Mental Health Monthly #11: De-escalation: Changing Confrontation to Collaboration

<p><span style="font-weight: 400;">Contributor: Dr. Kimberly Nordstrom</span></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">De-escalation usually takes less time than physical and chemical restraints, which leads to decreased injury to staff members, better patient trust and increased patient throughput as accepting facilities oftentimes delay transfer acceptance following physical restraints</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Prepare to engage prior to entering their room in two ways: cognitively and emotionally</span> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Why do you want to de-escalate the patient? Remind yourself you don’t want to introduce more trauma</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Check your emotions, and ensure you don’t bring your emotional state into</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">If possible, engage the patient when they’re in mild agitation before their anger is out of control</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Be authoritative not authoritarian or permissive, impart your expertise in medicine and explain your rationale to them without claiming to be an expert on them personally</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Small acts of kindness like the provision of a warm blanket, snacks or voluntary medications appropriate to the situation can aid in establishing trust and rapport</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Take a break to cool off if the interaction is too charged</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Verbal de-escalation pearls: </span> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Res