TERMS & CONDITIONS

URAWarrior Clinical Crisis De-Escalation Protocol

Version 1.0

Updated January 2026

What is a Mental Health Crisis?

A crisis is any situation in which a person’s behaviors puts them at risk of hurting themselves or others and/or when they are not able to resolve the situation with the skills and resources available.

For the purpose of this crisis protocol, a mental health crisis defined as: “behavioral, emotional, or psychiatric situation which, but for the provision of crisis response services, would likely result in significantly reduced levels of functioning in primary activities of daily living, or in an emergency situation, or in the placement of the recipient in a more restrictive setting, including but not limited to, inpatient hospitalization.”

Here are some examples of situations or stressors that can trigger a mental health crisis:

Home or Environmental Triggers

Changes to family structure

Changes in relationship with boyfriend, girlfriend, partner, spouse

Loss of any kind: family member or friend due to death or relocation, pet’s death

Strained relationships with roommates, loved ones

Changes in friendships

Conflict or arguments with loved ones or friends

Trauma or exposure to violence

Poverty

School/Work Triggers

Worrying about upcoming projects or tasks

Feeling singled out by co-workers/peers; feelings of loneliness

Mounting pressures, anxiety about deadlines

Lack of understanding from peers, co-workers, teachers or supervisors who may not understand that behaviors are symptoms

Real or perceived discrimination

Failing grades, losing a job

Other Triggers

Stops taking medication or misses doses

Starts new medication or new dosage of current medication

Medication stops working

Use or abuse of drugs or alcohol

Pending court dates

Being in crowds or large groups of people

Community violence or trauma

Major crisis in the world such as natural disaster, terrorism

Here are some warning signs of a mental health crisis:

Inability to cope with daily tasks

Doesn’t bathe, brush teeth, comb or brush hair

Refuses to eat or eats too much

Sleeps all day, refuses to get out of bed

Doesn’t sleep or sleeps for very short periods of time

Rapid mood swings

Increased energy level

Inability to stay still, pacing

Suddenly depressed, withdrawn

Suddenly happy or calm after period of depression

Increased agitation

Makes verbal threats

Violent, out-of-control behavior

Destroys property

Culturally inappropriate language or behavior

Displays abusive behavior

Hurts others

Cutting, burning or other self-injurious behaviors

Uses or abuses alcohol or drugs

Loses touch with reality (psychosis)

Unable to recognize family or friends

Is confused, has strange ideas

Thinks they are someone they are not

Does not understand what people are saying

Hears voices

Sees things that are not there

Isolation from school, work, family, friends

Decreased interest in usual recreational activities

Changes in friendships

Stops going to school or work

Unexplained physical symptoms

Facial expressions look different

Increase in headaches, stomach aches

Complains they don’t feel well

What are the Warning Signs of Suicide?

People who are thinking about taking their own lives may exhibit one or more warning signs, either through what they say, what they do, or moods and feelings that you detect.

A suicidal individual may talk directly about wanting to die or about taking their life. They may be more indirect and talk about having no reason to live, not wanting to be a burden to others, feeling trapped or experiencing unbearable pain.

A person’s suicide risk increases if a behavior is new or worsens, especially if it’s related to a painful event, loss, or change. You may see an increase in alcohol or drug use, reckless and/or aggressive behavior, isolation, sleeping or eating too much or too little, or giving away prized possessions. They may also be searching online for ways to take their life and acquiring the means to do so. You may observe that they have withdrawn from activities that they once enjoyed or that they have visited or called people to say goodbye. They may become preoccupied with death and begin to put their affairs in order.

You may detect anything from a change in mood to extreme mood swings. These changes may be expressed through irritability, unexplained rage, feelings of humiliation, and/or increased anxiety and depression. You may also observe an unexplained peacefulness or calmness that can indicate that they have created a plan for their suicide.

The more warning signs you see, the greater the risk. They need immediate care by a mental health professional or doctor. The National Suicide Prevention Lifeline is available 24/7 for crisis counseling, information, and referral services in your area.

If the individual is presenting suicidal warning signs, immediately recommend they call:

Suicide Hotline: Dial 988 or 1-800-273-TALK(8255)

De-escalation Techniques

A person in the midst of a mental health crisis cannot always clearly communicate their thoughts, feelings, or emotions. They may find it difficult to understand what others are saying. It is important to empathize and connect with the person’s feelings, stay calm and try to de-escalate the crisis.

De-escalation techniques that may help resolve a crisis:

Keep your voice calm

Avoid overreacting

Listen to the person

Don’t make judgmental comments

Don’t argue or try to reason with the person

Express support and concern

Ask how you can help

Keep stimulation level low

Offer options instead of trying to take control

Be patient

Gently announce actions before initiating them

Give them space, don’t make them feel trapped

If you haven’t been able to de-escalate the crisis yourself, you will want to suggest additional help from mental health professionals who can assess the person to determine the level of crisis intervention required. If these strategies do not work, advise the individual to seek outside resources for help:

National Suicide Prevention Lifeline

Call 1-800-273-TALK (8255) En español 1-888-628-9454 Use Lifeline Chat on the web The Lifeline is a free, confidential crisis service that is available to everyone 24 hours a day, seven days a week. The Lifeline connects people to the nearest crisis center in the Lifeline national network. These centers provide crisis counseling and mental health referrals.

Crisis Text Line

Text “HELLO” to 741741 The Crisis Text hotline is available 24 hours a day, seven days a week throughout the U.S. The Crisis Text Line serves anyone, in any type of crisis, connecting them with a crisis counselor who can provide support and information.

