Crisis Prevention

Crisis prevention and intervention are key components of psychiatric-mental health nursing. Psychiatric-mental health nurses often serve on the front lines in identifying, de-escalating, and managing behavioral health emergencies by responding with strategies that prioritize patient dignity and safety. This includes using therapeutic communication, trauma-informed approaches, and building rapport to prevent crisis and support recovery by fostering trust and emotional regulation. A cornerstone of effective crisis intervention is the use of least restrictive alternatives. This emphasizes preserving a patient’s autonomy and rights while maintaining safety. Instead of relying on restraints, seclusion, or involuntary medication, psychiatric-mental health nurses lead with verbal de-escalation and work side by side with the patient, family, and trusted peers to co-create treatment and safety plans, and modify the environment to ensure every aspect of care reflects shared goals, cultural needs, and the interdisciplinary team’s expertise. Research has shown that minimizing coercive practices leads to better patient outcomes, lower rates of staff injury, and improved therapeutic relationships. Psychiatric-mental health nurses also champion post-event debriefing where insights can be harvested from each encounter to refine future least-restrictive approaches and drive continuous quality improvement. Together, these efforts support a healing-centered culture, reducing trauma for both patients and staff.

The following resources and research, organized chronologically from newest to oldest, document the methods utilized in crisis prevention, evidence supporting their use, and the strategic use of crisis response teams by delivering compassionate, trauma-informed, evidence-based treatment that honors both the patients receiving the care and the staff delivering the care.

Resources

OSHA Guidelines for Preventing Workplace Violence for Healthcare & Social Service Workers

CDC Workplace Violence Information

The Joint Commission’s Workplace Violence Prevention Resources

APNA 2022 Seclusion & Restraint Position Paper

Mental Health America Seclusion & Restraint Position Paper

SAMHSA 2025 National Guidelines for a Behavioral Health Coordinated System of Care

SAMHSA National Guidelines for Behavioral Health Crisis Care Best Practice Toolkit

References

Pitfalls and platforms in workplace violence prevention
Ellen W. Blair, Diane E. Allen, Kathleen R. Delaney, Ruthy Lindvall, Amanda McGill, Michael Polacek, Lisa Schneider, David Sharp, Tamsyn Weaver. Pitfalls and Platforms in Workplace Violence Prevention. Journal of the American Psychiatric Nurses Association. 2025;0(0). (0). https://doi.org/10.1177/10783903251320377

Beyond crisis: Enhancing behavioral response through a conceptual framework
Olmedo, A., & Muir, J. (2025). Beyond crisis: Enhancing behavioral response through a conceptual framework. Journal of the American Psychiatric Nurses Association, 31(2). https://doi.org/10.1177/10783903251315947

The missing link in behavioral health: Defining competencies for Crisis Response Teams
Olmedo, A., Metili, C., Mayfield, A., Betts, D., & Weaver, T. (2025). The missing link in behavioral health: Defining competencies for Crisis Response Teams. Journal of the American Psychiatric Nurses Association, 31(2), 129–130. https://doi.org/10.1177/10783903241307952

Uncovering complexities in reducing aggression, conflict and restrictive practices in acute mental healthcare settings: An overview of reviews.
Daguman, E. I., Hutchinson, M., & Lakeman, R. (2024). Uncovering complexities in reducing aggression, conflict, and restrictive practices in acute mental healthcare settings: An overview of reviews. International Journal of Mental Health Nursing, 33(6). https://doi.org/10.1111/inm.13376

The effectiveness of brief non-pharmacological interventions in emergency departments and psychiatric inpatient units for people in crisis: A systematic review and narrative synthesis.
Huber, J. P., Milton, A., Brewer, M. C., Norrie, L. M., Hartog, S. M., & Glozier, N. (2024). The effectiveness of brief non-pharmacological interventions in emergency departments and psychiatric inpatient units for people in crisis: A systematic review and narrative synthesis. Australian & New Zealand Journal of Psychiatry, 58(3), 207-226. https://doi.org/10.1177/00048674231216348

Evidence-based practice: Implementing trauma-informed care of children and adolescents in the inpatient psychiatric setting.
Hale, R., & Wendler, M. C. (2023). Evidence-based practice: Implementing trauma-informed care of children and adolescents in the inpatient psychiatric setting. Journal of the American Psychiatric Nurses Association, 29(2), 161–170. https://doi.org/10.1177/1078390320980045

An educational intervention to decrease the number of emergency incidents of restraint and seclusion on a behavioral health unit
Dixon, M., & Long, E. M. (2022). An educational intervention to decrease the number of emergency incidents of restraint and seclusion on a behavioral health unit. The Journal of Continuing Education in Nursing, 53(2), 70–76. https://doi.org/10.3928/00220124-20220104-07

Violence factors and debriefing in psychiatric inpatient care: A review.
Asikainen, J., Vehviläinen-Julkunen, K., Repo-Tiihonen, E., & Louheranta, O. (2020). Violence factors and debriefing in psychiatric inpatient care: A review. Journal of Psychosocial Nursing and Mental Health Services, 58(5), 39–49. https://doi.org/10.3928/02793695-20200306-01

Overview of Project BETA: Best practices in evaluation and treatment of agitation
Holloman Jr, G. H., & Zeller, S. L. (2012). Overview of Project BETA: Best practices in evaluation and treatment of agitation. Western Journal of Emergency Medicine, 13(1), 1. https://doi.org/10.5811/westjem.2011.9.6865