How to De-escalate a Mental Health Crisis in the Home

During this time of sheltering in place and while America is on ‘pause’, many families are experiencing stress from many different directions. In an effort to keep everyone safe and slow the spread of the COVID-19 viral pandemic, non-essential businesses, schools and a host of  service provider agencies are temporarily closed. Parents are at home from work, children are at home from school-the entire family is under one roof, together 24 hours each day. For some families, that dynamic alone, can be stressful, and may overwhelm-challenging their ability to share the same space without incident.

There is one population about whom we rarely mention–those with existing mental health disorders or psychiatric diagnoses. Persons with anxiety disorders, depression and with psychoses- are also at home. Depending on the diagnosis and level of severity, many with mental health conditions have their illnesses managed with prescription medication. Day habilitation and outpatient treatment programs are likely closed in this health crisis. Supports are limited, and it is up to the skills of the family to maintain functioning levels.

There is always the possibility,  particularly while in self-isolation, that someone in your home may experience a mental health crisis. It may be a first time occurrence, which can be scary for both that person and the loved ones at home. Should a loved one in your home experience a crisis, it is important that you are prepared, by being able to recognize a mental health crisis when you see it, and have a working knowledge of things you can do to de-escalate the situation. Priority number one is to reduce the potential for harm.


A mental health crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community.

Many things can lead to a mental health crisis and examples of situations that can lead or contribute to a crisis include:

  • Home or environmental stressors
  • School/work stressors
  • Using or abusing drugs/alcohol
  • Starting new medication or new dosage of current medication
  • Stopping medication or missing doses
  • Treatment stops working

Anyone that may be going through a mental health crisis may experience guilt, anger, or grief. It is important to address a mental health emergency quickly and effectively. Some individuals who are dealing with a mental health illness may not exhibit any warning signs. Please remember no one is to blame, not the person or the family.


It is important to know and recognize the warning signs that an individual may be struggling with so that you can support them in the best way possible.

According to NAMI (National Alliance on Mental Illness), these are the most common warning signs:

  • Inability to perform daily tasks, bathing, getting dressed, etc.
  • Rapid mood swings
  • Increased agitation, risk-taking/out of control behavior
  • Abusive behavior to self or someone else
  • Isolation from school, work, family, and friends
  • Loss of touch with reality
  • Paranoia


Keep these important techniques in mind in the event of a crisis. Remember that you are there to listen, be supportive, and get the person the help they need. Do your best to remain calm, and let them know that you are there for them and they are not being judged.

  • Keep your voice calm
  • Avoid overreacting
  • Listen to the person
  • Express support and concern
  • Avoid continuous eye contact
  • Ask how you can help
  • Move slowly
  • Offer options instead of trying to take control
  • Be patient
  • Avoid touching the person unless you ask permission
  • Gently announce actions before initiating them
  • Give them space, don’t make them feel trapped
  • Don’t make judgmental comments
  • Don’t argue or try to reason with the person


5 Steps for Mental Health First Aid

You can help in a crisis situation by following the ALGEE action plan:

A– Assess for risk of suicide or harm
L– Listen non-judgmentally
G-Give reassurance and information
E-Encourage appropriate professional help
E-Encourage self-help and other support strategies

What Is A ‘Safety Plan’?

  • Step 1 – Warning signs that a crisis may be developing
  • Step 2 – Internal coping strategies, things I can do to take my mind off my problems without contacting another person (relaxation technique-physical activity)
  • Step 3 – People and social settings that provide distraction.
  • Step 4 – People whom I can ask for help.
  • Step 5 – Professionals or agencies I can contact during a crisis. (Therapist, emergency contact, AA, NA, PACT team worker)
  • Step 6 – Making the environment safe.

If you cannot de-escalate the crisis yourself, you can seek additional help from mental health professionals who can assess the situation and determine the level of crisis intervention required. There is nothing wrong with asking for help. You just might save the life of a loved one.


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