What can lead to a crisis?
A person in crisis can no longer cope with an event or situation. The stressful event may have occurred a long time ago or unexpectedly in the present.
Sexual abuse and other experiences of violence can trigger shock reactions and mental crises. Several stressful incidents can often come together and lead to a crisis. In addition to experiences of violence, these include experiences of loss, illness, accidents, the death of a loved one and other traumatic experiences. Long-term stresses such as mental illness, loneliness, pressure and social conflicts can also become too much to cope with and cause mental distress. People can react to a highly stressful event or particularly stressful life circumstances with a mental crisis. Anyone can potentially experience this. People with pre-existing mental illnesses often find it very difficult to cope with crisis situations on their own. Generally speaking, when several stressful events come together, there is a greater risk of experiencing a crisis. Even events that are in themselves positive, such as pregnancy or the start of a new relationship, can be overwhelming and trigger such strong emotions that they can cause a crisis in victims of sexualised violence.
How do you recognise an acute crisis?
Perhaps you feel you have lost your inner balance? Everything you usually do to cope with difficult situations no longer works? You cannot manage the situation by yourself?
This is what many people feel in an acute crisis. Often, the way people think and feel also changes: Some people can only think about one thing, while others jump from one thought to the next. The same is true for feelings. Some people in a crisis barely feel anything. Others experience their own emotions with such intensity that they can find it difficult to control them, such as excessive fear or anger. Or they feel completely hopeless, lonely and sad.
If their feelings become too powerful or even threatening, some people also think about suicide or self-harm, or drink excessively. Sometimes people experience the crisis situation as such a threat that they leave their home, for a short or longer period of time, and seek refuge elsewhere or stay in a hospital. The symptoms can vary in their intensity and last from days to weeks.
Crises in children and adolescents
Adults are not the only people who experience crises, children and adolescents also do. Often they react to the experience with behaviour that they had already grown out of. Some children might start sucking their thumbs again, wet themselves or want to sleep in bed with their parents. Adolescents also often react by changing their behaviour. They may become withdrawn or isolate themselves entirely. Or they become impulsive and develop aggressive behaviour – directed against themselves or others. Behavioural changes can, of course, have many different causes. But if you suspect sexualised violence, please do not hesitate to contact the Hilfe-Telefon
People deal with crises in different ways
People deal with a crisis in different ways and also experience the consequences of stress in different ways. Not everyone needs professional help to process their experiences. A lot of people manage to cope with a crisis on their own, or with the help of a person they trust. But what if they are unable to deal with the crisis on their own? If this is happening to you or someone close to you, professional support can help. In the „An wen können Sie sich wenden?“ (Who can you turn to) section you can find points of contact that you can get in touch with if you need help yourself, or you want to help someone else in a crisis.
How can you support someone in crisis?
People cope with a crisis better with help and support. Be there for the person and think about who might be able to help.
This is what you can do:
- Address the person's worries. Most importantly, listen and tell them that they can talk to you at any time.
- Stay calm and convey a sense of safety. If you fret or panic, you can make the situation worse and upset the person even more.
- Try to understand their distress and show that you do. Keep your own distress and stress to yourself as much as possible.
- Ask the person what makes them feel good or what has helped them before. This can be quite simple things such as going for a walk, having a cup of tea, exercising, tidying up or listening to music. Encourage the person to do something that makes them feel better.
- Don't say things like "Why don't you simply …" or "If I were you …". Even well-intentioned advice is inappropriate at this point ("Of course, a breakup is always difficult, but you never got along anyway.").
- Encourage the person to seek professional help if the stress becomes too great.
- It is also very important that you keep your own boundaries in mind. Only make promises you can keep, and seek support from a trusted person or a support facility.
When should you seek professional help?
Generally speaking, you should seek professional help if you or someone close to you is finding it difficult to cope with the crisis on their own, or with the support of people close to them.
Everyone has the right to get professional help. It is neither shameful nor are there any minimum requirements regarding the extent to which you suffer or experience the crisis. Stress relief and stabilisation are the most important things out of the crisis. This is called crisis intervention, or we might also call it psychological first aid. The main focus here is on psychosocial care and treatment.
Who can you get in touch with?
