CRSS Crisis Support and Safety 4 — Questions and Answers
Question 1: A peer discloses that they have been stockpiling prescription medications 'just in case.' This should be treated as:
- A normal precaution for managing chronic illness
- A potential means of self-harm requiring immediate safety planning (Correct answer)
- Evidence of medication non-compliance to report to the prescriber only
- An irrelevant detail unless the peer expresses intent
Correct answer: A potential means of self-harm requiring immediate safety planning
Stockpiling medications is a lethal means that must be addressed in safety planning regardless of whether the peer has expressed explicit intent.
Question 2: Which approach is MOST aligned with a recovery-oriented crisis response?
- Removing all autonomy from the peer to ensure their immediate safety
- Supporting the peer's self-determination while managing acute safety concerns (Correct answer)
- Focusing exclusively on symptom reduction rather than the peer's goals
- Hospitalizing the peer as the default response to any crisis
Correct answer: Supporting the peer's self-determination while managing acute safety concerns
Recovery-oriented care balances safety with preserving the peer's autonomy, dignity, and self-determination even during a crisis.
Question 3: Crisis Intervention Team (CIT) training was originally developed to improve:
- Medication management protocols for emergency rooms
- Police responses to individuals experiencing mental health crises (Correct answer)
- Discharge planning in inpatient psychiatric units
- Peer specialist training curricula
Correct answer: Police responses to individuals experiencing mental health crises
CIT (Memphis Model) was developed in the late 1980s to train law enforcement officers in de-escalating mental health crises.
Question 4: When using motivational interviewing during a crisis, which response best demonstrates reflective listening?
- 'You shouldn't feel that way — things will get better.'
- 'So it sounds like you're feeling completely overwhelmed and don't see a way out right now.' (Correct answer)
- 'Have you tried calling your sponsor or going to a meeting?'
- 'I need you to calm down before we can talk about this.'
Correct answer: 'So it sounds like you're feeling completely overwhelmed and don't see a way out right now.'
Reflective listening involves mirroring the emotional content of what the person expressed without judgment or immediate problem-solving.
Question 5: A peer specialist working in a community setting encounters someone who is unknown to their program and is in apparent crisis. The appropriate first step is to:
- Walk away to avoid liability for someone outside the program
- Approach safely, introduce themselves, and assess immediate safety needs (Correct answer)
- Call 911 immediately without attempting any contact
- Take the person directly to the nearest emergency room
Correct answer: Approach safely, introduce themselves, and assess immediate safety needs
Peer specialists should approach safely, introduce themselves, and assess the situation before deciding what level of intervention is needed.
Question 6: Which of the following is an example of 'means restriction counseling' in suicide prevention?
- Teaching a peer how to identify emotional triggers for suicidal thoughts
- Discussing with the peer and their family how to secure or remove firearms from the home (Correct answer)
- Encouraging the peer to journal their suicidal ideation for review in therapy
- Scheduling more frequent therapy appointments during high-risk periods
Correct answer: Discussing with the peer and their family how to secure or remove firearms from the home
Means restriction counseling focuses on reducing access to lethal methods, such as securing firearms, which is one of the most evidence-based suicide prevention strategies.
Question 7: In crisis support, the term 'lethality assessment' refers to:
- Evaluating how dangerous a neighborhood is for a home visit
- Estimating the probability and severity of a peer harming themselves or others (Correct answer)
- Calculating a peer's risk of overdose based on substance use history
- Assessing environmental hazards in the peer's living situation
Correct answer: Estimating the probability and severity of a peer harming themselves or others
A lethality assessment evaluates factors such as plan, means, intent, and history to estimate the risk of imminent self-harm or harm to others.
CRSS Crisis Support and Safety 4
A peer discloses that they have been stockpiling prescription medications 'just in case.' This should be treated as: