This is a rare occurrence and most people with MH issues are more likely to hurt themselves than others, and are far less dangerous than very drunk people! They are also much more vulnerable to other people’s violent actions. But if you are spending time with someone who becomes aggressive then you need to have a plan for their sake and for yours.
There is always a reason for challenging behaviour. It is useful to spend time trying to identify the particular triggers that produce this response and then work to reduce or remove these if possible.
Suspicions of being harmed or poisoned happen sometimes, especially if people’s taste or smell is affected as part of a psychotic condition. Maybe they see you in that moment as interfering, over protective or unsupportive. Maybe they want you to do something for them
that they know you don’t want to do. Maybe they feel threatened by visitors or loud music.
Maybe they have just seen a black car outside and are convinced there is a killer in there and you just aren’t listening.
They may also be using violence and threats to achieve their own goals and have no recognition of the consequences for others.
Identifying early warning signs that things are about to ‘kick off’ is helpful too. If you feel there is an outburst coming, it is better to leave and come back to some damage to your furniture than stay and run risks with your own welfare.
The suggested reaction to being threatened or to destructive behaviour is to ask them quietly but firmly to stop. Acknowledging their mood and point of view can diffuse a situation more quickly but don’t get into an argument about detail – now is not the time.
If this doesn’t work then get out of the immediate area, leave the house altogether if necessary. If it happens frequently could you create a safe space? Consider supplies including a bottle of water, a snack, a book and a mobile phone that works. This may be the bathroom as a locked door is not out of place here.
Leave them until they have calmed down and, if possible, speak to them on the phone to check out their mood and to warn them before you return. You may feel concerned about leaving them but being alone may ensure a quicker ‘calming down’ – having an audience may increase the agitation.
Always ensure that the MH team know exactly what is going on. During an incident you may have to call the police. The MH teams may deal with emergencies, but their response time will be much slower and they won’t confront a violent person without the police anyway. You may be reluctant to call them, but the aggressive person won’t be arrested and get a criminal record if their behaviour is seen to be due to their mental ill health.
They may be taken to a place of safety, which is either a special 136 Suite at the hospital, or a police cell. There they will be assessed by a qualified professional and offered treatment and/ or to be sectioned under the Mental Health Act.
After it has all calmed down it may be useful to have a conversation with the person in which you are clear that this aggression is unacceptable behaviour, no matter how angry or upset they felt, and that you will always call the police as you have to keep yourself safe. Tell others who may spend time with the person to do the same.
The message is, “You clearly feel really agitated and angry, but you need to find a safer way to deal with it”.
Don’t feel you have to protect them from their behaviour. If you both enter into some kind of secret contract of silence, then you will be left to deal with it alone and they may come to resent their dependence on you.
It isn’t helpful if the behaviour has no negative consequences either. You walking away and leaving them when they are aggressive may be the best thing you can do. It isn’t betraying them to tell MH teams who need to know if they are to be effective.
Get out, tell people, get help.