Beyond Traditional De-escalation

When people hear the term de-escalation, they often think of conflict resolution: staying calm, listening carefully, and helping two parties reach a solution. While those skills are important, de-escalating someone who is intoxicated or experiencing an acute mental health crisis requires a fundamentally different approach.

Traditional approaches often assume that a person has access to logical reasoning and can participate in problem-solving. However, individuals in an altered state may be experiencing impaired judgement, emotional dysregulation, paranoia, fear, confusion, or significant cognitive impairment. Their ability to process information and access the “thinking” part of their brain may be temporarily limited. In these moments, attempts to reason, persuade, or debate can actually increase frustration and further escalate the situation.

De-escalating potentially violent situations for impaired states takes a trauma-informed approach, recognizing that behaviour is often driven by stress responses, fear, and impairment rather than defiance or intentional aggression. Instead of focusing on fixing the problem immediately, the goal is to create safety – reducing stimulation, preserving dignity, and helping the individual regain enough regulation to move toward stability.

Individuals in an altered state may be experiencing impaired judgement, emotional dysregulation, paranoia, fear, confusion, or significant cognitive impairment.

A Shift in Approach

When approaching someone in an altered state, take a moment to consider the environment and context you are in.  It’s important to consider what outcome you want with the de-escalation before you engage, and that success is not always about resolving the issue. Sometimes a successful outcome simply means that everyone remained safe and the situation did not escalate further.

Example 1

If I work in a library, my goal is probably not to solve the person’s underlying issue or find them the book they are looking for. Instead, my priority is to keep myself, other patrons, and the individual safe while helping reduce the intensity of the situation until they can access the support they need.

Example 2

If I work in a homeless shelter, my goal may be to help the person access a safe bed for the night. In this situation, de-escalation can help create enough calm and stability for the individual to move safely to an appropriate space and receive support.

De-escalating a situation can feel scary. People can become unpredictable when they are angry or aggressive, and this unpredictability increases when someone is intoxicated or experiencing a mental health crisis.

5 Strategies to Help You Be Prepared and Remain Safe

1. Regulate Yourself First

One of the best ways to remain safe and influence someone’s behaviour is by controlling your own. You can do this by modeling the tone, volume, and language that you want the other person to use. This doesn’t always work, but engaging in a power struggle will most definitely add fuel to the fire. The more you can remain calm, neutral, and nonthreatening, the better the person who is impaired will mirror that behaviour and not escalate.

2. Prioritize Safety

Safety always comes before problem-solving. Maintain appropriate distance, be aware of exits and hazards, reduce stimulation where possible, and continuously assess risk. The goal is to keep everyone safe, not necessarily to resolve every concern in the moment. This also includes maintaining psychological safety for the escalated individual. Trauma may be influencing their actions and can impact the aftermath of the current situation. Taking care to maintain a positive, non-judgmental approach will support healing.

3. Connect Before Correcting

People in an impaired state are often driven by emotion rather than logic. Focus on building connection by showing respect, compassion, and genuine interest. Acknowledge how they are feeling before discussing facts or solutions. Validation helps people feel heard without excusing inappropriate behaviour. The individual may feel out of sync with themselves, and you can help by remaining grounded, present, and focused on them.

4. Communicate Calmly and Simply

Someone who is intoxicated or experiencing an acute mental health crisis is experiencing changes in the chemicals in their brain, and they cannot access the usual rational part of cognitive functioning. Keep your sentences short, simple, friendly, and expect repetition. The goal is not to win an argument, outsmart, or blame, but to reduce distress and build trust. Allow for slower processing time, remain patient, ask open ended questions, and paraphrase in short reflections.

5. Offer Choices Instead of Control

People in crisis often feel powerless. Offering simple choices (where to sit, whether they would like water, etc.) can help restore a sense of control. Avoid power struggles, demands, and confrontational language. Cooperation is more effective than control. Offering simple choices is a trauma-informed approach that can build self-efficacy and confidence when these characteristics might not be part of their usual life.

Conclusion

De-escalating someone in an impaired state is about understanding that they may not currently have full access to the thinking and reasoning skills we often rely on in everyday conversations. By focusing on safety, connection, calm communication, and choice, you can reduce tension and create the conditions for recovery. Ultimately, this approach is not about winning an argument – it is about supporting people through some of their most vulnerable moments with respect, compassion, and dignity.