Unit 5 Crisis, Suicide and de-escalation

Crisis

is an acute stage of psychological imbalance resulting in poor coping with evidence of distress and functional impairment

Erich Lindemann

1944: Research on grief from the Coconut Grove fire established that preventive interventions can mitigate severe psychological impacts. He believed that bereavement techniques are also effective in crisis management.

Gerald Caplan

1960s: Advanced crisis theory & intervention. Further developments have deepened our understanding of crisis impacts, leading to Gerald Caplan Canada's national mental health framework prioritizing MHFA training, early intervention, and support crisis intervention.

Donna Aguilera & Janice Mesnick

Developed a key framework for crisis assessment & intervention. Aguilera continues to set the standard in crisis assessment, focusing on individual reactions, education, coping, & problem-solving.

Albert R. Roberts

Created seven-stage model of crisis intervention

Hobfoll & Colleagues

Identified five essential elements of mass trauma interventions.

Maturational Crisis

Erikson conceptualized the process by identifying eight stages of ego growth and development. Each stage represents a time during which physical, cognitive, instinctual, and sexual changes prompt an internal conflict or crisis, which results in either psychosocial growth or regression.

Situational Crisis

Arises from events that are extraordinary, external rather than internal, and unanticipated. Examples are job loss, death of a loved one, an unplanned pregnancy etc.

Adventitious Crisis

results from events not part of everyday life, such as a natural disaster (flood, fire, earthquake) or a national disaster (acts of terrorism, war, riots, airplane crashes)

Suicide

an act of taking one’s own life

Suicide Plan Assessment

1. Presence of risk factors for suicide

2. Degree of suicidal ideation

3. Intent to carry out suicide plan

4. Means and availability of resources to carry out the selected method of suicide

5. Presence of protective factors

6. Degree of hope for improvement of psychological state

SLAP

• Specificity

• Lethality

• Availability

• Proximity

Specificity

What are the details of the suicide plan?

Lethality

How quickly or likely would death occur if the client acted on the plan?

Availability

Does the person have access and the means to carry out the plan?

Proximity

Are there others available who could intervene?

Non-Suicidal Self-injury

Statistics: Between 13-17% of adolescents engage in NSSI. Peaks between the ages of 20-29 and usually subsides after. There was an increase in these statistics related to the COVID-19 pandemic 

Causes: Other co-existing mental health disorders, intrapersonal and interpersonal influences. Neurotic personality, low self-esteem, inability to recognize one's own emotions, impulsivity, depression. Family dysfunction, lack of social support, or dissatisfaction.

De-escalation

refers to the methods and actions taken to decrease the severity of a conflict, whether of physical, verbal or another nature.