Reaching out

How to help someone experiencing a crisis

This article was published on 09.19.19

Every day, thousands of people walk Reno’s streets, often uneventfully. Yet, sometimes, pedestrians might witness someone shouting at no one in particular or moving erratically—even in and out of traffic. Other times, it might seem like someone is confused or perhaps lost, their behavior much more timid, but still out-of-place. These people could potentially be suffering a psychotic episode or other mental health crisis, and, to concerned members of the public, it might seem responsible or even necessary to intervene in some way.

According to Danica Pierce, a behavioral health provider at Northern Nevada HOPES hospital, it’s important to trust your instincts about what’s happening, especially if you’re untrained.

“The only checklist is [your gut],” Pierce said. “If you’re noticing like, ’this seems odd,’ then it’s probably odd.”

“Some of it is really intuitive,” added Brandon Cassinelli, an embedded resource officer in the Reno Police Department, about identifying a mental health crisis in public. “You can almost feel that something is going on.”

Both stress the importance of prioritizing safety first before offering any assistance. Pierce suggests asking if they’re OK from a safe distance as a good first step. They said to pay attention and note as much detail about the incident as possible in order to help you better assess what to do next, as well as provide a comprehensive report to any intervening law enforcement or medical help that might follow.

Pierce and Cassinelli are both in key positions within the architecture of mental health care in Reno.

At HOPES, Pierce coordinates the Medicated Assisted Treatment program for people addicted to alcohol and opiates, which prescribes medication to help them achieve stability. It’s important work as alcohol and opiates are two of the three most abused substances in Reno, according to the Washoe County Health District.

Meanwhile, Cassinelli recently pitched his bosses on integrating the management of community behavioral health and the police department’s internal mental well-being—an offshoot of his graduate studies in psychotherapy at the University of Nevada, Reno.

His bosses, agreed and for the past month, he has been working with Pierce to ensure that law-enforcement is fully aware of the available mental health resources that they can deploy in managing mental health crises in public, but also in taking care of themselves. So far, it’s working out—internally and externally.

The experts said that providing help to people experiencing a crisis—whether it’s a stranger or a friend—should affirm their autonomy and right to refuse help as long as they do not pose a danger to themselves or others.

Although one can feel obligated to help a friend who is struggling, Cassinelli cautions that imposing mental health resources on a friend is guaranteed to change your relationship—for better or worse—and can be counterproductive if the friend is not invested enough to help themselves. In addition, it’s necessary to provide specific resources for each situation rather than just a general appeal to seek help.

HOPES, Community Health Alliance, and Northern Nevada Adult Mental Health Services all offer free to affordable behavioral health services—from therapy to medication—for all patients, including the uninsured. Pierce reports that 33 percent of the clients at HOPES are uninsured, and over 70 percent are on Medicare or Medicaid.

The Crisis Support Services of Nevada also operates a 24/7 call center that people can call anonymously for critical support in dire moments, which can sometimes be the difference between a tragedy and recovery.

Additionally, the Mobile Crisis Response Team, a crisis intervention service across Nevada for adolescents, can be on-site for individuals who need immediate intervention. There’s no such support service for adults, though, and Pierce and Cassinelli recognize that it is one of the many gaps in behavioral health services that the city still has to fill in order to provide robust care.

Of course, Emergency Services, or more commonly 9-1-1, remains an invaluable resource in crisis situations—even mental health. Although it’s synonymous with police, Cassinelli clarifies that there will usually be a mental health care provider riding with the responding officers, who will advise and sometimes take lead on handling the situation.

As of now, this ride-along service is available seven days a week but not round the clock (there’s no one during graveyard shifts) and providers in the area are limited, but it’s a marked difference from the previous systems.

“Before, [a resource] might have gone completely under our radar, [that we could refer people to], as opposed to the old revolving door of incarceration: arrest and release, arrest and release,” Cassinelli said.

Sometimes, depending on the situation, dispatch may also send a medical response team instead.

No matter the case, the key to providing good care is inquiry, compassion and attentiveness. The best response usually starts with being circumspect in assessing what’s happening. Then, inquiring from the affected party if there’s any way they’d like you to help. Finally, informing the owners or representatives of the relevant establishment before involving law enforcement or emergency services—at all stages, reinforcing their humanity.

“No one is immune, any demographic, any job, any socioeconomic status, [to] struggle,” Cassinelli said.

Northern Nevada HOPES

580 W. Fifth St.

786-4673

nnhopes.org

Community Health Alliance

330 Crampton St. 336-3700

3915 Neil Road 870-4333

chanevada.org

Reno Police Department

Non emergency number 334-2115

Northern Nevada Adult Mental Health Services: