CMA POST 9 Response

Question: Compare interventions used for psychiatric crises with those used for other crises.  What are the similarities? What are the differences? 

Posts are a minimum of 250 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and a minimum of 2 references (which may include the course textbook). Reply to at least one classmate's initial discussion post by Friday at 11:59 PM ET. 

STUDENT’S POST- SHO

Psychiatric crisis interventions often require additional assessment of mental status, suicide and violence risk, decision-making capacity and the potential need for voluntary treatment. It is crucial for PMH-APRN to understand both the similarities and differences between psychiatric and other crisis interventions to support appropriate clinical decision-making, interdisciplinary collaboration and evidence-based care.

Similarities between Psychiatric and Other Crisis Interventions:

Both psychiatric and non-psychiatric crisis intervention require rapid assessment, prioritization of life-threatening concerns and implementation of appropriate protective measures. In medical emergency, providers assess and stabilize patient’s airway, breathing and circulation and in psychiatric emergencies, providers assess for severe agitation, suicidal behavior, self-harm and harm to others, psychosis and impaired functional abilities (Johnson et al., 2022). Psychiatric and non-psychiatric crisis interventions involve obtaining background information on the patient, identifying the presenting symptoms, identifying causative factors, evaluating patient’s needs and providing emotional support (Wang & Gupta, 2023).

Effective communication is integral in both types of crisis interventions. Providers communicate clearly, listen actively, validate the patient’s distress, demonstrate empathy and avoid judgement. In both settings, patients may experience fear, confusion, helplessness or loss of control. Providers use calm and supportive communication to reduce distress and improve cooperation with treatment. Providers for psychiatric and non-psychiatric crisis should avoid applying similar approaches to every patient. Instead, they should tailor interventions to the severity of crisis, patient’s preferences, presenting signs and symptoms, available resources and underlying medical or psychiatric conditions. Both types of crisis requires collaboration and involvement of interdisciplinary team and social workers. Appropriate discharge planning, clear communication between providers and patients, patient involvement in decision making, and timely follow-up in both crises can help reduce the complication and promote recovery.

Differences between Psychiatric and Other Crisis Interventions:

Although the foundational principles overlap, clinical priorities and assessment methods and treatment approaches may differ from each other. In psychiatric crisis, assessment focus on mental status, suicidal or homicidal ideation, psychosis, mania, depression and substance-related presentations. In contrast, medical crisis assessments focus on physiological instability such as respiratory distress, cardiac arrest, infarction, stroke, hemorrhage and altered mental status. Communication during psychiatric crisis emphasizes empathy, active listening, validation, acknowledgement of the patient’s concerns and verbal de-escalation. In contrast, other crisis may require rapid and direct instructions to address imminent physical danger. Interventions for psychiatric crisis may include crisis counseling, safety planning, psychiatric evaluation and pharmacological intervention including hospitalization whenever needed. Other crisis interventions may involve first aid, emergency medical management, rescue operation, evacuation and disaster relief. Long-term support following psychiatric crisis may include individual and group therapy, peer support and mentoring, social services, psychiatric treatment, ongoing mental health management programs and advocacy (Johnson et al., 2022). For other crisis, long-term support may include physical rehabilitation, financial assistance, housing support and trauma counseling.

Both the psychiatric and non-psychiatric crisis interventions involve assessment, safety, communication and coordination. However, psychiatric crisis response focuses on emotional stabilization and behavioral health needs whereas other crisis response prioritize physiological stabilization, injury management and management of acute medical conditions. Regardless of the type of the crisis, interventions should be respectful, tailored to individual’s needs and focused on safety and recovery. Collaborative crisis planning is intended to carry out during crisis, and is considered as the most effective intervention in preventing mandatory hospitalization when appropriate (Johnson et al., 2022).

 

 

References:

Johnson, S., Dalton‐Locke, C., Baker, J., Hanlon, C., Salisbury, T. T., Fossey, M., Newbigging, K., Carr, S. E., Hensel, J., Carra, G., Hepp, U., Caneo, C., Needle, J. J., & Lloyd‐Evans, B. (2022). Acute psychiatric care: Approaches to increasing the range of services and improving access and quality of care. World Psychiatry, 21(2), 220-236. https://onlinelibrary.wiley.com/doi/10.1002/wps.20962

Wang, D., & Gupta, V. (2023). Crisis intervention. In StatPearls.  StatPearls Publishing. https://www.ncbi.nlm.nih.gov/sites/books/NBK559081/