A woman has called you to help her middle-aged friend, who has stopped eating and talking and has frequent crying spells. Your history reveals that the woman lost her husband a few months ago, and has been withdrawn and despondent ever since. Throughout the assessment, the alert and oriented woman continually states that she wants to be left alone. When you bring the stretcher into the room, the woman states, 'I do not want to go to the hospital. Let me sign whatever I need to sign.' What is your best response to this situation?

Emergency medical services (EMS) providers should follow these steps for pre-hospital treatment of psychiatric disorders: Stabilize the crisis, Avoid coercion, Treat in the least restrictive setting, Form a therapeutic alliance, and Formulate an appropriate disposition and aftercare plan.  Here are some de-escalation techniques for psychiatric emergencies: Maintain a calm, reassuring, and compassionate tone of voice Ask the person's name and use the name they give you Do not touch the patient unless required and permission is given Physically lower yourself to eye level with the... Show more

Emergency medical services (EMS) providers should follow these steps for pre-hospital treatment of psychiatric disorders: Stabilize the crisis, Avoid coercion, Treat in the least restrictive setting, Form a therapeutic alliance, and Formulate an appropriate disposition and aftercare plan. 

Here are some de-escalation techniques for psychiatric emergencies:
Maintain a calm, reassuring, and compassionate tone of voice
Ask the person's name and use the name they give you
Do not touch the patient unless required and permission is given
Physically lower yourself to eye level with the patient
Slow down
Acknowledge hallucinations, but don't dismiss them: 
For example, "I understand that you see bugs. I do not see them. That sounds scary. We care about you and I would like to try to help you with that" 

Behavioral health emergencies are a priority for EMS professionals. 
These emergencies can take many forms, including:
Mental health crises, such as those related to bipolar disorder, schizophrenia, or PTSD
Intoxication due to alcohol, drugs, or both
Neurodegenerative disorders, such as Alzheimer's disease or dementia
Patients or bystanders who present a danger to themselves or others 

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