How to HELP Customers Who May Be Experiencing a Mental Health Crisis

When someone is experiencing psychological distress or showing signs of mental illness, they may display heightened anxiety, agitation, confusion or unusual behaviour which can contribute to challenging interactions and difficulty in communicating. These steps will help you communicate effectively and connect people with appropriate support and resources.

The Calm + HELP Model

When we notice someone who appears to be having a mental health crisis or is in distress, we want to apply the key steps of CALM and HELP. The Calm+HELP model, a component of Aspect’s Psychological First Aid program, provides a blueprint for effective communication.

Safety First!

If someone appears extremely distressed or in danger of hurting themselves or someone else, always make sure safety comes first. Familiarise yourself with your organisation’s crisis response protocol or call the emergency services to assist.

Tip: Remain in a public space, unless it is unsafe for you/them to do so.

Calm

CALM is about helping the person to come out of ‘fight-flight-freeze’ mode using stabilisation techniques. The aim of stabilisation is to calm and orient an emotionally overwhelmed person using simple tools such as breathing and ‘grounding’ exercises (which we teach in our Psychological First Aid program).

Signs that stabilisation may be needed include:

Hyperventilating
Crying uncontrollably
Experiencing intense physical reactions (e.g. shaking)
Extreme agitation
Being unresponsive to questions
Losing touch with surroundings

Once the person has been stabilised we can apply the HELP model. HELP consists of four simple actions:

Hear: What is happening for this person?
Empathise: Connect with the person without judgement and empathise with their experience
Limit: Let the person know what you can/can’t do and what is expected of them
Progress: Next steps to support the person in crisis

Hear

Listen carefully and take the person’s concerns seriously. Keep your voice calm and the tone of your voice non-judgemental even if they become angry or defensive. Showing compassion and concern for the person will help to build trust.

Develop Active Listening Skills:

Self-awareness: Be aware of your body language. Posture, gestures, facial expressions, eye contact, and tone of voice, all contribute significantly to the messages you give, over the phone as well as face-to-face.

Listen for feelings: Try to understand what emotions your customer is experiencing and reflect your understanding back to them to build empathy and trust “I can understand that you may be feeling (angry, frustrated, sad, upset…) right now.”

Observe their body language: Listen and make eye contact (unless you think your customer may find this threatening). What does their posture or facial expression tell you about how they’re feeling?

Help them feel heard: Use paraphrasing and repeat what you think they’re saying back to them using phrases like, “If I understand you correctly, you …” and “Is that what you’re saying?”. Acknowledge what the other person says, and how they feel, even if you don’t agree.

Ask clarifying questions: “Can you tell me a bit more about that?”

Don’t rush: If you talk very quickly or abruptly try to end the conversation the person may become more frustrated or agitated.

Empathise

Find out what they need: Be empathetic and show them you are willing to listen and assist, but keep your questions limited to avoid overstepping the boundary of your role.

Ask:
“What’s been happening?”
“Are you safe?” “Do you have somewhere to go?” “Do you have a way to get there?”
“Is there someone you want to call, or who I can call for you?”
“What do you need right now?”

Tip: If the customer starts to delve too deeply into their personal situation and ongoing challenges, politely but firmly re-set the boundary.

“I hear you are going through a tough time. My role today is to help you get to someone or somewhere where you feel supported and safe and you can get the assistance you need. How can I help you do that right now?”

Aim to:
Validate their experience: “I can understand that must be frustrating/upsetting…”
Be reassuring: “I can see that you’re scared. Let’s see if there is anything we can do to help the situation.”
Use “I” and “We” statements: “We will help you get this issue resolved” “…have I got that right?”

Limit

Manage expectations: Let the customer know what your role is and set limits about what you can and can’t do in the situation.

Don’t:
Overcommit
Promise something you can’t deliver
Engage in questions that delve too deeply into their lives or challenges

Examples of statements you could use:

“I’m keen to hear what you have to say, let’s walk over here where it’s a bit quieter.”
“Can you help me understand? I just have a couple of questions so I can help you.”
“I’m not a counsellor but I’m here to help and keep everyone safe.”
“Let’s work this through. How can we make this better for you?”

Progress

Provide immediate assistance: Assist with what they need, so long as it is in your power to do so. If they are distressed, you can offer to call a service or person on their behalf, but you must ask for consent before doing so.

Refer them on: If you are going to refer the customer to community service, ensure you know they are reputable and will be able to assist.

Exit the interaction: Kindly but firmly re-set the boundary with comments that your role is to help them get to someone or somewhere safe.

Don’t:
Tell them when you will next be on duty or provide personal contact details.
Follow-up directly to check in on them, unless the situation forms part of the usual incident response.
If you want to follow up, do this through the relevant service provider/s they are connected with and not directly with the customer.