide your actions in future emergencies.

 The Plan

  • The plan should be written. Trying to remember details in a crisis can be difficult. Having a written list of steps and procedures can help you focus on the immediate situation.
  • Include phone numbers and addresses of resources:
    • Mental health clinic, outpatient facility.
    • Emergency inpatient facilities.
    • Emergency/Crisis teams who have responded in the past.
    • Friends and relatives who will provide support.
  • Have solutions to problems that have worked in the past.
    For example, “Call the outpatient clinic and leave a message telling the doctor what has been happening and suggesting that an increase or change in medication may be helpful.”
  • Have instructions on what to do and how to act.
    For example “If _______gets upset, stay calm and call the emergency line # __________________.
  • Have alternatives for all times: day and night, weekdays and weekends.
    For example, “If the outpatient clinic is closed, call __________________.
  • Have alternatives if first steps don’t work.
    For example, If such and such number doesn’t answer, try ______.
  • Have the plan carry through to the final resolution of the problem.
    Don’t leave anything to chance.

What do I do if I feel that my life or the life of my loved one is in immediate danger?

If the you feel that the patient is an IMMEDIATE DANGER to self or others, call 911. Mention that the person is suffering from a mental illness. Police or sheriff deputies will respond.

What do I do if I feel that my loved one is a danger to themselves, or others but will not seek treatment and isn't immediately threatening?

If the aren't eating, aren't seeking shelter, or have vocalized threats of harm to themselves or others, what should I do? I can't convince them to go to the hospital.

Contact one or all of the following:

Mental Health Psychiatric Mobile Response Team (PMRT / Pet Team) Psychiatric Mobile Response Team (818) 832-2410 or 2400. Weekdays 8a.m.-5p.m., Other times call (800) 854-7771


S.M.A.R.T. Team* — Monday – Friday (213) 473-8263 *(Systemwide Mental Assessment Response Team)


MEU – Mental Health Evaluation Unit – LAPD Mental evaluation team (213) 485-3300, after hours ( 213) 485-3261


MET - Mental Health & Sheriff for County (800) 854-7771

 

Some of these my have lengthy response times, so REMEMBER, if you or the patient is in immediate danger call 911.

 

What if I can convince them to get help, but feel that they need hospitalization at this point?

I think I can convince my loved one that they need to get help, but where should I take them? I believe they need to be hospitalized.

I am not sure that my loved one needs hospitalization, but they definitely need to be seen immediately by a doctor. Where can I take them

They are not doing so well, but I don't think that hospitalization is something they need or will agree to, but they are willing to see a doctor. Where can I take them? 

You can take your loved one to Olive View Urgent care from 8am -10pm Monday through Friday, and from 9am-5:30pm on the weekends. 

Olive View Community Mental Health Urgent Care Center

14659 Olive View Dr Sylmar, CA (818) 485-0888

 Or these other care centers: 

Center for Family Living 
Hillview Mental Health Center
Santa Clarita Mental Health Clinic
San Fernando Mental Health Center
Verdugo Mental Health Center
West Valley Mental Health Center
Sherman Oaks Hospital
MacDonald Carey East Valley Mental Health Center

Please be sure to call ahead to check their hours before you leave. 

My loved one has been arrested! What can how do?

Follow this link, My Family Member Has Been Arrested, to access a to help families cope with the criminal justice system in Los Angeles County when a family member who suffers from a brain disorder (mental illness) is arrested.

Helpful Forms:
English: Inmate Medication Form 
Spanish: Inmate Medication Form

What should I do when the crisis is over?

What should I do when the crisis is over? What should I do to prepare for long-term care?

(This article originally appeared in NAMI Long Beach Newsletter in May, 1994 and has helped many families and individuals)


Keep an Up-to-date History Summary
Keep a summary of up-to-date information on your mentally ill loved one. This summary can be given to treatment facilities to speed treatment and avoid confusion and mistakes. The summary should be only one or two pages long. List items of significance pertaining to your love one’s illness:

I myself am having some issues with my mental well being, where can I get help?

I have been diagnosed with a mental disorder, or am having symptoms of one, what do I do? Where should I go? 

If you need someone to talk to anonymously about your mental well being you can call: 

Mental Health Crisis Hotline –  800-854-7771

Its ALWAYS OPEN, and can give you guidance with most concerns about your mental health.

SUICIDE HOTLINE: (877) 727-4747

The hotline is open 24 hours a day, and a counselor can try to help if you are having thoughts of suicide.

Teens- Teen Line: (310) 855-HOPE or TLC-  TEEN. 

Teens can call the teen line from 6p.m. to 10p.m to discuss their concerns with a counselor.

 

If you would like to see a doctor you can go to a mental health urgent care: 

Olive View Community Mental Health Urgent Care Center

14659 Olive View Dr Sylmar, CA (818) 485-0888

Walk-in voluntary care for those in mental health crisis. 8am – 5pm

 

If you feel like you need hospitalization, you can visit one of these hospitals:

Where to go if the patient / your loved one needs psychiatric hospitalization-Hospitals with psychiatric units:

 

This is all new to our family, we haven't really processed any of it emotionally. How do others react?

Predictable Stages Of Emotional Responses To Mental Illness

I. Dealing with the Catastrophic Event

Denial: A protective response giving us time to process the painful events that have turned our lives upside down. We decide all this is not really happening and/or there is a perfectly logical explanation for these events and/or it will pass, etc. We “normalize” what is going on.

Hoping-against-hope: The dawning of recognition and the hope that “this is not what I think it is”—that it is something easier to deal with. Here we assume that if we make a huge effort it will change everything and our lives will go back to normal. This usually does not work; another crisis or relapse dashes our hopes (families call this the “roller-coaster”).

Needs: *Support *Comfort *Empathy for confusion *Help finding resources *Crisis intervention *Prognosis *Empathy for pain *NAMI

II. Learning to Cope: “Going through the Mill”

Recognition: The fact that a catastrophic illness happened to someone we love becomes a reality for us. It is clear something tragic occurred that has changed our lives together. We begin to mark time as before/or/after the event of illness.

Grief: We mourn the loss of the time before illness struck; we deeply feel the tragedy of what has happened to the person who is ill; we grieve that our future together is uncertain. If our loved ones have attacked or rejected us in their illness, we feel inconsolable. Because these illnesses are either episodic or chronic, our grief does not go away: it is “chronic sorrow.”

Needs: *Vent feelings *Keep hope *Education *Self-care *Networking *Skill training *Letting go *Cooperation from system *NAMI

III. Moving Into Advocacy: “Charge!”

Acceptance: Yes, we finally say bad things do happen to good people. We surely wish this trouble had not come into our lives, but it did, and we can accept our misfortune. It is not our fault; it is not their fault. It is a sad and difficult life experience, but we will hang in there and manage.

Advocacy/Action: With a measure of acceptance, we can now focus our anger and grief, and work to confront the system that has often failed us. We are ready to “come out,” to fight discrimination and to change the world that shames the mentally ill and their families. We join public advocacy groups. We get involved.

Needs: *Activism *Restoring balance in life *Responsiveness from system *NAMI

There are some important points to emphasize here:

  1. None of these states are “wrong” or “bad.” They are normal reactions everyone experiences when struggling to cope with serious illness and trying to deal with critical disruptions in their lives.
  2. This process is ongoing—for most of us it has taken years. The process is also cyclical; we will start it all over again every time our relative has a relapse, or suffers a serious setback.
  3. Different family members are often at different places in the cycle, which is why we sometimes have difficulty communicating with each other and agreeing on what to do.
  4. This developmental account is not about expectations. This is a human process that you do your way. If you know where you are in it you can be gentler with yourself. We think it offers hope to see that we do progress through pain and grief to acceptance.