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OF mental health care and mentally ill

Counselling in a crisis

A crisis is a situation when a person feels completely overwhelmed or defeated by the problems heis facing. What one person may see as a crisis would not necessarily be regarded as a crisis bysomeone else. Thus, the definition of a crisis is based on the person’s view of his situation, and onhow the situation has affected his ability to cope with the problems.

Crisis counselling should help such people cope better during this period of extreme distress.

The key steps in crisis counselling are:

Get more information. What has happened? Why did she come to the clinic? Who are the peoplewho can support her at this time? Get information from the family or others who have comewith her.

Establish rapport. Allow her to tell her story at her own pace. Do not appear to be in a rush. Seeher in private.

Assess the person’s mental health. By talking to and observing her, see if she is behaving in an oddor unusual way. Is she saying things that are irrelevant? Is there any sign that she is drunk?

Assess what is the main problem that has caused the crisis. Usually, there is a single major problemthat causes the crisis. Most often, the problem is a relationship breakdown, bereavement or theresult of violence.

Try to suggest solutions. These could include sharing the problem with others, reassuring her thatshe is not going mad, making contact with the police or otheother helping agencies, and referring toa hospital for a short admission in severe situations.

Give medication if appropriate. For example, if she is very agitated and has not slept well, you canprescribe a few days’ supply of sleeping medication.• Always ask to see the person again for review in a day or two. Many people will be much calmer onreview and more in control of the situation. A more thorough mental health assessment shouldthen be made.


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