How to Provide First Aid in a Psychological Crisis?
If you come into contact with someone who is experiencing a psychological crisis, it is good to keep several principles (simple steps) in mind before directing the person further (to a professional or specialized center).
What is a Psychological Crisis?
A psychological crisis is an acute disruption of psychological balance in which usual coping mechanisms fail, stress is present, and the ability to function is impaired. It is a subjective reaction to a stressful life experience that threatens an individual's stability.
The cause of a crisis may be a loss, a major life change, or a traumatic event.
It manifests as emotional instability, reduced ability to make decisions and act, and loss of perspective.
What does a person in crisis look like?
Every person reacts to a crisis individually; the signs may be very visible, although it is not uncommon for some people to appear rather uncommunicative. Someone may cry, someone may laugh, someone may function “too well,” someone may isolate themselves...
The most common manifestations of a crisis are: Stress reaction (Fight / flight / freeze), narrowed (so-called tunnel) perception, emotional overwhelm, isolation, procrastination, insomnia, changes in usual habits (loss of interest in hobbies, stops going to school,..), changes in eating habits, rapid breathing, heart palpitations, tension in the body, sweating, trembling, digestive problems, changes in speech, aggression, shame, panic, irritability, anger, memory problems, tendency towards catastrophic scenarios, indecisiveness, regression,...
How to Help Another Person in Crisis?
The following procedure applies: STOP → CONNECT → GROUND → DIRECT FURTHER → TAKE CARE OF YOURSELF
- Notice what is happening and decide who will intervene (if there are more of you)
- First calm yourself (e.g. grounding, having a drink, breathing exercise)
- Ensure safety (e.g. water, blanket, privacy,...)
- Slow down, be present in the moment
- Speak slowly, do not overwhelm them with questions
- Respect the other person's space and pace
- Establish contact, introduce yourself
- Acknowledge the other person for seeking help
- Use simple open-ended questions
Validate their experience:
- “I noticed that you are not feeling well. Can I help you in any way?”
- “I am here with you now.”
- “Would you like to tell me what is happening?”
- “That must be really difficult. It is totally ok that you are crying.”
Help slow things down
Focus on the here and now and divert attention away from the trigger of the crisis.
Break the situation down into smaller steps
Use a stabilization technique:
- “What would make you feel at least a little better right now?”
- “What do you need right now?”
- “Would you like some water / chocolate / to take a breath?”
Helping also means directing someone to further support
Help the person think of the nearest possible next step towards further support (a close person, professional help – a crisis line, counselling service, crisis center, hospital,…)
- “I can see that you are having a really hard time. You don't have to be alone in this.”
- “Can you think of someone we could write to together right now?”
- “Do you have someone close to you that you can turn to right now?”
- “There are crisis lines you can contact in such a situation. Would you like to call them together?”
- After helping someone in a crisis, do not be alone in the situation, share it.
- Give yourself what you need at that moment (stretching, a walk, a drink, something good to eat, a weighted blanket, peace and quiet,...)
- Distract yourself with a simple activity
- Give yourself time to decompress
RESPECT YOUR OWN LIMITS
- Speak slowly and clearly
- Respect individuality (everyone reacts differently in a crisis)
- Be patient (a crisis takes time)
- Trying to make them laugh (“Smile, everything will be fine.”)
- Labelling (“You're just being too sensitive, it's nothing.”)
- Trivializing (“It's nothing, other people have worse things happen to them.”)
- Judging (“I think the best thing would be for you to leave him.”)
If the person
- talks about suicide,
- wants to hurt themselves,
- poses a threat to themselves or others,
- is severely disoriented,
- is unable to perform basic functions.
What to do:
do not deal with it alone and contact additional professional help:
Crisis Intervention Centre (Bohnice Psychiatric Hospital)
- English-speaking doctor is always present, however English-speaking service over the phone is not guaranteed.
- Phone help line (anonymous, non-stop): +420 284 016 666 (charged according to your phone provider's tariff)
- Personal visit: Ústavní 91, Prague 8; no need to schedule an appointment, 24/7
Prague Helpline (Prague Social Services Centre)
- Phone line (anonymous, non-stop): +420 222 580 697 (charged according to your phone provider's tariff)
- Online chat (anonymous, according to operating hours, weekdays 9-21 h): www.chat-pomoc.cz
- English speaking specialist available by prior arrangement
- Personal visit: Varšavská 37, Prague 2, Mon-Fri 9am-8pm
- E-mail: linka.duvery@diakonie.cz