Psychiatric/Mental Health Response

In the field, not every call is about physical injury or trauma. Some patients won’t be bleeding, won’t be unconscious, and won’t even want help — but they’ll still need it.

Mental and behavioral health calls are among the most complex scenes EMS units will encounter. These situations often lack visible injuries but carry high emotional and psychological risk. Confusion, fear, and disorganised behavior can escalate quickly without proper response. The goal of this section is to provide EMS personnel with clear, professional tools to recognise, respond to, and stabilise individuals in mental or emotional distress, while preserving the safety and dignity of everyone involved.

This protocol exists to:

  • Promote calm, controlled patient interactions in unstable environments

  • Equip EMS personnel with verbal and behavioral techniques that reduce risk

  • Encourage respectful, non-threatening engagement during psychiatric episodes

  • Ensure smooth transitions from field response to medical facility hand-off

EMS providers are often the first point of contact for individuals undergoing emotional crisis. Your presence, words, and actions may define whether that scene ends in chaos or calm resolution.

You are not expected to be a therapist. You are expected to be professional, observant, and compassionate. These techniques are here to help you fulfill that duty with confidence and control, even when the patient’s mind is in turmoil.

OOC Note: Associated roleplay scenarios are designed to enhance immersive, respectful EMS roleplay within the server. Please be aware that certain themes, including but not limited, to suicide, self-harm, and other high-risk behaviors are strictly prohibited by Let’s RP rules. Participants must always follow server guidelines and avoid engaging in roleplay content that could violate these rules or cause distress to others. If any scenario or roleplay element conflicts with server rules or personal comfort, players should consult the Admin team. The purpose of this training is to promote safe, responsible, and empathetic roleplay that aligns with community standards.

MENTAL HEALTH RESPONSE TECHNIQUES

These techniques are to be used on-scene when responding to calls involving altered mental states, emotional instability, or behavioral disturbance.

Each technique can be adapted depending on the situation, scene dynamics, and patient demeanor.

Grounding Language Technique

Use direct, clear, and reality-based speech to reconnect a distressed patient to the present moment.

Use When:

  • The patient appears overwhelmed, dissociated, or panicked

Key Phrases:

  • “You’re here with me right now.”

  • “Feel the ground beneath you. You’re safe.”

  • “Look at me. Take one breath in, and out.”

  • “You’re not alone. I’m staying right here.”

Verbal De-escalation Technique

Slow down the situation with calm, structured conversation. Focus on tone and pacing, not urgency.

Use When:

  • The patient is agitated, paranoid, or reacting erratically

Steps:

  • Speak in short, gentle sentences

  • Avoid questions that sound like demands

  • Allow silence — don’t fill every gap

Key Phrases:

  • “I hear you.”

  • “I’m not here to hurt you.”

  • “Let’s figure this out together.”

  • “Can you tell me your name?”

Breath Synchronisation Technique

Guide the patient’s breathing by modeling your own. Calm breath can influence theirs subconsciously.

Use When:

  • Patient is hyperventilating, anxious, or feels “trapped”

Steps:

  • Breathe slowly and audibly

  • Verbally count the rhythm (e.g., “In… 2… 3… out… 2… 3…”)

  • Offer visual focus (e.g., your hand, a light, the sky)

Key Phrases:

  • “Just follow my breathing.”

  • “You’re doing good — let’s keep going.”

  • “Breathe in through your nose… and out through your mouth.”

Environmental Control Technique

Remove or reduce environmental stimuli that may worsen symptoms.

Use When:

  • The patient is overwhelmed by lights, noise, or a chaotic scene

Steps:

  • Move the patient to a quieter spot (if safe)

  • Limit radio use nearby

  • Reduce flashing lights or sirens

  • Create personal space around the patient

Key Phrases:

  • “Let’s step over here where it’s quieter.”

  • “You’re safe. No one’s crowding you.”

  • “Take a seat if you’d like, we’ve got time.”

Simple Choices Technique

Offer small, low-pressure decisions to give the patient a sense of control.

Use When:

  • The patient is nervous, hesitant, or feeling powerless

Steps:

  • Ask yes/no or binary questions

  • Avoid forcing compliance

  • Use cooperation language, not authority

Examples:

  • “Would you rather sit on the curb or in the back of the unit?”

  • “Can I take your pulse, or would you like a minute?”

  • “Do you want water, or just a moment to breathe?

Non-Threatening Positioning Technique

Use body language and posture to convey calm, safety, and professionalism.

Use When:

  • The patient is skittish, defensive, or cornered

Best Practices:

  • Keep hands visible

  • Stand sideways, not squared up

  • Maintain eye level or lower (kneeling if safe)

  • Avoid sudden movements or reaching

Minimal Stimulation Technique

When a patient is overloaded or experiencing a panic episode, keep interaction minimal and focused.

Use When:

  • The patient is non-verbal, trembling, or overreacting to sounds

Technique:

  • Don’t flood them with questions

  • Offer physical comfort items if carried (e.g., water, blanket)

  • Speak slowly and with pause

Key Phrase:

  • “I’m not going to rush you. We’re here to help — when you’re ready.”

ADDITIONAL SUPPORTING ACTIONS

These are supportive behaviors field units may use depending on situation type:

Support Type Examples in Scene
Stabilising Sitting with patient, using calm tone, removing bystanders
Evaluative Asking orientation questions, checking vitals
Comforting Offering reassurance, blanket, water, small gestures
Referral/Transport Arranging non-emergency transport to facility

Disclaimer Statement

Medical role play training in this community is designed solely for educational and simulation purposes to help participants develop communication, problem-solving, and procedural skills in a fictional (Roleplay) medical setting. These sessions do not represent real-life medical training or practice and must not be interpreted as medical advice or guidance. Scenarios involve simulated situations and fictional cases under facilitator supervision, with strict boundaries separating role play from actual medical conduct. Participants are responsible for their actions, must not attempt to apply role play techniques in real life, and acknowledge the limitations and simplified nature of these exercises. Participation is voluntary, and by joining, individuals agree to these terms and the educational intent of the activities.