4.4. Describe what might constitute a mental health ‘crisis’ or emergency

This guide will help you answer 4.4. Describe what might constitute a mental health ‘crisis’ or emergency.

When working with children and young people, recognising a mental health crisis or emergency is crucial for providing timely and appropriate support. These crises can manifest differently across individuals and can include acute distress, risk of harm, or severe escalation of existing mental health issues. This guide explores some examples of what constitutes a mental health crisis or emergency, helping you identify and respond effectively. Always follow your organisation’s policies and procedures. Seek professional medical advice where required. Understanding mental health and being able to recognise the signs and symptoms of a crisis is essential for anyone working with children and young people. By being aware of potential warning signs, such as sudden changes in behavior or mood, professionals can intervene early and provide the necessary support. Additionally, increasing awareness and understanding of mental health can help create a more supportive environment for children and young people, reducing the stigma often associated with seeking help.

What is a Mental Health Crisis?

A mental health crisis refers to situations where a young person’s mental or emotional state poses a challenge that they or others cannot manage safely. This can be an acute episode where their mental health significantly deteriorates. Crises can occur in those with pre-existing mental health conditions or those experiencing sudden distress due to external factors.

Signs of a Mental Health Crisis:

Recognising the signs of a mental health crisis is imperative. Look for:

• Severe Mood Changes: Sudden or severe mood swings that are atypical for the person.
• Withdrawing from Usual Activities: Losing interest in everyday activities can indicate mental distress.
• Self-Harm: This includes any form of self-injury or behaviour intending to cause harm.
• Expressing Hopelessness: Verbalising feelings of despair or worthlessness.
• Risks of Harm to Others: Aggressive or threatening behaviour towards others.
• Talking About Suicide: Mentioning suicide or accessing means of self-harm.

A mental health crisis is not always visible and may require sensitive communication to identify.

What is a Mental Health Emergency?

A mental health emergency involves an immediate risk to a young person’s life or safety. Unlike a crisis, an emergency requires urgent intervention by professionals. This could include medical or psychiatric attention, or law enforcement if there is a risk to the safety of the person or others.

Recognising a Mental Health Emergency:

Mental health emergencies vary, but common scenarios include:

• Suicidal Behaviour: If a young person attempts suicide or expresses a clear intent to end their life.
• Severe Self-Harm: Injuries that pose an imminent risk to their life or require medical attention.
• Extreme Confusion: Disorientation or inability to understand their environment.
• Violent Behaviour: Physical harm to themselves or others.
• Psychosis: Experiencing hallucinations or delusions that impair their perception of reality.

Differentiating Between a Crisis and an Emergency

Understanding the difference between a crisis and an emergency can steer the appropriate response. A crisis may allow for intervention through community resources, family support, or mental health services. An emergency warrants immediate intervention from emergency services or medical professionals.

Immediate Actions to Take

In a mental health emergency:

1. Stay Calm: Your composure can help de-escalate the situation.
2. Call for Help: Engage emergency services by dialling 999 if there is an immediate danger.
3. Provide a Safe Environment: Remove any potential hazards that may cause harm.
4. Engage the Young Person: Converse with them to understand their needs and fears.
5. Inform Guardians or Caregivers: Ensure they are aware and involved if safe to do so.

When dealing with a crisis:

• Encourage Communication: Allow the young person to express themselves openly.
• Reach Out to Support Services: Involve mental health professionals and advocates who can provide guidance.
• Develop a Crisis Plan: Work with the young person and their family to establish a support plan.

Potential Causes of a Mental Health Crisis or Emergency

Understanding the triggers for these situations aids prevention and better management:

• Stressful Life Events: Relationship breakdowns, academic pressure, or loss can exacerbate mental health conditions.
• Existing Mental Health Conditions: Conditions like depression, anxiety, or psychosis can escalate without proper management.
• Trauma: Experiencing or recalling traumatic events may trigger a crisis.
• Substance Use: Alcohol or drug misuse can impair judgement and exacerbate symptoms.
• Social Isolation: Lack of support networks can leave young individuals feeling isolated.

Proactive Strategies

Taking proactive steps can help prevent crises or emergencies:

• Regular Mental Health Check-Ins: Monitor the mental wellbeing of children and young people regularly.
• Build a Support Network: Encourage connections with peers, teachers, and family members they trust.
• Educate on Coping Strategies: Teach techniques like deep breathing, mindfulness, or journaling.
• Create a Safe Environment: Ensure physical and emotional safety in homes and educational settings.
• Access to Mental Health Resources: Ensure awareness and availability of support services.

Communicating with Young People in Distress

Effective communication can alleviate distress and provide comfort:

• Listen Actively: Show that you are fully engaged and empathetic.
• Use Simple Language: Avoid complex terms and provide reassurance.
• Be Patient and Calm: Give them time to express their feelings without interruption.
• Validate Their Feelings: Let them know their feelings are valid and understandable.
• Encourage Professional Support: Normalize seeking help from counsellors or therapists.

Legal Responsibilities and Guidelines

Workers must adhere to legal and organisational guidelines:

• Safeguarding Policies: Follow protocols to protect children and young people from harm.
• Confidentiality: Maintain confidentiality but communicate with necessary parties if safety is at risk.
• Consent: Understand when parental or guardian consent is required for actions taken.
• Record-Keeping: Document incidents and your actions accurately.
• Training: Engage in regular training on mental health awareness and response protocols.

Seeking Professional Help

If a crisis or emergency is beyond your scope:

• Contact Mental Health Services: Reach out to Child and Adolescent Mental Health Services (CAMHS) or equivalent services.
• Emergency Contacts: Keep a list of emergency contacts for rapid response.
• Therapists and Counsellors: Facilitate connections with mental health professionals.
• Local Support Groups: Participate or refer to local community support initiatives.

Summary

Recognising and responding to a mental health crisis or emergency in young people requires vigilance, compassion, and prompt action. By understanding the signs, differentiating between crises and emergencies, and employing proactive strategies, you can make a significant difference in the lives of those experiencing mental health challenges. Your role in supporting and guiding them through such times is invaluable, and always remember that professional resources are available to support both you and the young people you work with.