MindCare Learn
Instructor-led deck for Ontario AIPU practice: crisis phases, suicide risk, concurrent disorders, withdrawal/OAT safety, and trauma-informed stabilization.
Section 2 map
Instructor frame
Prevent harm, reduce physiological arousal, preserve dignity, and keep options open.
Leave the patient less isolated, less ashamed, and more likely to accept help next time.
2.1 Crisis phases
2.1
Listen, name the problem, offer choices, reduce stimuli, use brief intervention.
Short phrases, fewer choices, one speaker, safety support nearby.
Team response, role clarity, environmental control, medication pathway if ordered, least-restrictive safety action.
2.1 Brief intervention
2.1 BERT / Code White
2.1 Simulation
A patient is crying, incoherent, and has thrown a chair in the common area.
Have learners assign roles before anyone enters the patient's space.
2.1
2.1 Post-crisis
"What was happening for you before we saw the escalation?"
"What was the earliest cue, and what would we try sooner next time?"
Debriefing should not become interrogation, blame, or forced trauma disclosure.
2.2 Suicide prevention
Asking clearly about suicide does not plant the idea. It names the risk, reduces isolation, and creates a pathway to safety.
2.2
2.2
"Everyone would be better off if I went to sleep and did not wake up."
2.2 Tools
Plain-language questions about ideation, behaviour, intensity, and acuity.
Dynamic risk, protective factors, environment, access to means, and current presentation.
2.2 Environment
Cords, belts, drawstrings, sheets, anchor points.
Razors, glass, medications, cleaning products, contraband.
Visibility, bathroom risk, line of sight, handoff precision.
2.2
2.2 Canada resource
9-8-8 is Canada's suicide crisis helpline. It can be included in discharge, pass planning, and collaborative safety plans when appropriate.
2.3 Concurrent disorders
Mood, psychosis, trauma, suicidality, cognition, sleep, medications.
Substance, amount, route, last use, tolerance, withdrawal history, overdose history.
2.3 Harm reduction
2.3 Opioid toxicity
Act on breathing and level of consciousness. Naloxone does not replace airway and monitoring.
2.3 Withdrawal tracker
2.3
Pounding headache, visible tremor, sweating, anxiety, rising vital signs.
Score using local withdrawal tool, check vitals, escalate per protocol, prevent seizures and delirium tremens.
2.3 OAT safety
If doses have been missed, verify the OAT order, last observed dose, local protocol, and prescriber/pharmacy direction before administration.
2.3
Inform withdrawal risk, overdose risk, medication interactions, and treatment planning.
Do not use results to shame, threaten, or invalidate the patient's account.
2.3 Secondary data
2.4 Trauma-informed crisis
Assume the person may have a trauma history. Reduce coercion, explain what happens next, ask before touch, preserve dignity, and offer choice where possible.
2.4
2.4 Elena scenario
Call loudly from the end of the hall, stand over her, ask for trauma details.
Approach slowly, stay at an angle, lower voice, explain next steps, offer a quieter option.
2.4
"Here is what will happen next: I will check your pulse and breathing, then we will decide together whether the quiet room, a walk, or medication support is the next step."
2.4 Stabilization toolkit
Short, structured, motivational, respectful.
Patient-owned warning signs and coping steps.
Make sense of what happened without forcing disclosure.
2.4 Caregiver safety
Section 2 wrap
Read acuity. Name suicide risk directly. Assess substance use and withdrawal. Protect oxygen, safety, dignity, and consent. Use the team early. Repair after crisis.
Section 2 references
Section 2 references
Section 2 references
Section 2 references