Managing Crisis Safely Rich Roell, MSW, LCSW Washington County - PowerPoint PPT Presentation

Managing Crisis Safely Rich Roell, MSW, LCSW Washington County Crisis Team Lifeworks Northwest

“Working safely may get old, but so do those who practice it.” -- author unknown

Today’s talk…  Introducing the Washington County Crisis Services  Your resources in a crisis  Keeping each other safe  Further training available  Communicating in a crisis

Who we are… The Washington County Crisis Services  Crisis Line (24 hrs): 503-291-9111  Hawthorn Walk-In Center – 9am-8:30pm daily  24-hour mobile crisis response also available

What we do…  Urgent mental health & addictions care  Psychiatric custodies (i.e. mental health holds)  Crisis counseling, education & resource connection  Medication bridges when appropriate  All adults & children in county are eligible  No charge for any of our services

Hawthorn Walk-In Center

Elam Young Parkway Site

Hawthorn Walk-In Center

Hawthorn Walk-in Center  5240 NE Elam Young Parkway (Hillsboro) right next to Hawthorn Farm MAX stop  Open every day of the year, 9am – 8:30pm  Free & confidential urgent care for mental health & addictions concerns

How to reach us…. Washington County Crisis Line (24 hrs) 503-291-9111 Clackamas Cty Crisis Line 503-655-8585

Who to call & when… 911 ( and then call us )  Violent threats, gestures, weapons  Threatens to harm self w/ means at hand  Leaves shelter suicidal or homicidal  Unwanted physical contact  Unresponsive or incoherent  Medical emergency

Who to call & when Crisis Team (first)  Ideas of harm, but safe until we arrive  Non-threatening, but concerning behavior  Very distressed, unable to calm  Wants to speak with a counselor urgently  Wants to make appt with the WCCT  You want to consult

What we’ll do…  Safety/mental health assessment  Hospitalization (if meets criteria)  Provide immediate crisis support  Discuss resources  Plan for follow-up

Factors for violence toward others  Previous violence  Substance abuse, intoxication  Active mental illness, esp. w/ paranoia  Negative attitudes, no insight  Socially isolated, chronically unemployed  High-levels of stress  Lack of compliance with treatment/courts

What to be concerned about…  Restlessness, agitation  Angry, fearful body language  Pressured speech or silence; intense staring; auditory hallucinations  Disorganization, impulsiveness  Fixation on a specific staff member

Safety Habits  Trust your gut  Safety in numbers  Situational awareness  Talk safety with your guests  Carry your phone  Code phrases  Call for help, then assist

Safety Habits (cont’d)  Limit self-disclosure  Remember, it’s not personal  Defusing ‘by choice’  What’s the plan?  Practice, practice, practice It’s better to apologize for overreacting, than to regret underreacting.

GetTrainedtoHelp.com  QPR (Question, Persuade & Refer) – 2 hours  Adult Mental Health First Aid – 8 hours  Youth Mental Health First Aid – 8 hours  Applied Suicide Intervention Skills Training – 2 days ALL TRAININGS ARE CURRENTLY FREE

“People are disturbed not by things, but by the view s that they take of them.” Epictetus, 1 st Century A.D.

Serious & pervasive mental illness  Mental illness disrupts a person’s normal state with powerful shifts in the brain’s neurotransmitters  Physical, mental, emotional & social functioning are severely impaired, and insight is often limited  Serious & untreated mental illness is usually beyond anyone’s ability to cope with alone, and frequently results in a crisis

It helps to remember…  No one wants to believe they’re sick, much less mentally ill  With current laws & funding, it’s difficult to get help, even for those who are motivated  Meds can control symptoms, but may also create distressing & permanent side effects

Often the person is…  is fearful …Be calm  is confused …Be simple, truthful  is insecure …Be accepting  has trouble …Be brief, repetitive concentrating

Often the person is…  is overstimulated …Limit input  is preoccupied …Get attention first  has poor judgment …Expect limitations  has changing plans …Keep to one plan

Often the person is…  feels ashamed …Stay positive, non-blaming  has little empathy …Accept as a symptom  is tired, withdrawn …Set realistic goals  feels stigmatized …Don’t define the person by their symptoms

Communication specific to PSYCHOSIS, including Paranoia & Delusions  Speak calmly & slowly,  Limit emotion  Minimize distractions  Give more personal space  Build rapport slowly, focus on problem-solving  Roll with delusions (don’t argue or endorse)

Communication specific to MOOD DISORDERS (e.g. depression, anxiety)  Speak slowly  Limit input  Depression feels Personal, Pervasive & Permanent  Offer hope, but be honest  What’s worked before?  Be patient

Communication specific to PERSONALITY DISORDERS  Be prepared for sudden shifts in emotions  Focus on feelings to build alliance  Avoid self-disclosing  Expect irritation, projection of blame  Keep focus on problem-solving  Remember, this is about trauma

Support T HE N ATIONAL A LLIANCE FOR THE M ENTALLY I LL (NAMI) OF W ASHINGTON C OUNTY 18680 SW Shaw Street Aloha, OR 97007 503-356-6835

In closing… THANK YOU!! Please call us at 503-291-9111 if you have any questions or concerns.