What Is a Mental Health Crisis Intervention?

Psychological crisis refers to the obvious changes in living conditions caused by sudden severe disasters, major life events, or mental stress, especially the difficulties that are difficult to overcome with the existing living conditions and experience, causing the parties to be in a state of pain and uneasiness , Often accompanied by despair, numbness, anxiety, and autonomic symptoms and behavioral disorders. Psychological crisis intervention refers to timely and appropriate psychological assistance to individuals in a state of psychological crisis so that they can get out of difficulties as soon as possible.

Psychological crisis intervention

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Common causes are acute disability or acute severe illness; broken relationships; sudden loss of loved ones (such as father

Everyone responds to serious events, but different people respond to events of the same nature in different intensity and duration. The general response process can be divided into three phases:

(1) Quickly identify issues to intervene.

(2) A family member or friend must participate in the crisis intervention.

(3) Encourage self-confidence and don't let the parties involved

(1) usually

(1) Prevent aggressive behavior, such as suicide, self-injury, or aggressive behavior.

(2) Promote communication and communication, encourage the parties to fully express their thoughts and emotions, encourage their self-confidence and correct self-evaluation, and provide appropriate suggestions to promote problem solving.

(3) Provide appropriate medical assistance to deal with syncope, emotional shock or irritability.

Preparation for psychological crisis intervention

An understanding of the situation in the disaster area, including roads, weather, and disaster conditions.

1. Identifying intervention sites

2. Identify interventions and their distribution and number

3 Develop a crisis intervention implementation plan

4 Develop and print psychological crisis intervention assessment tools and related promotional materials

5. Liaise and understand the distribution and resettlement situation of the community, hospitals, hospitalized injured people, victims and their families, and develop specific intervention procedures and routes.

6. Intervention team board and accommodation arrangements, intervention team members' own items, preparation of commonly used drugs.

7. When possible, train local psychiatric medical staff on crisis intervention knowledge and expand human resources.

Purpose of psychological crisis intervention

Actively prevent, timely control and mitigate the psychological and social impacts of disasters; promote the reconstruction of mental health after disasters; maintain social stability and safeguard public mental health.

Psychological crisis intervention principle

1. Integrate with the overall rescue activities, adjust the focus of psychological rescue in a timely manner, and cooperate with the overall disaster relief work;

2. Work on the premise of social stability without increasing the burden on overall rescue work and reducing secondary injuries;

3 Comprehensive application of intervention techniques.

4 Protect the privacy of the recipients and not disclose personal information casually;

5 .. It is clear that psychological crisis intervention is part of medical rescue and is not a panacea.

Psychological crisis intervention

Combining assessment, intervention, education, and publicity to provide disaster psychological rescue services; as far as possible, psychosocial monitoring and forecasting of disasters, and providing early warning and solutions for emergency organizers to deal with psychological events of emergency groups; and promoting the formation of a community psychosocial intervention support network .

Psychological crisis intervention group

The psychologically affected people of the earthquake disaster are roughly divided into five groups. The first and second levels are high-risk groups, which is the focus of intervention work. Without psychological intervention, some of them may have long-term and severe psychological disorders. The first group: the direct survivors of the earthquake disaster, the families of the victims and the wounded.

Second-level crowd: Individuals and family members who have close ties with the first-level crowd may have severe sorrow and guilt reactions and need to mitigate secondary stress reactions; on-site ambulance personnel (fire fighting, armed police officers, 120 ambulance personnel, others Ambulance staff). Level 3 crowd: Off-site workers (back-up) engaged in rescue or search, personnel or volunteers who assist in reconstruction or rehabilitation after the earthquake disaster.

Tier 4 crowd: Organizations outside the affected area who provide materials and assistance to the affected people and who have some responsibility for the potential of the disaster.

Level 5 crowd: Individuals who are out of control when approaching a disaster scene are highly susceptible and may show signs of psychological morbidity.

Timeline of psychological crisis intervention

According to the target population and the number of members of the intervention team, the work schedule is excluded.

