Crisis Intervention & Suicide Prevention
J. Elizabeth Lawrence Dixon, MSW
The EPIC Foundation
Abstract- This article is a brief introduction to what crisis intervention is and lays a foundation for understanding how to utilize these interventions with the goal of suicide prevention. The article gives both local and national options while explaining the importance of early, crisis intervention. This article is in no way a training tool, but a simplified explanation of the topic. This is the first of several short articles that will be addressing suicide, mental health, chronic illness, and trauma.
Keywords- Suicide; Crisis; Prevention; Interventions; Social Work
November 19, 2016 was International Survivor Day. These survivors are those who have lost a loved one who has died by suicide. It is important to recognize the language used there, “died by suicide.” In many cases those who have left this Earth too soon were battling a disease and the death by suicide was a complication of that disease. No one dies from AIDS they die of an AIDS related illness, Major Depression, Mood Disorders, and Psychotic disorders are sometimes the catalyst that causes the death. That is not to say everyone with a mental illness will attempt to harm themselves or die by suicide, but there is always additional risk with those that are chronically ill whether it is physical, mental, or both.
In December of 2014 a friend of mine lost a family member to suicide. The day I found out I was more concerned about the living than the deceased. As someone who works in the field I had seen some tragic moments at the scene of a death to the mourning that exists months to years later. I knew how the Fire department and police show up to create safety and security. I knew how it could be hours until the medical examiner showed up to document the death. I knew what the bag looked like that the body is put into. I knew the phrases that would be said, in that excruciating moment that would be helpful or not. I knew that I would hear of an empty void that would be left without that person alive. Suicide is difficult because it is rarely planned out with family members, excluding those states were assisted suicide is legal. There is this shock, inability to find closure, and the nagging questions of “why didn’t I know? Why didn’t I save them?”
The day of the funeral I showed up despite not feeling well and being exhausted after working a 24-hour shift with the local Fire department. This was the same place I had gained the intimate knowledge of what life looks like the moments to hours after a death. At the memorial service, I remember the flowers, the tears, the hugs, the looks on people’s faces, and how peaceful the cool day felt. I still have the memorial card that was left out on the tables of the gathering, with the person’s picture and name on it. The card sits in my wallet as a reminder for many things and on my worst days I think about it, about that person, and why I do the work I do.
In Maricopa County, Phoenix Arizona there is a dedicated crisis response model. This model includes a 24/7 crisis hotline that is ground zero for free to the community transportation and crisis mobile teams. The crisis mobile teams are run by two non-profit organizations with at least 1-2 mobile teams running at any point of the day. In addition to crisis mobile teams that focus on all forms of crisis, several Fire departments use a volunteer base to have crisis response vans to assist at scenes of death, accidents, fires, and disaster situations.
A favorite article of mine that addresses the importance of having Social Workers (BSW and MSWs) working in the field of crisis was co-written by a former MSW supervisor of mine. The article is a brief snapshot of how I spent 500 plus hours of an MSW internship. It eloquently outlines how Social Workers can affect positive crisis intervention in the community and in doing so provide suicide prevention (Cacciatore, Carlson, Michaelis, Klimek, & Steffan, 2011). Everly (2000) defines the five core principles of crisis intervention and risk reduction. The article continues with a well-defined description of crisis, but simply put, crisis is any stressful incident that overloads the person’s ability to cope and therefore causes a rapid escalation of emotional and somatic symptoms.
The outcome of this event could be ongoing psychological issues such as PTSD. A crisis event could be a car accident, house fire, death, natural disaster, and in more recent years for the United States domestic and international terrorist attacks (Everly, 2000). A crisis intervention is for deescalating acute symptoms of distress, reduce the symptoms, restore the person to previous functioning, and create a referral/follow up for the person to address ongoing symptoms (Everly, 2000). A crisis intervention may be used to mitigate a person’s symptoms that could lead to a suicide or it may occur after someone has died by suicide. This remainder of this article focuses on how crisis intervention can be utilized to address suicide prevention.
Maricopa County is not the only County to offer crisis services. Many cities, states, and even at the federal level has crisis response teams or crisis response training due to the need. This portion is not to educated you about how to perform in-depth crisis intervention, but it is to educate you on how to use resources. If you are not familiar with your local resources and it is an immediate crisis, such as a person is unable to keep themselves or others safe, always call 9-1-1. First responders such as Police and Fire are able to keep a person safe until a professionally trained person/team can assist.
If the situation does not warrant immediate intervention, utilizing the National Suicide Prevention Lifeline during a crisis is appropriate. The hotline consists of a network of 161 crisis centers that will support you with addressing the current crisis. The website for National Suicide Prevention lifeline has a chat component for those who have hearing impairments. Below are some other helpful numbers and links that address suicide prevention by interacting with mental health professionals and trained volunteers. This is a very short list, but most hotlines can refer you to a local or specialized hotline as needed.
- National Suicide Prevention Lifeline – 1-800-273-8255
You can visit at http://suicidepreventionlifeline.org/
- National Suicide Prevention Lifeline: Hearing Impairments http://suicidepreventionlifeline.org/help-yourself/for-deaf-hard-of-hearing/
- Crisis Text Line – text 741741 to get help
- IMAlive is a web based chat line- https://www.imalive.org/
- Trevor Lifeline (LGBTQ) has talk, text and web based chat systems – 866-488-7386
- Sexual Assault Hotline – 800.656.HOPE
Cacciatore, J., Carlson, B., Michaelis, E., Klimek, B., & Steffan, S. (2011). Crisis Intervention
by Social Workers in Fire Departments: An Innovative Role for Social Workers. Social Work, 56(1), 81-88.
Everly, G. S. (2000). Five principles of crisis intervention: Reducing the risk of premature crisis
intervention. International Journal of Emergency Mental Health, 2(1), 1-4.