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Initial Management of Behavioural Crisis

Initial Management of Behavioural Crises

Introduction

Behavioural crises can arise from complex circumstances. This tool presents a systematic and sequential assessment of contributing factors, such as Health issues, Environment and supports, Lived experiences and emotional issues, and Psychiatric disorders (H.E.L.P.). It points to practice tips and tools for healthcare providers to ensure the patient’s safety while assessing and managing the crisis situation. Observation and information collected during this process is a first step in illuminating what might have contributed to the crisis; this in turn offers opportunities for prevention of further crises.

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Clinical leads

Elspeth Bradley, MB BS PhD FRCPC FRCPsych, is a psychiatrist and psychotherapist in intellectual and developmental disabilities (IDD). She is an Associate Professor at the University of Toronto and currently holds courtesy appointments at The Centre for Addiction and Mental Health and at St Michael’s Hospital, Toronto. Dr. Bradley has had the pleasure of contributing to the Developmental Disabilities Primary Care Program since its inception in 2005 and of working with people with intellectual and developmental disabilities and autism (ASD) for several decades in the UK and Canada. Her current focus on trauma, triggers and emotional engagement as a necessary pre-requisite to any psychiatric evaluation, is described in a recently co-authored book Responsive Communication: Combining attention to sensory issues with using body language (intensive Interaction) to interact with autistic adults and children.

Kerry Boyd, MD FRCPC, Associate Clinical Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, Ontario. Her clinical work includes working with people who have developmental disabilities. Education and research initiatives have focused on promoting inclusion and care for people with IDD. As an AMS Phoenix Fellow she brought expertise together as Curriculum of Caring course developer. More information on the Curriculum of Caring

Authors

Marika Korossy, BA, librarian and information specialist (retired)

Laurie Green, MD, CCFP(EM), FCFP, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario

Maureen Kelly, MPA, nurse (retired)

Yona Lunsky, Ph.D., C.Psych, Senior Scientist, Director of the Azrieli Adult Neurodevelopmental Centre, and Director, Centre for Addiction and Mental Health, Toronto; Full Professor, Department of Psychiatry, University of Toronto; Adjunct Scientist at ICES, Toronto

Karen McNeil, MD, CCFP, FCFP, family physician and Assistant Professor, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia

Ullanda Neil, MD, CCFP, Scarborough, Ontario

Anupam Thakur, MBBS, MD, MSc, Psychiatrist-in-Chief, Surrey Place, Toronto; staff psychiatrist and education scholar, Centre for Addiction and Mental Health, Toronto; Assistant Professor, Department of Psychiatry, University of Toronto

Alicia Thatcher, MD, CCFP, Regina, Saskatchewan

William Sullivan, MD, CCFP(COE), FCFP, PhD, Joseph P. Kennedy Sr. Chair in Bioethics, Senior Research Scholar, Kennedy Institute of Ethics; Full Professor of Family Medicine, Georgetown University

This is an update to a previous version of this tool, published as Initial Management of Behavioural Crises in Family Medicine , in: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors.
Tools for the primary care of people with developmental disabilities. Toronto: MUMS Guideline Clearing House; 2011, p.64-65.

  • Meet the team

    Clinical leads

    Elspeth Bradley, MB BS PhD FRCPC FRCPsych, is a psychiatrist and psychotherapist in intellectual and developmental disabilities (IDD). She is an Associate Professor at the University of Toronto and currently holds courtesy appointments at The Centre for Addiction and Mental Health and at St Michael’s Hospital, Toronto. Dr. Bradley has had the pleasure of contributing to the Developmental Disabilities Primary Care Program since its inception in 2005 and of working with people with intellectual and developmental disabilities and autism (ASD) for several decades in the UK and Canada. Her current focus on trauma, triggers and emotional engagement as a necessary pre-requisite to any psychiatric evaluation, is described in a recently co-authored book Responsive Communication: Combining attention to sensory issues with using body language (intensive Interaction) to interact with autistic adults and children.

    Kerry Boyd, MD FRCPC, Associate Clinical Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, Ontario. Her clinical work includes working with people who have developmental disabilities. Education and research initiatives have focused on promoting inclusion and care for people with IDD. As an AMS Phoenix Fellow she brought expertise together as Curriculum of Caring course developer. More information on the Curriculum of Caring

    Authors

    Marika Korossy, BA, librarian and information specialist (retired)

    Laurie Green, MD, CCFP(EM), FCFP, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario

    Maureen Kelly, MPA, nurse (retired)

    Yona Lunsky, Ph.D., C.Psych, Senior Scientist, Director of the Azrieli Adult Neurodevelopmental Centre, and Director, Centre for Addiction and Mental Health, Toronto; Full Professor, Department of Psychiatry, University of Toronto; Adjunct Scientist at ICES, Toronto

    Karen McNeil, MD, CCFP, FCFP, family physician and Assistant Professor, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia

    Ullanda Neil, MD, CCFP, Scarborough, Ontario

    Anupam Thakur, MBBS, MD, MSc, Psychiatrist-in-Chief, Surrey Place, Toronto; staff psychiatrist and education scholar, Centre for Addiction and Mental Health, Toronto; Assistant Professor, Department of Psychiatry, University of Toronto

    Alicia Thatcher, MD, CCFP, Regina, Saskatchewan

    William Sullivan, MD, CCFP(COE), FCFP, PhD, Joseph P. Kennedy Sr. Chair in Bioethics, Senior Research Scholar, Kennedy Institute of Ethics; Full Professor of Family Medicine, Georgetown University

  • Version history

    This is an update to a previous version of this tool, published as Initial Management of Behavioural Crises in Family Medicine , in: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors.
    Tools for the primary care of people with developmental disabilities. Toronto: MUMS Guideline Clearing House; 2011, p.64-65.

All rights reserved. No part of this website may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior written permission of the copyright owner, Surrey Place. Contact the Developmental Disabilities Primary Care Program at Surrey Place at ddpcp@surreyplace.ca for permission to adapt information and tools to your local practice setting.