What is a crisis?

During an acute psychotic episode, when symptoms are at their most obvious, individuals and families can find themselves in severe crisis or emergency situations in which help is needed straight away. Remember that during an acute psychotic episode, individuals will often not recognize that they need assistance, and families will need to seek assistance on their loved one's behalf, even against their will. Sometimes families are not sure if a situation is a crisis or an emergency. In these circumstances it is wise for the family to trust their feelings - if they are feeling overwhelmed, afraid, and unable to manage the person's behaviour, then prompt action should be taken. Some crisis situations are noted below.

• The individual talks about or is trying to hurt or kill themselves, or hears voices directing them to hurt themselves. All threats or gestures of this type need to be taken very seriously, and help needs to be sought straight away.
• The individual threatens or seems likely to harm others. If the person is behaving in a threatening or aggressive manner towards another person, or if the individual is hearing voices directing them to hurt somebody else, then this must be taken very seriously indeed and help needs to be obtained straight away. Sometimes people who are experiencing delusions believe that another person is trying to harm, poison or kill them or someone they love, and they may take violent action against someone to prevent this happening. However, it is important to remember that in general, people who are experiencing a psychosis are not necessarily more dangerous or violent than anyone else. Much depends on the type of disturbed thinking they are experiencing. Sometimes this can be concealed from the treating professional and it is vital that families, in such a situation, communicate their fears.
• The individual may become verbally aggressive, abusive, and becomes angry easily.
• The individual experiences very obvious symptoms of a psychotic state including hallucinations and delusions.
• The individual behaves recklessly, such as walking alone at night, or engaging in dangerous or inappropriate sexual behaviour.
• The individual has stopped eating or drinking.