Psychological crisis intervention intervention technology

ABC method:

A, psychological first aid, emotional stability

B. Behavior adjustment, relaxation training, interviewing techniques (CISD)

C. Cognitive adjustment, emotional stress reduction and sad counselling.

1. First, gain the trust of the injured and establish a good communication relationship;

2. Provide venting opportunities and encourage them to express their inner emotions;

3 Provide missionaries with knowledge of psychological crisis and crisis intervention, explain the development process of psychological crisis, build self-confidence, and improve the ability to cope with physical and psychological stress;

4 According to different individuals' response to events, different psychological intervention methods are adopted, such as: actively dealing with acute stress reactions, conducting psychological counseling, supportive psychotherapy, cognitive correction, relaxation training, and interviewing techniques (CISD), etc. , Depression and fear, reduce the occurrence of excessive behavior, and appropriately apply sedative drugs when necessary;

5. Mobilize and play the role of social support systems (such as families, communities, etc.), encourage more contact and contact with family members, relatives and friends, colleagues, and reduce loneliness and isolation.

Key points of psychological crisis intervention technology

1. Psychological first aid

(1) Contact and participation

Goal: Listen and understand. Respond to survivors, or start contacting survivors in a non-compulsive, compassionate, and helpful way.

(2) Safety confirmation

Goal: To promote current and future security and provide practical and emotional relaxation.

(3) emotional stability

Objective: To bring emotional calm and reorientation to survivors who are emotionally overwhelmed or disoriented. Anger management technology, sad intervention technology.

(4) Dispel doubts

Objective: To identify issues that require immediate attention and explanation, and to give possible explanations and confirmation immediately.

(5) Practical assistance

Goal: Provide practical help to survivors to address real needs and concerns. Problem solving techniques.

(6) Contact support

Goal: Help survivors establish short-term or long-term relationships with major supporters or other sources of support, including family members, friends, community help resources, and more.

(7) Provide information

Objective: Provide information on stress response, information on correct coping to reduce distress and promote adaptive function.

2. Psychological interview

A method of reducing stress through systematic conversation, either individually or collectively, and participating voluntarily. For patients with mild earthquakes in the ward, or medical staff and rescue workers, they can conduct group interviews according to different groups of people.

The goals of psychological interviews: openly discuss inner feelings; support and comfort; resource mobilization; help the parties to psychologically (cognitively and emotionally) digest the traumatic experience. Time limit for group interviews: 24-48 hours after a disaster is the ideal time to help, with little effect after 6 weeks. Formal group interviews, usually under the guidance of a qualified mental health professional, implemented between 24-48 hours after the incident, the instructor must have a broad understanding of group help, the instructor must have a broad understanding of the irritable response syndrome No collective talks will be held within the next 24 hours. All persons involved in the incident must participate in a collective interview.

Interview process: It is divided into 6 phases in a formal way, and the second phase, the third phase, and the fourth phase can be combined for the occasional operation.

The first introduction period: the mentor introduces himself, introduces the rules of the collective interview, and carefully explains the issue of confidentiality.

The second period of facts: Participants were asked to describe some actual situations of themselves and the event itself during the earthquake event; asked the participants where they were, what they heard, what they saw, what they smelled and what they did during these serious events; each Every participant must speak, and then the participants will feel the truth of the whole event.

Phase III Feeling: Ask questions about feelings: How did you feel when the incident occurred? How are you currently feeling? Have you had similar feelings before?

Stage 4 Symptoms: Participants are asked to describe their symptoms of stress response syndrome, such as insomnia, loss of appetite, brain flashing events, inattention, memory loss, and reduced ability to make decisions and solve problems , Easy to lose temper, easy to be frightened, etc .; ask participants about the unusual experience during the earthquake event, what is the current unusual experience? What happened to life after the event? Please discuss the experience of the family, work and life What impact and change has it made?

Fifth Coaching Period: Introduce normal responses; provide accurate information, explain events and stress response patterns; normalize stress responses; emphasize adaptive capacity; discuss positive adaptation and coping styles; provide information on further services; Remind possible coexisting problems (such as drinking); give strategies to reduce stress; self-identify symptoms.

The sixth period of recovery: conclusions; summarizing the interview process; answering questions; guarantees; discussing action plans; reiterating common responses; emphasizing the mutual support of group members; available resources;

The whole process takes about 2 hours to complete the entire process. Follow-up is weeks or months after a serious event.

Notes for interview:

(1) Those who are in depression or who view interviews in a negative way may add negative influence to other participants.

(2) Given that interviews are consistent with specific cultural recommendations, cultural rituals can sometimes replace interviews.

(3) It is not appropriate to participate in a group interview for those who are acutely sad, such as those who have died in the family. Because the timing is not good, highly traumatized people may bring more catastrophic trauma to others in the same talk if they participate in the interview.

