Saturday, January 25, 2020

How to Handle a Behavioral Emergency


I’ll be writing three separate articles dealing with Behavioral Analysis.  I’ll also  give you some examples of what pre-event indicators may look like, and finally, we’ll have a discussion on Behavioral Analysis training.

To say that we live in stressful times is an understatement.  It seems our world has never been more stressful.  There are so many contributing factors, it is hard to know where to start to identify all the stressors we face.  The 24-hour news cycle is a good place to start.  The “always on, always connected” lifestyle that center on continuous use of smartphones and similar devices.  

The distinct decline in civility, particularly is political and religious discussion.  This lack of respect has created a rising intolerance of different viewpoints.  Attacks against Christianity and other religions are on the rise.  This stress can, and does effect individuals and can lead to a behavioral emergency where the person in crisis can be a threat to themselves and others.

There can be different types of triggers to behavioral emergencies.  What triggers a behavioral emergency in one person may have no effect on another.  To be certain, accumulation of stress can be a contributing factor.  A common result of stress is anxiety, fear that the endless parade of bad news and hatred is leading to a disastrous result.  Anxiety is one of the most widespread disorders, with an estimated 10% of the American population suffering from such effects as panic attacks.

Personal events contribute to stress.  Death of a loved one, divorce, loss of a job, an injury, or the effects of a major weather event on property and people.  Substance abuse, medical issues, either undiagnosed or from failure to take the prescribed medications are possible triggers.

Unfortunately, symptoms can be hard to spot.  The people in the best position to notice symptoms are family members, close friends, and co-workers.  Onset can take time, and people who have infrequent interaction are likely to miss symptoms or view them as the person is not feeling well or is having a bad day.

People will exhibit symptoms that show they are susceptible to a behavioral crisis and can be identified by people close to the individual.  Symptoms include:
1) Depression
2) Anxiety
3) Scattered, unfocused thinking
4) Self-doubt
5) Loss of motivation
6) Lack of patience or irritability
7) Paranoia

Special attention should be paid to individuals who have experienced some sort of significant life event as listed previously.  A panic attack can be considered a behavioral emergency, although it can be easier to manage.  Panic attacks can occur suddenly.  Symptoms that a person may be vulnerable to having a panic attack include the following:
1) Extreme uneasiness and worry
2) Agitation
3) Restlessness
4) A person having a panic attack may exhibit one or more of these symptoms:
5) Racing or pounding heartbeat
6) Heart palpitations or an irregular heartbeat
7) Dizziness
8) Tingling or numbness of the fingers and mouth
9) Uncontrollable shaking as though the person is very cold and teeth chattering

When a person is suffering a more severe crisis, common symptoms exhibited may include:
1) Anger
2) Extreme agitation
3) Paranoia
4) Hallucination

Perhaps the most severe aspect of a behavioral emergency is the possibility of violence and subsequent harm to the sufferer and others.  One article reports that nearly 70% of behavioral emergencies result in injuries to nearby people due to attempted assault and other actions.  So, it is vitally important to defuse the situation as soon as possible.

Indications that a behavioral crisis is on the verge of becoming violent include:
1) Pacing
2) Yelling
3) Making threats
4) Clenched teeth or fists

When confronted with an individual exhibiting these symptoms, your Security Team Members need to respond quickly.  They must clear people away from the individual and, maintaining a safe distance, begin to engage that person verbally.

Engaging a person in crisis is best handled by a minimum of two Team Members.  If two Team Members are not available, someone in the congregation or gathering should be enlisted as quickly as possible for support.  The ‘volunteer’ may be a family member, which can be beneficial if the crisis is the result of medication issues.  Regardless, that person needs to take charge of nearby people, make sure they are well back from the person in crisis, and aid the team member if requested.

Note: Only trained individuals should engage a person in crisis due to the volatility of the event.

Your Team Member must remain calm, and speak directly to the individual in a conversational, reassuring, and non-threatening tone.  The Team Member must immediately make and keep eye contact.  While exhibiting a relaxed demeanor, the Team Member needs to remain alert to sudden moves by the individual.  On this point, it is essential that the Team Member not make sudden movements that may be misinterpreted as an aggressive action.  The support person must make sure that no one nearby makes sudden moves for the same reason.

Note: If people in the area can quietly and quickly move to a safe location without leaving the engaging Team Member alone, be sure to do that as soon as possible.

Important: Try not to distract either the Team Member engaging the individual or the individual.  Distractions may provide the motivation to act violently.


Let’s look at a few Verbal De-Escalation Techniques.

When engaging a person in crisis, how you talk to them is as important as what you say.
The tone of voice, volume, and inflection matter.  Be calm, neutral, and conversational.  If the person is shouting or speaking loudly, respond in a lower tone.  If they raise their voice, lower yours more.  This removes the fuel (volume) people in crisis seek.  By lowering your voice if they raise theirs, they get tired of yelling at themselves.

Be polite and courteous without being condescending.
Listen ‘actively’ repeating and rephrasing comments, so the person realizes you are listening. Ask empathetic questions.  This is not the time for drill sergeant approaches (Full Metal Jacket bathroom scene, anyone?).

Engage in a dialog and slowly talk the individual down.
Ask questions.  Answer the individual’s questions.  Do not join into a hallucination by saying you see what they see.  Tell them you are not experiencing the same thing.

Important: A critical piece of advice is never to tell a person to calm down, or some other similar phrase. This can trigger a more aggressive response.

Do not leave the person alone.
Stay with them and keep them calm until family, friends, or medical assistance arrives.  If necessary, have the other Team Member or volunteer summon medical assistance and stand ready as a backup.  Once the crisis has passed, it is vital that the person seek further help.

Note: It may become necessary for the Team Member engaging the individual to ‘tag out.’  If they feel they are losing the ability to remain calm, they should have their backup take over.  This can be a delicate maneuver and is only recommended as a last resort, especially if the backup is an untrained volunteer. 

Be safe! 



Integrity Security Consulting
Russ Sharrock
405-762-2471 | integrityseccon@hotmail.com

 
I have developed and made available to anyone interested, for FREE, a series of Security & safety forms that can be printed for your use:

1) A Safety & Security Risk Assessment Form
2) Church Security Plan Template
3) Church Emergency Plan Template
4) A General Fire Safety Checklist
5) A Bomb Threat Checklist
6) A Bomb Threat Distance Chart:  Includes various types of explosive devises and to be referred to in an event of a bomb threat evacuation.  These are minimum distances to evacuate away from the area of explosion.
7) Facility Lockdown Checklist
8) Child Protection Covenant

These MS Word documents can be adapted as necessary to fit your church size and needs.  I will be adding new forms as time allows.

For a copy of any of these FREE forms, or if you have any questions, contact me and let me know what your needs are.








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