Handy Guide for Crisis Team Workers

Times when it is appropriate to suggest a service user has a bath:

  • When service user is stinky
  • When service user has joint or muscle pain
  • When service user has a new rubber duck or submarine toy they want to try out

Times when it is appropriate to suggest service user has a nice cup of tea:

  • When service user is thirsty
  • when the service user wishes to throw tea at you
  • when service user has a surfeit of biscuits that need dunking. (Please note, in the interests of safeguiding we offer the following link to avoid the “drop off” http://news.bbc.co.uk/1/hi/sci/tech/220400.stm)

Most mentals can count, I’d you tell them you will ring them back in a set number of hours, despite being mentals, they might notice if you don’t .

2 min of speed talking support  is generally not considered an adequate amount of phone support time. It suggests mania on the part of the crisis team worker.

Try not to audibly sigh when you pick up the phone to one of those pesky mentals who insists on feeling desperately suicidal more than once in their lives.

Don’t run your colleague over when picking up a mental to take to hospital (advice based on experience of this happening…)

A choice is only a choice if someone can see that there are multiple, better, options to choose from. Abdicating any professionalism or responsibility in your paid role of supporting the most desperate by suggesting that, to you, ending their life is about as important as deciding whether to have cornflakes or shreddies is not at all helpful or empathetic. If you are so jaded / behind with your paperwork / bored of all those people phoning you about the same old thing, that you are unable to assist the person to see and achieve viable alternatives please try really really hard to reimagine the person on the other end of the phone as a unique human being every bit as important and worthwhile as you and yours. If this is too hard for you please consider an alternative career asap, I have heard the DWP are recruiting.

Replace “It is your choice if you want to die” with “Would you feel better if you punched me hard enough to bloody my nose right now?” This is a phrase that may actually make your patient feel better.

“Dear crisis team…why do you tell us ‘it’s our choice’ when we call and say we are suicidal. Do you think that we have somehow lost our capacity to understand the nature of free will?”

Please note that most callers have been assured that “help is there” and so are phoning to access said help. Being told one must “take responsibility” negates all previous and potential offers of “help”. (“they think that is helping us – it’s helping us understand adult roles and encouraging our independence”)

Don’t suggest gardening as a relaxation activity if:

  • the caller lives in a flat with no garden.
  • Or hates gardening.
  • Or has bodies buried in said garden.
  • Or is phobic of garden things.
  • Or if the person is a gardener for a living.

“ I once got told to take my dog for a walk. At 2am. When I lived in a dodgyish part of town. And I didn’t have a dog. Oh and was terrified of dogs.”

Suggesting callers distract themselves by watching daytime TV can increase suicidal ideation (have you SEEN the crap that’s on?!!).  Instead, suggest throwing television through a plate glass window, or remodelling it with a baseball bat.  “I once got told by a consultant psych to ‘go home and watch more tv’. Think I waited about 6 months for that appointment.”

Unless the Crisis Team have team uniforms like the Power Rangers they are not a real team.

Daily meds drop off does not constitute crisis care. This is Med FedEx.

“I’d like a computer crisis plan. Cake Crisis Intervention would also work”

Spell crisis Krysis, it’s fun and will distract you.

No one has yet suggested ‘mindfulness lego’. Lego could bring out a special range of undemanding kits that make – well, something soothing.

Get clients to sign up for a monthly care package, then once a month just post them a bin bag of junk you cleared out that even the charity shop rejected.

Do not suggest colouring in unless you are speaking to a child. If you are speaking to a child they have the wrong number.

We understand the government are fucking you over too, don’t take it out on us. And if you do take it out on us, don’t be surprised if we respond by asking if you’d consider taking a bath.

Don’t ask service users if they are “having thoughts” because to answer means having one.

To save time offer an automated phone service with options for dx and activity. (see http://rebot.me/april-61*)

If your attitude towards other humans would make you a good bouncer of a rough hartlepool nightclub….then maybe thats where you should work?

Stop telling us that refusing to help us is for our own empowerment and recovery …

If someone is suicidal/has attempted suicide, don’t try and scare them out of completing by telling them how awful “the other side” might be (actually happened to me)

“Yes, have had all off the above, including been told to find Jesus. Telling them I have already found him in the bath you will tell me to have, and we are painting the walls with our nipples, didn’t go down very well. Neither did telling the crisis worker it was their bath we were in.”

It is just a matter of time until the crisis line has call waiting muzak such as ‘Jump’ by Van Halen and ‘Loser’ by Beck, etc

Do not tell us our ‘serotonin module is broken’.

When advising suicidal people to ‘go and sit on the beach’ please check that the beach is not located under a 100 foot cliff.

If Jim calls late friday night feeling suicidal and desperate, do not ring jim on saturday morning pretending to be mary poppins and start the conversation, ‘so how is jim today?’ You are not a primary teacher and you have not listened to jim.

“we have a crisis/htt and a ‘crisis line’ the only thing the crisis line can do is call an ambulance for you. There is one woman on the line who gets angry if you say you want to hurt yourself, and tells you quitters don’t win and winners don’t quit. Yeah, uh, thanks for that.”

Maybe don’t say “who gave you this number. Don’t call this number” ( that’s when the number is even given or available, otherwise it’s covered by the Official Secrets Act or the answerphone is on”)

Please understand the double bind you put suicidal people in when you tell them they are attention seeking

You can’t spell crisis without ISIS. Suspicious eh?

I used to work in a crisis team and I loved it but a) the tories happened and shagged everything up and b) it demonstrated so clearly that there is *nothing* (apart from driving out with meds or arranging MHA assessment) crisis team can really do. There’s not enough time to properly spend with people, the shift pattern means you can’t work consistently with people to do anything genuinely useful. It all becomes an unsatisfactory stopgap. Again this is the NHS insisting they’ve got the answer and they’ve got nothing…”

 

Useful advice for service users

Show that you are putting in some effort and taking responsibility by having a crisis only during scheduled hours and not for too long. And then recover, so we look good.  “I once ‘phoned the out of hours crisis team in distress only to be told that there was no one there who could help and could I ‘phone back in the morning after 9am. I informed them that ok I would try to have a breakdown then instead then and slammed the ‘phone down.”

You’re crisis is simply too urgent to be called a crisis, we’ve upgraded you to complex needs, god will help you now, if you just didn’t have that 666 tattoo we could have helped.

“distress tolerance techniques” (never mind dealing with the cause of distress, tolerate it better!)

*Crisis bot courtesy of Mind our Minds https://mindourminds.wordpress.com/