Veterans Crisis Line

Call 1-800-273-TALK (8255) and press 1 or text to 838255 Use Veterans Crisis Chat on the web The Veterans Crisis Line is a free, confidential resource that connects veterans 24 hours a day, seven days a week with a trained responder. The service is available to all veterans, even if they are not registered with the VA or enrolled in VA healthcare.

Disaster Distress Helpline

Call or text 1-800-985-5990 The disaster distress helpline provides immediate crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster. The helpline is free, multilingual, confidential, and available 24 hours a day, seven days a week.

Substance Abuse and Mental Health Services Administration (SAMHSA)

Call or text 1-800-985-5990 For general information on mental health and to locate treatment services in your area, call the SAMHSA Treatment Referral Helpline at 1-800-662-HELP (4357). SAMHSA also has a Behavioral Health Treatment Locator on its website that can be searched by location.

The Trevor Project

Call 1-866-488-7386 or text START to 678678. A national 24-hour, toll free confidential suicide hotline for LGBTQ youth.

National Domestic Violence Hotline

For any victims and survivors who need support, call 1-800-799-7233 or 1-800-799-7233 for TTY, or if you’re unable to speak safely, you can log onto thehotline.org or text LOVEIS to 22522.

StrongHearts Native Helpline

Call 1-844-762-8483. The StrongHearts Native Helpline is a confidential and anonymous culturally-appropriate domestic violence and dating violence helpline for Native Americans, available every day from 7 a.m. to 10 p.m. CT.

The National Sexual Assault Telephone Hotline

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

NAMI, the National Alliance on Mental Illness

Call 1800 950 6264. NAMI is the nation’s largest grassroots mental health organization dedicated to building better lives.

Caregiver Help Desk

Contact Caregiver Action Network’s Care Support Team by dialing 855-227-3640. Staffed by caregiving experts, the Help Desk helps you find the right information you need to help you navigate your complex caregiving challenges. Caregiving experts are available 8:00 AM – 7:00 PM ET.

The Partnership for Drug-free Kids Helpline

Call 1-855-378-4373 if you are having difficulty accessing support for your family, or a loved one struggling with addiction faces care or treatment challenges resulting from COVID-19 circumstances, the Partnership for Drug-free Kids’ specialists can guide you. Support is available in English and Spanish, from 9:00 am -midnight ET weekdays and noon-5:00pm ET on weekends.

Not in immediate danger

If you do not believe the individual is in immediate danger, suggest they call a psychiatrist, clinic nurse, therapist, case manager or family physician that is familiar with the person’s history. This professional can help assess the situation and offer advice. The professional may be able to obtain an appointment or admit the person to the hospital. If they cannot reach someone and the situation is worsening, take action by suggesting they call 911 or their county mental health crisis team.

LEAP Method

Dr. Xavier Amador, in his book, I am Not Sick, I Don’t Need Help, outlines a communication skill (L.E.A.P.) that can be used to engage the individual and help them stay calm. LEAP stands for Listen, Empathize, Agree and form a Partnership. It is a family-friendly version of a form of therapy called motivational enhancement therapy.

Steps to using the LEAP method:

LISTEN. The goal is to listen to the individual’s needs without making judgment, to understand their point of view and to use reflective listening to state back that you understand (not necessarily agree with) what they said or need.

Listen and learn; drop your agenda

Use questions, not statements

State what you heard - all of it (reflecting)

Let the person correct you

Don’t avoid scary topics or thoughts (even delusions)

Know their “hot button” fears

Don’t rush it

Don’t have an emotional reaction to what you hear

Don’t try to problem-solve

Avoid going right to empathy

Give your opinion:

ONLY if asked

Delay 3 times before answering

Follow the 3 A’s: Apologize, Acknowledge that you could be wrong, Agree (to disagree)

EMPATHIZE. If you want the individual to consider your point of view, it is necessary for you to understand theirs. This is not the same as agreeing with them; it’s about empathizing with them about how they feel.

Express empathy for feelings

This doesn’t mean you have to agree with beliefs

Normalize: “I think I would feel that way too (if I had those beliefs).”

Listen + Empathy = “What do you think?”

Common feeling and experiences to empathize with:

Frustration

Gear

Discomfort

Hopes and dreams (desired)

AGREE. Find common areas on which both you and the individual can agree. Acknowledge that the individual has personal choices and responsibility for the decisions they make about their behaviors and the consequences of those choices.

Stick to perceived problems and symptoms only

Review advantages and disadvantages of treatment or adherence from the person’s perspective

Agree to disagree when needed. It’s okay to set boundaries

You can try to correct misinformation gently

Reflect back and highlight the advantages. Use this as the basis for a plan.

PARTNER. Form a partnership to achieve shared goals. This involves you and the individual developing an action plan to meet agreed-upon goals.

Move forward with agreed-upon goals

Use phrases that support feelings of control and safety

“Would that be all right?”

“Do I have that right?”

“So, let me see if I got this straight. Are you saying that . . . ?”

“Would you mind if I . . .”

“I can see why you’d feel that way . . .”

“I am sure it is upsetting to hear and I know you don’t agree. It’s just how I feel. Can we agree to disagree on this one?”

UraWarrior’s ADA Commitment: Inclusive Mental Wellness for Everyone

UraWarrior is committed to ensuring that mental wellness resources are accessible to everyone, including individuals with disabilities. We actively work to make our mobile app user-friendly, fully accessible, and compatible with assistive technologies. Our goal is to create an inclusive digital environment that accommodates diverse needs and empowers all users on their mental wellness journey.