A psychiatric emergency is a condition that is often caused by a psychiatric illness such as schizophrenia and involves a high level of need for action to prevent life-threatening or other serious consequences (Rupp 1996). If there is danger for the helper, both a mobile operation and the involvement of the police may be necessary. The description of a psychiatric emergency can be clarified through the use of status pictures. Those affected are often afraid , confused, apathetic or restless, possibly no longer controllable or slowed down, have a disturbed relation to reality with clear consciousness, are desperate, possibly even violent or suicidal. The extent of the emergency is measured by the degree to which someone is still able to talk and enter into a contract, a contact can be made, he or she is a danger to himself or others (Rupp 1996). Learn about our crisis intervention courses at our crisis intervention courses page.
The challenge is that crisis workers have to decide quickly whether they may be in a threatening situation. Depending on whether contact with the client is difficult, further help must be organized and coordinated.
The following intervention tasks arise as a first step in emergency assistance(Rupp 1996):
- Clarification of the urgency, especially in the case of telephone crisis intervention
- if a mobile operation is necessary, clarification of how the interim time will be bridged until arrival
- possibly requesting further help such as the police, ambulance, psychiatrist, crisis team and relatives.
It might be possible locally, given the logic of the crisis(Neumann 2004) to act as in a psychosocial crisis intervention in contrast to an emergency logic in the context of a psychiatric illness. There are two completely different approaches: In the crisis logic, it is important to establish relationships, to listen, to counteract the tension of the client and relatives, to conduct a crisis discussion as described above, and to accept responsibility on the part of the client. to achieve the client. In the emergency logic, the crisis worker mainly tries to avert danger(ibid., p. 273). The rescuer must make a decision in the emergency logic of what to do next, alone or in an emergency conference with or without the client. If accommodation in a psychiatric clinic is not necessary, suitable measures must be taken after the end of the emergency intervention to initiate basic care, activate a social network, ensure protection and provide information for a possible further course.
6 New Developments
Bergold and Schuermann(2001) found that crisis intervention has established itself as a new form of intervention. Crisis facilities have now opened up to new client groups such as people with intellectual disabilities or relatives of those affected. In addition, the traumatic crisis was discussed more strongly and a corresponding need for help became clear. Psychosocial help in the event of major incidents as well as aftercare for the helpers became established. Internet crisis advice began in the 1990s and has been further developed since then. Health apps are currently being developed that are intended to be helpful, for example, in self-diagnosis of depression . Women’s helplines emerged for both raped women and women experiencing domestic violence experienced, recently also for victims of stalking . In addition to the psychiatric facilities, alternatives such as the crisis pension in Berlin for those seeking help who cannot or do not want to stay at home, but also do not want to go to a clinic, have emerged. The trialologic principle, namely the simultaneous involvement of those seeking help, the professionals and the relatives, is also applied here(Mosquito 2009).
Recent social developments lead to new needs such as crisis intervention in the context of flight and expulsion(Hulshoff 2017). The uncovering of sexual abuse in various institutions has led, among other things, to the establishment of state- and church-financed telephone crisis counselling. But there is still a lot to do here. There are still supply bottlenecks for people with crises in rural areas. This list can be expanded. A warning should be given at the end: since crisis intervention has historically stood for prevention and health promotion , care should be taken not to become monopolized by the field of psychiatry.