A Crisis. What to Do.

In my work in the community sector, in particular, I often hear about crisis and crisis intervention. What I don't hear is complete understandings of what crisis and crisis intervention are. At one level, not being able to pay the electricity bill is a crisis. A crisis of a different magnitude, such as bushfire, flood or hurricane, is a different problem all together. Both types of crisis are complex but in different ways.  Further confusion exists surrounding "emergency relief" and "crisis intervention". They are different services but would benefit from a close relationship. There is no panacea to help to restore the equilibrium but here are some thoughts to help in your planning or understanding.

 

What is crisis?

Using  six different definitions of "crisis", James, (2008), concluded that crisis  is "a perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person's current resources and coping mechanisms".

Rather than viewing crisis as a pathological condition, basic crisis theory relates crisis to situations or human development. This can be expanded by incorporating elements of psychoanalysis, general systems, ecosystems, adaptation, interpersonal, chaos, and development theory.

Some examples of crisis situations include: suicide, sexual assault, partner violence, addiction, bereavement, grief, violent behaviour in institutions, hostage negotiations, burnout, compassion fatigue, natural disasters.

Crisis Intervention Models

James describes five fundamental crisis intervention models: equilibrium, cognitive, psychosocial transition, developmental-ecological, and contextual-ecological.

1. "The equilibrium model ... defines equilibrium as an emotional state in which the person is stable, in control, or psychologically mobile. It also defines disequilibrium as an emotional state that accompanies instability, loss of control, and psychological immobility.

2. The cognitive model views the crisis state as resulting from faulty thinking and belief about life's dilemmas and traumas.

3. The psychosocial transition model assumes that people are products of both hereditary endowment and environmental learning and that crisis may be caused by psychological, social, or environmental factors.

4. The developmental-ecological model combines developmental stages in relationship to the ecological system within which the individual develops. A contextual-ecological model looks at layers, relationships, and time when it examines a crisis.

5. An eclectic theoretical position incorporates and integrates all valid concepts of crisis intervention.

Crisis Intervention Service Provision

The most common complaint I have heard from people seeking crisis intervention assistance is that they invariably have to travel to multiple sites to receive different types of crisis intervention service. In this regard, the concept of Community Hubs has developed.

Community Hub is a commonly used term in community planning. However, as with many commonly used terms, it can mean different things in different contexts and there is no widely accepted definition. However, it is fair to assume that in very general terms a Community Hub refers to a centrally located, publicly owned place where a variety of activities and services come together for the purposes of addressing the needs of a local population.

Individual Community Hubs should focus on the needs and desired outcomes of the host community rather than being constrained by a pre-determined notion of what a Community Hub should be. Therefore, to be effective a community Hub needs to respond to the social, economic, cultural and environmental opportunities and constraints that exist in a particular local community. While crisis intervention and support services are distinct they are related activities. Therefore a Community Hub might contribute to addressing the often  fragmented funding and structural arrangements for the planning, delivery and coordination of emergency relief, material aid and crisis intervention services.  

Every community is unique and every disaster/crisis presents unique problems. In a small community, where the mental health centre is the "only game in town," its role as a direct service provider will be increased. In a large metropolitan area, where coordination of agencies is going to be difficult, the role of facilitator via coordination and consultation will take precedence. In all cases, however, planning for the provision of services under various circumstances should be a central focus of intervention and relief efforts.

My extensive work with community organisations has made me acutely aware of the need for an easily accessible and seamless support experience for members of the community who are in crisis.

There are numerous models that could be considered. Some Hubs attempt to cluster with private commercial uses that draw in activity. Others have promoted some form of social enterprise so that profit/surplus can be reinvested back into the enterprise. It is both the range and clustering of people generating and attracting activities whereby community hubs become more than just multipurpose community centres. They can be catalysts for community building, community activity and social interaction. It is all very well having a Community Hub, but it has to be attractive at many levels for people to feel comfortable using it. For example, not everyone feels comfortable being seen walking into a building with a sign that says "emergency relief" or "mental health services". In some cultures, even admitting to mental illness is still taboo.

There may be no panacea to help to restore the equilibrium in a crisis, but dignified, easy accessibility of emergency relief, material aid and crisis intervention services would have to rate highly in any planning project. Followed by easy follow-on linkages that might prevent a compounding crisis. For example, having received emergency relief to pay an overdue telephone bill is helpful in itself, but a dignified, automatic referral to crisis intervention support close by might also avoid a domestic violence situation.