Psychological First Aid in Crisis

Watch for signs someone is in crisis: confusion, rapid breathing, trembling, inability to think clearly, numbness, or extreme agitation. They may seem dissociated (staring blankly) or overly emotional. This is normal under extreme stress. Your calm presence helps. Do not diagnose; simply notice and respond with care.

Move the person away from immediate danger. Remove hazards nearby. If they pose a risk to themselves, stay nearby but do not restrain unless absolutely necessary. Speak in a low, calm voice. Maintain a non-threatening posture: face them at an angle, give space, keep hands visible. Safety must come before everything else.

If danger persists, prioritize escape. Do not stay in an unsafe situation to provide support.

Speak slowly and gently. Use their name. Say: 'You are safe now. I am here to help.' Suggest slow breathing: breathe in for 4 counts, hold for 4, out for 4. Repeat 5–10 times. This activates the parasympathetic nervous system. Do not rush them. Sit or crouch to their eye level if safe to do so.

Let them talk without interruption. Nod. Say 'I hear you' or 'That sounds very hard.' Validate feelings: 'Your fear makes sense given what happened.' Do NOT offer platitudes like 'everything will be fine' or 'at least you...' Do NOT ask 'why' repeatedly. Do NOT give advice unless directly asked. Silence is okay. Your presence alone is healing.

Minimizing, rushing, or dismissing their experience deepens psychological harm. Listen without judgment.

Guide them to name: 5 things they see, 4 they can touch, 3 they hear, 2 they smell, 1 they taste. Slow down. Example: 'Look around. Tell me 5 things you see.' This anchors their mind to the present moment and reduces dissociation or panic. It works for both you and them. Repeat as needed.

Help them take small, concrete actions: drink water, sit down, find shelter. Ask: 'What do you need right now?' Empower them to decide. If they want others, help them contact family or trusted people. If alone, stay nearby. Remind them: 'You survived today. You are stronger than you think.' Connect them to others when possible.

Help with immediate needs: shelter, water, first aid, finding missing people. Do not promise outcomes you cannot control. Instead say: 'We will take this one step at a time.' Normalize recovery: 'Many people have felt this way and recovered.' Encourage rest and basic care. If professional help is available, guide them toward it without force.