When to stop de-escalating and get help

De-escalation has limits. If there is a threat, violence, serious risk, severe distress or you feel unsafe, stop managing the situation alone and follow your agreed local procedure for getting help.

Red lines for immediate support

Certain behaviours should trigger safety procedures rather than further attempts at calm conversation. Staff must not wait for injury before asking for help.

• Threats to harm staff, patients, self or others
• Objects thrown, property damaged or physical space invaded
• Discriminatory abuse or targeted harassment that continues after a limit
• Severe distress or possible medical emergency
• Your own sense that you are unsafe, trapped or unable to think clearly

Ending a phone call safely

If abuse continues on the phone, set a clear limit and end the call unless there is an immediate clinical or safeguarding risk that requires a different local action. Make a record of what was said, the limit you set and what happened next.

At the desk or in the waiting room

In person, possible safety steps include calling a colleague, using an alarm, moving other patients away, asking the person to step back, involving a manager or following your local emergency procedure. Do not place yourself between the person and the exit unless your local training and safety policy explicitly advise doing so.

Emergency Routes

Knowing when to stop is part of de-escalation skill, not a failure of it.