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Blog: Blog2

Stuck on the Crisis Service Merry-Go Round?

Updated: Sep 7, 2023

Mental health crisis services are an essential part of the healthcare system, & provide essential emergency interventions for many people needing urgent help.

Crisis services have the role of providing immediate safety, containment & assessment for people who are unable to stay safe. This is usually in the case where someone is having intense thoughts &/or urges to harm themselves or end their life.

However, what many people (including many healthcare providers) don't realise, is that recommended treatment for chronic self harm & suicidal thoughts is entirely different from the treatment for acute & sudden-onset suicidality.

Below is an illustration of what the crisis services journey often looks like for people:

The common stages are:

  1. The person expresses suicidal thoughts/ plans to someone

  2. They are seen in their local Emergency Department for assessment

  3. They may have a brief hospital admission (only sometimes)

  4. Discharged home with follow up from generalist mental health services (eg. general counsellor/ therapist; community mental health team/ case management service).

The problem is, if the person's thoughts & urges of self harm have not resolved, they often get referred straight back to the Emergency Department as soon as they express suicidal ideation to their community workers.

And the cycle continues!!! Nothing is improving.

Do you recognise this cycle for yourself or someone you love???? It can leave people feeling even more hopeless. The good news is if this is you- it's not you that is the problem- it's the system!!!

This crisis treatment structure can be helpful for people with acute suicidality or self harm urges, & with underlying conditions such as major depression or psychosis.

But this treatment model does nothing to help people whose suicidal & self harm urges are LONG-TERM & CHRONIC in nature.

What's long-term or chronic mean? Months & years of pretty constant feelings of hopelessness & thoughts of self harm &/or suicide. Many people I work with state they have felt somewhat like this since childhood. They've often tried medication & other treatment options, with no affect. These people need better treatment options!

Here's what a better treatment plan looks like for anyone with chronic self harm or suicidality:

  1. The person expresses suicidal urges & plans

  2. Crisis assessment & brief admission may be required if unable to stay safe in the short-term

  3. The person is discharged to a SPECIALIST SERVICE who work with chronic suicidality & self harm as part of their daily business (usually a DBT program/ service)

  4. At this service, the person & their family are supported to develop a better safety plan that incorporates new skills to manage the thoughts & urges.

  5. Treatment is focused on building long-term distress tolerance & emotion regulation skills, with a goal of recovery & creating a life that feels worth living.

If you identify with this struggle, & like the idea of a better way, we can help- it's what we do!!!

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