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First Aid for Aggressive Behaviors

If You or Someone You Know is in Crisis and Needs Immediate Help

Call 988, Suicide & Crisis Lifeline or 911

Majority of mental health challenges do not result in aggressive behaviors, but some do. Substance abuse (including alcohol intoxication), personality disorder, psychosis, or PTSD are some passible exploitation for the aggressive behaviors.  


A child or adolescent may be unable to articulate the connection between their aggressive behavior and a mental health challenge, disorder, or severe emotional distress. Typically, children with traumatic stress have trouble regulating their behaviors and emotions. They may be possessive and fearful of unfamiliar situations. Or, all of these: easily frightened, difficult to console, aggressive and impulsive. Symptoms of ADHD co-occurring with disruptive behavior disorders, such as oppositional defiant disorder or conduct disorder, may also include aggressive, negative, defiant, destructive, or hostile behavior.

(From Mental Health First Aid USA)

How to Assist

Aggression can vary between individuals and across cultures, but de-escalating the situation is a universal solution. In this situation, it is very important to keep yourself and others safe. 911 should be summoned if you feel your safety is in jeopardy. Do not argue with the individual nor question their logic. Only describe the person's behaviors to the responders(police, EMS or mental health professionals), do not attempt to make any diagnosis. 

  • Ensure your own safety. You should never put yourself at risk, and you must always ensure you have access to an exit.

  • If you are frightened, seek outside help immediately. Similarly. if the person's aggression escalates out of control at any time, you should remove yourself from the situation and call for emergency assistance (e.g.,911 or the police).

  • Take any threats or warnings seriously, particularly if the person believes they are being persecuted.

  • Remain as calm as possible, and try to de-escalate the situation.

(From Mental Health First Aid USA)

How to De-escalate the Situation

  • Speak slowly and confidently with a gentle, caring tone of voice.

  • Avoid raising your voice or talking too fast.

  • Do not respond in a hostile, disciplinary or challenging manner.

  • Do not argue with or threaten the young person, because it may increase fear or prompt aggressive behavior. Use positive words (such as "Stay calm") instead of negative words (such as "Don't fight"). Ask "What's happened?" rather than "What's wrong with you?”

  • Avoid nervous behavior (e.g., shuffling your feet, fidgeting.or making abrupt movements).

  • Do not restrict the young person's movement (e.g., if they want to pace up and down the room).

  • Keep your distance from the youth, carefully calculated for their cultural comfort.

  • Remain aware that certain acts, such as involving the police, might exacerbate the situation.

  • Consider taking a break from the conversation to allow the young person a chance to calm down.

  • Invite the young person to sit down if they are standing.

  • If the young person is responsive, ask them if they have a safety or crisis plan in place, and work with them to follow the plan as well as you can.

(From Mental Health First Aid USA)

The youth's response to a challenging situation is crucial in de-escalating the behavior. You show the emotions and behaviors you desire to see in others. Maintain your composure, relaxed body language (with your arms at your sides), and a carefully calculated distance from the youth to ensure their cultural comfort and safety. Continued counseling after the episode is recommended.

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