A practical guide to crisis management.

ABSTRACT

Family physicians often treat patients who are experiencing psychological or medical crises. Any event perceived as overwhelming by the patient may trigger a crisis reaction consisting of psychological and physiological symptoms. Physicians are encouraged to assist patients who are experiencing a crisis by (1) providing reassurance and support; (2) evaluating the nature of the problem and determining the patient's mental, psychiatric, suicidal or homicidal, and medical statuses; (3) ensuring the safety of the patient and others; (4) assisting the patient in developing an action plan that minimizes distress, and obtaining patient commitment to the plan; and (5) following up with the patient and other relevant persons to ensure follow-through, assess progress, and provide additional assistance and support. Medication or referral for psychiatric or psychological counseling may be necessary for patients with continuing problems.