You can sense there will be a crisis long before it happens. You have days when you’re so concerned about your child and family (and work and responsibilities) that you can’t think straight. You can’t even spend time on little things like chatting with a friend or reading a magazine. Your intuition says it’s only a matter of time and you won’t be able to handle it.
Before this happens, make a Crisis Plan with these priorities in order:
- Safety for everyone comes first
- Stabilization and treatment for your child
- Stress reduction for the family afterwards
- Lessons learned
What constitutes a mental health crisis?
- When something dangerous has happened or is likely to happen because of a child’s behavior, words, plans, or triggering events that they experience.
- Anytime a child’s behavior leads to harm or imminent harm to the child or someone else (including pets), or significant damage to property. Harm also includes emotional harm, threats, running away to unsafe places or doing unsafe things.
Trust your gut and trust your intuition.
Examples of a crisis when you must act
- Watch. Pay attention to evidence your child has plans for suicide, which may include seeking dangerous items; or making multiple references to hating life; or they have a worsening mental state, or there’s been a prior suicide attempt. Try this: “Use the “S” word: talk openly with your child about suicide.”
- Look for increasingly troubled behavior over time that leads to extreme behavior: non-stop raging, assault, repeated running away, threatening, talking about strange things, or spending too much time alone.
- Pay attention following a traumatic event, such as someone else’s suicide or a newsworthy major tragedy. These can trigger a child to act dangerously on thoughts they already have.
- The child runs away while psychotic, or depressed, or with a dangerous person–perhaps another troubled child–or under the influence of drugs or alcohol.
- Psychosis of any kind including hallucinating or hearing voices; odd ideas; extreme agitation, anxiety, or paranoia; or a belief they have special powers.
The Crisis Plan
Have a crisis plan for home, school, and any other place where the child spends time. For some, it’s also the parents’ workplace. If a child is in college, a student adviser or someone in the campus health clinic needs to be a contact for checking in on your child.
Plan A: call 911. You will not be bothering the police or emergency responders!
Plan B: Answer these questions
For a runaway. Who gets on the phone to call 911, and who goes out to look for the child and bring him or her back without mutual endangerment? Both should know how to work with police and other community members. There is no waiting period in a missing person’s report. Check this article for what to say in call and do when police arrive. “How to work with police once you’ve called 911.”
Note: children have been known to behave perfectly once the police arrive, and police sometimes implicate the parents as having the problem. Don’t let this bother you. You have demonstrated to your child that you are willing to call the police, and you’ve asserted your authority. You might point this out to them–another episode of extreme behavior will be countered with significant action on your part. Use a neutral tone and avoid making this sound like a threat!
Who else knows your child and is trustworthy: others parents, businesses, teachers, their friends? Are any of them able to assist you with talking to your child or keeping them safe? Can any them help you “hold the fort” while waiting for an emergency responder? Build a support network in advance:
Who gets on the phone and calls for extra assistance? And is there a list of phone numbers? Does your town or city have a crisis response team for kids? What about a crisis line run by the mental health authority? Check. They are there to help.
Who should be appointed to communicate with the child? This should be a family member or friend or teacher that the child trusts. Communication with the right person can solve things fast, but with the wrong person can backfire, even from a parent… perhaps especially from a parent.
Who should step in and break up a fight, physical or emotional? And what specifically should they do or say to de-escalate a situation spinning out of control? Think about this: your troubled child can often tell you exactly what works best and what makes things worse. Listen to them. It doesn’t have to sound rational to you as long as it works.
How should a time-out work? Who counts to 10, or who can leave the house and go out for a walk? Where can someone run to to feel safe and be left alone for a while? What are the emotional safety rules for when the time out ends? How can you and your child trust each other enough not to upset a fragile stability?
What should teachers or co-workers or others do to calm down a situation and get their classroom or office back to normal as quickly as possible?