The professional crisis intervention services differ both in how accessible they are, and with regard to the type of support they provide. We present the main ones here:
Crisis services and social psychiatric services
Crisis services are points of contact for people with acute mental problems. A crisis service usually only provides support for a limited time. However, since we do not know how long the mental crisis will last, longer-term support can also be provided in exceptional cases. Crisis service support can be provided on an outpatient basis. However, there are also mobile crisis services who visit people in their home.
Social psychiatric services of the health authorities also advise and care for people with mental and social problems and the people close to them. Their help is easy to access, and you do not need to wait for an appointment. Social psychiatric services also help in an emergency and offer crisis intervention. In the event of an acute crisis and risk of suicide or a high risk of violent behaviour, victims and helpers can contact the mobile emergency service around the clock. They assess the situation, provide on-the-spot help and initiate further steps.
Advice over the phone and crisis services
Advice over the phone and crisis services are easy to access in a crisis. You can find the right services under „Finding help“
You can also call the following advice hotlines: „Sexual Abuse Help Line“, „Support hotline for violence against women“, „Support hotline for violence against men“, the Samaritans or the „Nummer gegen Kummer“ advice hotline for children and adolescents.
Many people find it easier to write about their situation. Online support can also be helpful in a crisis. There are many online services for people in a crisis, such as [U25]'s email support service or online pastoral care. Many local advice and counselling centres also offer confidential advice online.
Psychosocial contact and advice and counselling centres
Some psychosocial contact and advice and counselling centres also offer support in a crisis. This is also called "crisis intervention". Take a look at their websites and find out about the services and specialisations the different advice and counselling centres offer. Or ask them over the phone. Many advice and counselling centres specialise in sexual abuse. You can find these services in the „Finding help“section.
Medical help and psychotherapy
Specialists in psychiatry and psychotherapy and child and youth psychiatrists and psychotherapists work in private practices. They will help you during surgery hours if you are under a lot of psychological stress. Going to a specialist medical practice is the right thing to do if you might need medication to stabilise your state of mind.
For people who are already in therapy, the therapist is often the first point of contact. But people who are not in therapy can also get in touch with such a practice. They can make an appointment and get advice there. There is also the possibility of acute treatment. You can find more information about that here.
For many people, going to see their familiar family doctor can be an important first step in a crisis. You can discuss what you should do next there.
There are various types of outpatient clinics including trauma, violence protection, child protection or psychiatric outpatient clinics. They help you quickly in an emergency:
- Trauma outpatient clinics mainly offer psychotherapy support for traumatised people. There are trauma outpatient clinics for children and adolescents, as well as for adults. Find out more about trauma outpatient clinics here. You can find outpatient clinics near you under „Finding help“.
- Violence protection outpatient clinics offer victims of violence the opportunity to have their injuries examined and documented by a forensic medicine specialist. This can be done without the crime having been reported to the police. The examination is free of charge. On the „Terre des Femmes“ website you can find a database of facilities which secure evidence anonymously.
- Child protection outpatient clinics focus on the medical protection of children. They investigate acute and chronic cases of physical or mental abuse, neglect and sexualised violence against children and initiate further help where necessary.
- Psychiatric outpatient clinics and outpatient clinics for child and adolescent psychiatry will immediately see you in an emergency. They are part of the local psychiatric hospital and come into play when other psychiatric or psychotherapy treatment is not available.
Places of refuge
Shelters protect people in need or in crisis situations – especially if there is an acute risk of violence. There are separate shelters for women, men, girls and boys. Some shelters are also open to people who feel they are neither a woman nor a man, or who have changed their gender identity.
Admission and stay in a shelter happens on a voluntary basis. The shelter's address is generally not publicly known. People can usually call the facilities at any time of the day or night and ask for refuge. Some regions have offices that coordinate places in shelters in that region. Shelters are a safe place for people to find stability, where they can take their time to consider what to do next.
Are you looking for a shelter near you? You can find them under „Finding Help“
What can you do in an emergency?
If the crisis comes to a head and you have a mental breakdown, you need help immediately. Family and friends should react immediately and get professional help.
Call the emergency service on 112. You can also call them yourself if you have suicidal thoughts and urgently need help. The social psychiatric services and the police also help in an emergency. The number for the police is 110.
You can also be admitted to a psychiatry and psychotherapy clinic at any time in an emergency. The medical and therapeutic professionals knows what to do in an emergency and will support you with therapy sessions and medication if necessary. You can also get in touch with a psychiatric outpatient clinic in such a case. Don't forget: never hesitate when it comes to getting help for yourself or another person.
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