Building Your Family’s Toolbox

Here a few examples of things that should be in your toolbox:

  • A copy of your loved one’s safety plan
  • A list of support people you can call
  • Documentation for emergency personal which may include:
    • Warning signs and situations that may trigger or escalate a crisis
    • Past hospitalizations and suicide Attempts
    • Alcohol and Drug Use
    • Emergency Contacts: therapist, doctors, support team, etc
    • De-escalation tips and suggestions
  • Caregiver Self-care Plan and reminders of your own coping strategies
  • Contact information for crisis lines, walk in crisis centres, mobile crisis units, etc.

Engage in Self Care

One of the key things that you need to think about in a crisis is that you need to make sure that you are okay, otherwise you won’t be able to help your loved one. Think about an emergency on an airplane and the instructions we receive. We are always told to put on our oxygen mask first, and then help others who may need it. If you allow yourself to become incapacitated, you won’t be able to effectively help your loved one.

Learn Strategies that May Help De-escalate A Crisis

While your sole intent may be to support and help your loved one when s/he is in crisis, our words, mannerisms and actions can often make a situation worse.  As a caregiver you have control over how you react to a situation.  Sometimes reframing how you see a crisis in your mind by looking at it objectively and without emotions will help you to determine your response.  While stressful, seeing a crisis as an opportunity for change and growth can be helpful.

Communication is key when your loved one is in crisis, because they may not be able to express how they are feeling or understand what is happening.  As a result it is important that you have the tools to effectively connect with your loved one, even in their moment of crisis.  Here are a few tips you can use to help de-escalate a crisis:

  • Remain calm, cool and collected.
  • Be present, give your loved one your undivided attention. Remember that paying attention is not just listening, keep your tone and body language neutral.
  • Focus on their feelings. Validating emotions helps your loved one to feel heard and understood.
  • Be empathetic and non-judgmental. Comments like “get over it” or “stop acting crazy” will give your loved one the impression that what they are going through isn’t important.  Whatever your loved one is going through is “real” to them.
  • Avoid getting into a power struggle. Ignore challenging questions, but not the person and try to bring the focus back to how you can help them.
  • Offer reassurance and let them know that you care.
  • Avoid touching your loved one without asking permission.
  • Respect your loved one’s personal space. If you must enter their personal space, explaining your actions can help them feel less frightened or confused.
  • Allow silence. This gives both you and your loved one a chance to reflect on what is happening and consider the next steps.

Where do you go when de-escalating strategies are not working?

Remain calm, assess the situation and determine the level of crisis.  Does you loved one:

  • Have a plan to harm themselves or others?
  • Is the situation life threatening?
  • Are they at risk of something that could harm themselves or others?

If the answer to one of more of these questions is yes and you believe that there is an imminent risk, call 911 or go to the nearest emergency room.

When contacting 911:

  • Explain to the operator that your loved one is experiencing a mental health crisis
  • Be very specific about the behaviours you are observing. Describe what is happening in the moment, not what happened in the past or what you fear will happen in the future.
  • Some jurisdictions have specialized teams that respond to mental health calls. Ask the operator to send someone who is trained to work with people with mental illnesses.
  • Be prepared for the involvement of both medical responders and law enforcement
  • If/when officers arrive, be prepared to provide as much information on your loved one as you can. This is a situation where your Family’s Toolbox will come in handy.
  • If your loved one is not taken to the hospital for assessment and the situation worsens, call for help again

If there is no immediate danger, reach out to professionals for advice:

  • Your local mental health crisis support line
    • Your local crisis support team has advanced training and will be able to assess the situation and help you to determine next steps and also provide your loved one with support.
  • Your loved one’s psychiatrist
  • Clinic nurse
  • Therapist
  • Case manager
  • Family physician
Pro Tips

While you wait for help

  • If you don’t feel safe at any time, leave the location immediately and seek support
  • Communicate with your loved one and explain what you are doing
  • Give your loved one space to move around freely
  • Give your loved one options and actively engage them in safety planning
  • Reduce stimulation in the room from TV, bright lights, loud music, etc.
  • Validate your loved one’s experiences, remember these experience are real to your loved one even if you disagree
  • Be comfortable with silence

When your loved one does not want help

  • Listen to what they have to say, ask questions and validate their feelings
  • Explore options and alternatives together
  • Resist the urge to fix the problem or give advice
  • Take care of yourself and make sure you are supported
  • Make sure you understand the Mental Health Act
  • Know for to access Crisis Resources
  • Safety come first – if your loved one is at risk, ask for help or call 911