I am writing this on the heels of a very difficult week. This week I was reminded how hard it is to know what to do during a mental health emergency.
People break.
Anyone can break. No one knows their stress-load and how much they can take.
When a person breaks, they start saying completely crazy off the wall things. They don't sound like themselves. It is as if they aren't inside their bodies.
They hear voices, they imagine people are out to get them, they say things that make no sense. One minute they are talking about one thing and the next minute they are crouching on the floor to avoid being seen by a crow in the tree.
If you are around someone who breaks, the word we call it is psychosis. Psychosis can happen when someone is very depressed, or very manic, or if they are schizophrenic.
If you are with someone who is having a psychotic episode, please know the person can be very dangerous to themselves and other people.
They may never be the kind of person that would hurt someone, but when they are out of their minds, and they don't know what they are saying or doing, they can accidentally hurt themselves, kill themselves, or hurt others.
It is very important to get the person into a safe place where they can't be hurt or hurt others.
Now here is where all things can go very wrong or very right.
It is very important to get the person to a hospital. You may need to call an ambulance to safely transport them. Ambulance drivers are angels here on earth. If you drive someone yourself, they could jump out of your moving car and start another situation on a road or bridge. Call an ambulance if possible.
But not all hospitals treat mental health emergencies. If you can, call and ask if the hospital has a psychiatric unit. Try to get the person to a hospital that has a psychiatric unit. Those hospitals are better equipped to help during a mental health emergency.
But you may not be near a hospital that has a psych unit. If not, please go to your emergency room. There are two things they can do in any hospital.
1) They can call for a mental health person to evaluate the seriousness of the situation in hospital. Having a CDMHP (County Designated Mental Health Professional) come evaluate is critical. I know most people think if a Doctor sees the person that will be enough. But actually, the Mental Health professional is the person who is authorized to get a temporary hold to have a person kept at a hospital to protect them from hurting themselves. These counselors don't work in the hospital. They have to be called to the hospital. You must ask, demand, and insist that they be called. There may be one person on call for a large region and it may take 8 hours for them to get to the hospital. But the hospital will not release the person until they are evaluated. Please wait for the evaluation. It may be the only way to get help for the person you love. WAIT.
2) Ask the staff to administer HALDOL. This is a medication to help a person who is having a psychotic episode. The medication will help them calm down and help the psychosis recede. They may wait to administer meds til after the Mental health counselor gets there, but do get the medication.
3) Any person having a psychotic episode needs round the clock supervision with someone who is awake at all times making sure the person doesn't get up and do something unsafe.
Arrange for psychiatrist and counseling to start the next day when the person comes out of the hospital. Care, medication, supervision/support needs to be surrounding the person until they recover. Recovery can take time. Every person is different.
This is a complicated thing to describe in a blog but these days our healthcare and mental health systems are simply NOT RESPONDING APPROPRIATELY IN EVERY SITUATION and it is up to you to ADVOCATE. You need to know how to help your family and friends.
1- Get to a hospital. Call for an ambulance.
2- Request a CDMHP
3- Ask for HALDOL medication
4- Provide 24 hour supervision until a counselor psychiatrist says it is no longer needed.
5- Get appointments lined up to be sure there is enough medication to help the person recover and therapy for the issues that may have contributed to the episode.
6- Create a support team of family and friends around the person to walk the road of recovery with them.
I feel sick that you need to be prepared because our systems are so broken, overburdened, and a person who needs help may not get it. One day someone may call you and say, "I don't know what to do" and you may be that person who knows what to say.
Every person needs an advocate during a mental health emergency. The person who breaks can't do this for themselves.
Without the medication, help, safety and support, the consequences are tragic.