Can a sibling stay at someone else’s house until things cool down at home? Which house? Sibling(s) can benefit from an escape to a friend’s house to protect them emotionally until a crisis has passed. Ask them.
Think of your family and support network as a team that springs into action when someone sounds the Red Alert that your child is in danger. Talk to family members and friends or neighbors ahead of time and give them an assigned role. Let each should know they will be backed up. This will be tremendously reassuring. Your child’s crisis will be an upsetting event, but reasonable people will pull together when they know what’s going on and what they should do. “Gang up on your kids: Parent networks for tracking runaway children”
Experiences and evidence shows that a rapid reduction of stress is effective at reducing the emotional wounds of a crisis. Rapid cooling down of emotions, or “de-escalation,” is what prevents or limits the fallout from a crises. You and your family can develop de-escalation techniques for bouncing back in tough situations. The goal is “resilience.” More than anyone, families with troubled children need resilience.
After the crisis
Everyone gets a mental health break. This could be anything: a day off, eating out, ice cream, going out for a movie… Do something to get everyone back to an OK place and on their feet. There should always be a reward for bravery, team work, and a job well done.
Next time it happens
There will be a next time. A troubled child will be fine for many months and you’ll be so relieved, and then WHAM. Use a previous crisis as a learning experience. What can be done better next time?
Your long-term goal is to reduce crisis frequency over time, or prevent them from happening in the first place.
Many parents have taken these steps to prevent a crisis or limit its severity.
- Communicate directly with a police officer or precinct, school counselor, or juvenile justice official to explain your child’s legitimate mental health disability and your willingness to cooperate. Build a working relationship with them.
- Locks on doors: a sibling can protect him or herself and their belongings; a parent can protect belongings, prescriptions, valuables, and money.
- Track via technology – Track where your child goes and what they see online, and let them know you are doing this. This is legal.
- Track via eyes and ears on the street – Befriend or build trust with your child’s friends, their parents, their teachers, neighbors, and businesses where they hang out. Ask for a report if they see or hear something of concern. They may not be able to do anything but just report.
- Search the child’s room for evidence of unsafe behavior, anything from razors for cutting themselves, harmful substances, porn, weapons, unusual ‘stockpiles’ of stuff (lengthy explanation goes here… just trust your gut if something is out of place). Room searches in your home are legal, but keep them secret and avoid acting on other things you find that aren’t 100% related to danger
- Lock up dangerous items even though it’s inconvenient for you–kitchen knives, weapons, alcohol, drugs and prescriptions, matches, etc.
- Lock up money, credit cards, and valuables. With money in hand, your child is on a path to victim-hood or association with people with criminal behavior. For example, they can buy drugs and alcohol from inappropriate people who then rob or assault them.
- Confront people who undermine your authority. This is often a friend’s parents or other person who thinks you are abusing your child (because your child has told them so). They ‘rescue’ your child and offer safe harbor, and actively help them run away. This is completely against the law, and they are subject to police action and criminal charges. People who do this do not have your child’s safety in mind.
There may be times when, for reasons of safety, you may to do things you are uncomfortable with while you wait for police, ambulance, or friends to arrive. These are things parents have done in a crisis: tackle a child and hold them down; or trick a child to get in a car and then have someone hold them down until they arrive at an emergency room (commonly needed in rural areas). The way to avoid the risk of being charged by your child with abuse or assault is to have those open relationships with the authorities, teachers, and other parents who know your situation. A letter from a doctor can be really important here. I was glad I had one.
There will be fallout if you use force or trickery. Your child will not accept your reasoning or the necessity for your actions. You can truly apologize for upsetting your child but without admitting guilt. Instead, ask what they want to happen next time they are in a crisis. You should also honestly reassure them you will never use extreme methods again unless there is a safety issue.
- Trust your gut
- Act immediately
- Follow a plan that includes others working as a team
- Take care of everyone afterwards
- Prepare for extreme measures
- Retain your authority as a parent by establishing supportive relationships.
You can handle this!