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.
The person may have to be hospitalized. Try to convince him or her to go voluntarily; avoid patronizing or authoritative statements. If necessary, take steps to start the involuntary treatment process. If indicated, call the police but ask them not to brandish any weapons. Explain that your relative or friend has mental illness and that you have called for help.
- Don’t Threaten. This may be interpreted as a power play or prompt assaultive behavior.
- Don’t Shout. If the person isn’t listening, other “voices” are probably interfering.
- Don’t Criticize. It will make matters worse; it can’t make things better.
- Don’t Squabble with Other Family Members over “best strategies” or allocations of blame. It is not the time to prove a point.
- Don’t Bait the person into acting out wild threats; the consequences could be tragic.
- Avoid Continuous Eye Contact or Touching.
- Comply with Requests that are not endangering or beyond reason. This gives the person the opportunity to feel somewhat “in control.”
- Don’t Block the Doorway but keep yourself between the person and an exit.