4. Recognizing and Responding to Crisis

Contents
Interacting with Unhoused People
The guide
For specific jobs

What you should come away with: the ability to choose the right response channel for what is actually in front of you — and say why.

The wrong channel is the expensive mistake. Calling police to a mental health crisis that a mobile crisis team could have handled changes the outcome for the person, sometimes permanently, and changes the exposure for your employer.

4.1 Recognizing a mental health crisis

Covers:

  • What you can and cannot tell from the outside. You diagnose nothing; you describe behavior.
  • Responding to internal stimuli, disorganized speech, paranoia — and how each changes the approach in 3. De-escalation.
  • Signs of suicidal crisis, and taking them seriously the first time.
Not written yet.

4.2 Substance use and intoxication

Covers:

  • Telling intoxication from a medical emergency — overdose, diabetic emergency, heat illness, head injury. Getting this wrong kills people, and it is the single most consequential judgment here.
  • Withdrawal, and why it looks like agitation.
  • Naloxone: whether your workplace has it, whether you are permitted to use it, and California's overdose Good Samaritan protections.
Not written yet.

4.3 Trauma responses

Covers: hypervigilance, flat affect, and sudden escalation from a resting state. What triggers a response in someone who has been assaulted while sleeping outside — and why your flashlight, your keys and your radio are part of that.

Not written yet.

4.4 Your own safety

Covers:

  • Distance, exits, and the decision to disengage — early, not late.
  • Weapons and needles: observing without searching. Searching is not yours to do (see 2.4 Belongings are property).
  • Telling someone where you are and what you are doing before you do it.
Not written yet.

4.5 Choosing the channel: 988, 911, or outreach

Learn a decision rule simple enough to repeat under stress, then test it against the presentations in 4.1–4.3.

  • 911 — immediate threat to life or safety, or a medical emergency.
  • 988 — suicidal or mental health crisis with no immediate threat of violence.
  • Mobile crisis or outreach team — the person needs help, not an emergency response. Know your local numbers and their hours before you need them.
  • Nobody — a real option, and often the right one. Someone sleeping is not an emergency.
  • What you say when you call, and how much of it is description rather than conclusion.
Not written yet.
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