When someone is in a behavioral health crisis, the people around them sometimes freeze up. Often, this is because no one ever showed them what to do.
The response a person receives during a crisis can reduce harm or deepen it (Wang & Gupta, 2023). Physical crisis intervention techniques provide caregivers, educators, and front-line staff with a structured and humane way to respond when behavior escalates.
It’s important to note that physical intervention should never be the starting point, and that knowing when and how to use it should begin long before a crisis.
Understanding What Happens During a Mental Health Crisis
Effective mental health crisis support starts with observation, not reaction.
Most crisis situations don’t appear out of nowhere. They typically follow a pattern that becomes recognizable well before it reaches a peak (Roennfeldt et al., 2024).
Under acute stress, the brain behaves differently: rational thinking can become difficult, and emotional regulation skills can go by the wayside, escalating someone’s behavior (Flores-Kanter et al., 2021). For those nearby, seeing such a shift can feel sudden and overwhelming.
Ultimately, a crisis reflects someone’s inability to cope with stressors in the moment. Remember that the person in front of you needs support, even if their behavior becomes difficult.
Therefore, physical crisis intervention techniques should be reserved for situations in which de-escalation efforts have been unsuccessful, and safety is at risk.
What Are the Signs of a Mental Health Crisis?
Recognizing a potential behavioral health escalation as early as possible is important, but the earliest warning signs aren’t always obvious to others. In fact, they can sometimes be easy to miss if you don’t know what you’re looking for.
Potential signs that someone may be entering a mental health crisis can include (NAMI, 2026):
- A sudden withdrawal from those around them
- Changes in speech patterns, such as talking louder or faster
- Disorganized behavior
- Becoming physically agitated, which can include pacing, rocking, or seeming unable to stay still
- A loss of eye contact or a disconnected expression
- Someone making verbal threats or expressing hopelessness
No single sign is likely to confirm an oncoming crisis on its own. However, a grouping of these changes—especially when they differ from someone’s baseline behavior—might signal that responding to a behavioral crisis appropriately will soon be necessary.
Responding to a Behavioral Health Crisis: Effective De-Escalation Techniques
Before any physical crisis intervention techniques are considered, de-escalation techniques can give you a chance to bring calm to the situation. They help create an environment in which someone in distress can feel safe again (Shook, n.d.).
The following de-escalation techniques may help:
- Stay calm and regulate yourself: Often, a steady, low tone can convey safety more effectively than specific words.
- Give the person space: Crowding someone in a crisis can increase the likelihood of misperceiving the threat. Take a step back, lower yourself to their level if possible, and remove any physical barriers.
- Use clear, direct language: Complex questions or long sentences can tax someone’s cognitive load. Keep things clear.
- Avoid a power struggle: Giving the person ultimatums or demanding compliance can quickly accelerate the situation.
- Validate their experience: Acknowledging someone’s feelings doesn’t have to mean endorsing their behavior. Making someone feel heard can make a big difference.
- Try to slow everything down: Pause between sentences. Don’t rush your responses. Silence, when used well, can be an effective tool.
Best Physical Crisis Intervention Techniques
If de-escalation techniques have been unsuccessful and there is an immediate risk to safety, physical crisis intervention may be considered. However, physical crisis intervention techniques should still prioritize dignity, minimize harm, and aim to resolve things quickly.
Effective physical crisis intervention techniques can include:
- Effective body positioning: Adjusting your physical stance and distance to reduce threat and maintain awareness without provoking escalation.
- Utilizing intentional, guided movement: Using gentle, controlled physical guidance to redirect someone away from a dangerous situation.
- Supportive holding: A last-resort technique used to prevent imminent harm to the person in crisis or those around them. Applied with the minimum force necessary and released as soon as it’s safe to do so.
- Team-based response: If available, a coordinated multi-person approach can reduce the risk for everyone and ensure no individual is fully responsible for the intervention.
It’s vital to note that physical techniques are only appropriate when used by someone trained to do so. Without the proper instruction, even a well-intentioned response can cause someone injury.
Crisis response best practices consistently link physical interventions to formal and ongoing training to keep everyone safe and free from harm.
Supporting Others Through Crisis Moments
What you choose to do in a moment of crisis can have a major impact on someone’s life. A calm presence can interrupt a potential spiral, and a poorly timed reaction can make everything much worse.
Supporting individuals in crisis takes practice and know-how, and preparation is key to success. Crisis response best practices rely on recognizing escalation early, using de-escalation techniques appropriately, and responding in ways that prioritize safety, dignity, and emotional regulation.
You can have a positive impact on a vulnerable person’s life by being prepared. It’s a major responsibility to bear, but it’s also a learnable and teachable one that could save someone’s life.
Learn More
At Pivot Crisis Intervention, we teach crisis response best practices that prioritize safety, dignity, and effective de-escalation before physical intervention is ever considered. Learning how to recognize escalation early and apply supportive strategies can improve outcomes when supporting individuals in crisis and help prevent situations from becoming more dangerous. To learn more, contact us at sales@pivotcrisis.com or at 1-866-GetPivo(t).
References
Flores-Kanter, P. E., Moretti, L., & Medrano, L. A. (2021). A narrative review of emotion regulation process in stress and recovery phases. Heliyon, 7(6), Article e07218. https://doi.org/10.1016/j.heliyon.2021.e07218
NAMI. (2026, January 7). Warning Signs and Symptoms. https://www.nami.org/warning-signs-and-symptoms/
Roennfeldt, H., Hill, N., Byrne, L., & Hamilton, B. (2024). The anatomy of crisis. International Journal of Qualitative Studies on Health and Well-Being, 19(1), 1–12. https://doi.org/10.1080/17482631.2024.2416580
Shook, J. (n.d.). De-escalation Strategies for Care Providers: Behavioral Health Symptoms and Crisis Situations. https://www.dshs.wa.gov/sites/default/files/ALTSA/hcs/documents/ND/Jessica%20Shook-%20De-escalation.pdf
Wang, D., & Gupta, V. (2023, April 24). Crisis intervention. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559081/
