Crisis Intervention and Special Populations
Core concepts
Crisis intervention requires recognizing mental illness, developmental disability, autism, dementia, traumatic brain injury, and substance intoxication. Use de-escalation: reduce stimuli, use one clear voice, allow time, avoid crowding, and ask about communication needs. Distinguish noncompliance from inability to comply. Suicide intervention requires direct, calm questions about intent, plan, and means, and removal of access to weapons when lawful. Connecticut law permits emergency examination when there is probable cause of mental disorder and dangerousness; know the statutory procedure. Special populations include juveniles, elders, deaf or hard-of-hearing persons, and limited-English speakers. Accommodations are part of lawful policing, not favors.
Traps
Questions often equate mental illness with dangerousness; it is not. Compliance is not consent. Do not assume a person who avoids eye contact is deceptive; it may be cultural or a disability. Do not rush a person in crisis. Do not ignore caretakers or family who can provide history. Do not use force as a first option when time and space are available.
Worked example
A man with autism is pacing and covering his ears. You reduce radio volume, keep distance, use short sentences, and ask his caregiver what usually helps. Rule of thumb: slow down, lower the stimulation, and identify the need before directing the behavior.