(4) WHO does not support a single implementation only among victims.

(5) After the victim interview, the intervention team should organize team members to conduct a team interview to alleviate the pressure on the intervention staff.

(6) Don't force the details of the disaster.

3 Relaxation technique

Except for those who have obvious separation reactions, a relaxation technique is taught to all the intervened: breathing relaxation, muscle relaxation, and imagination relaxation.

Psychological crisis intervention intervention process

(1) The expert group should promptly make recommendations to the government and relevant departments

1. If the wounded and family members of some hospitals are too concentrated, it will bring some hidden dangers to rescue work and aftercare.

2. The placement of the deceased's family members should be as dispersed as possible, and there should be continuous accompany to provide support and help; prevent them from experiencing emotional outbreaks together, so as to avoid passive treatment.

3 Information on the dead and wounded and their families should be open, transparent, truthful, and timely, so as not to cause excitement and bring secondary difficulties to rescue efforts.

4 While providing psychological assistance to the wounded and their families, various government departments should pay attention to the psychological stress of the rescue workers and organize them to participate in collective psychological counselling provided by the working group.

5. Mobilize the participation of social forces, use media resources, promote psychological crisis and mental health knowledge to the affected people, promote effective methods to cope with the disaster, and mobilize local government personnel, rescue workers, medical staff, community workers or volunteers to receive training from the working group Let them participate in psychological assistance activities.

6. Regular information conferences will be held to keep the public informed of the progress of the rescue work and the work done. Pay attention to organizing the information that must be communicated before release. Answer questions from reporters as accurately and completely as possible, and ensure that they are true If there is no information or the information is unreliable, answer truthfully; take the initiative to guide public opinion.

7. It is suggested that the headquarters be able to further coordinate the relations between various departments so that the psychological crisis intervention can proceed smoothly.

After the recommendations are made, they should try their best to communicate with the local government to gain attention and adopt them, and take strong measures to implement them.

(II) Work flow

1. Contact the rescue command and various hospitals to determine the distribution of hospitalization of the injured in the earthquake disaster and the situation of the medical staff entering the scene.

2. Develop psychological crisis intervention training content, brochures, psychological crisis assessment tools, and print urgently.

3 The convening staff held technical training at night in order to unify the thinking and technical line, including psychological crisis intervention techniques, processes, and assessment methods.

4 Emergency calls to personnel and equipment from your local mental health centre.

5. Grouped to various hospitals, communities, interviewed the victims of the earthquake disaster, related medical staff, and distributed knowledge and promotional materials related to psychological crisis intervention.

6. Apply assessment tools to conduct psychological screening, interview with key populations, and analyze crisis dynamics.

7. According to the results of the assessment, preliminary psychological intervention was conducted on the spot for those who experienced psychological stress reactions.

8. In each hospital, guidance to the hospital leaders on patient diagnosis and treatment, treatment and communication skills between staff and patients, and staff's own mental health care technology are presented.

9. Follow up every person who has been screened for acute psychological stress, intensify psychological intervention and necessary psychological treatment, and conduct psychological evaluation again after treatment.

10 Interventions such as group lectures, individual counselling, and group interviews were conducted for community cadres and hospital medical staff. It was found that the on-site rescue medical staff generally had obvious stress reactions. The main manifestations were flashbacks in traumatic earthquake disaster scenarios, emotional instability, anxiety, poor appetite, insomnia, and decreased work efficiency.

11. Every night, the working group held a meeting to summarize the work of the day, adjust the work plan, and deploy the next work. Supervise intervention personnel.

Points of attention for psychological crisis intervention

1. Psychological crisis intervention refers to timely and appropriate psychological assistance to individuals in a state of psychological crisis. This is not a procedural psychotherapy, but a psychological service.

2. The optimal time for psychological crisis intervention is 24 hours to 72 hours after a traumatic event. Crisis intervention is generally not carried out within 24 hours. If the crisis intervention is carried out after 72 hours, the effect will be reduced. If the crisis intervention is carried out after 4 weeks, the effect will be significantly reduced.

3 The method of psychological crisis intervention is the simplest method of psychological treatment, such as: purification talk, crisis management (psychological support), relaxation training, psychological education, and collective decompression of serious events.

4 Psychological crisis interventions must be integrated with social support systems. Especially in the face of major disasters, psychological crisis intervention and social work services are closely integrated.