Police-Encounters-With-People-In-Crisis

5. Comparison to unarmed professions
63. The Review received information from members of the mental health profession
and consumer survivors with respect to the techniques used in community facilities,
clinics, and hospitals to resolve situations with people in crisis. These techniques do not
involve the use of weapons, and often do not involve resort to physical restraints. Even
where an individual in crisis has a weapon, medical professionals start with verbal deescalation
attempts before proceeding to physical techniques. For example, mental
health hospitals regularly encounter “Code White” situations in which a patient becomes
aggravated and uncooperative, and may wield an improvised weapon. Although verbal
de-escalation is not effective every time, it is the starting point for all situations.
64. The Registered Nurses Association of Ontario has issued a Nursing Best Practice
Guideline for Crisis Intervention. 57 The Guideline incorporates a crisis intervention
model—which may usefully be contrasted with the Ontario Use of Force Model—aimed
at identifying the event that precipitated the crisis, assessing the patient’s perception of
the event, the patient’s level of functionality and distress, and previously attempted
coping mechanisms. The goal of crisis intervention for nurses is to return the patient to
his or her pre-crisis level of emotional, occupational and interpersonal functioning. A
visual depiction of the Nursing Best Practice Guideline for Crisis Intervention is shown
in Figure 2.
Figure 2. Nursing Best Practice Guideline for Crisis Intervention
• Develop rapport
• Maintain contact
• Identify the problem
• Explore coping
• Assess risk to life
• Negotiate an action plan
• Implement the plan
• Follow up on the plan
57
Registered Nurses Association of Ontario, “Crisis Intervention: Nursing Best Practice Guideline – Shaping the future of Nursing”
(March 2006), online: Registered Nurses Association of Ontario .
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