Saturday, June 18, 2011

My Awesome Person Trick!

Anyone who has ever met my sweet dog, Bayley, knows that she is a bit of a diva. "A bit of" might actually be an understatement. Bayley loves to be pampered in every way possible. She loves to cuddle up right next to you and gets slightly annoyed if you move and cause her discomfort. She likes to burrow under blankets (even if you are currently using the blanket) and is more than slightly offended if you fail to give her the blanket you are using when she wants it. Bayley loves to have you help her get comfortable under a blanket if she is struggling with this and she expects that you will allow her to curl up in the bed with you at night if she wants.

Bayley sometimes prances around the house while looking back at you to make sure you are following her to the destination she thinks you need to go with her. Usually, these destinations include going to the pantry to let us know it is time for us to feed her, going to the back door to let us know it is time for us to let her outside, or going to her toy box to let us know it is time to play with her.

But, of all the things Bayley does, the one I like the most is when she begs for treats. Bayley has a few favorite things in life and I believe that they are, in this order: 1) food of any kind (except veggies); 2) walks with her masters; 3) the dog park; 4) catching bugs; 5) blankets. So, it would make sense that if food of any kind is Bayley's favorite thing that dog treats would be favorite among food of any kind. In the dog treat category, there also exist different levels of love for Bayley. Bayley loves store bought treats. But, above all, Bayley loves dog treats that I make her from scratch. In fact, I think Bayley might even have a love affair with these treats. She loves them so much that I refer to them as "my people trick". You know how dogs do tricks to impress humans? Well, these treats are my trick that I do to impress my dog.

Here's how it works. I get out all the ingredients and begin to make the dog treats. Usually, you have to roll and cut the dough with cookie cutters (yes, I have dog themed ones!). Bayley has become familiar with this process and when I begin to make the treats, she comes running into the kitchen and prancing around excitedly. Then, I bake the treats. She runs to and from the oven throughout the baking process trying to tell me that she wants a treat. Usually, right when the treats come out of the oven, before they have even had time to cool, I will throw one on the floor for her to appease her curiousity. She will play with this treat by nipping and pawing at it until it cools and then devour it. Later, once the treats are cooled, I put them in a container on the kitchen counter. And this is where the real fun begins.

Bayley will frequently make trips to the kitchen to stare longingly at the kitchen counter where the treats are housed. She will come and get us to tell us that she wants a treat. She'll come and run to us and jump on us and then run into the kitchen while looking back to ensure that we are following and then sit down and stare up at the counter. If we fail to give her a treat, she will run into her crate and sit in there hoping we will then give her a treat. Bayley gets a treat when we put her in the crate to leave in the morning. She knows this. She also gets to eat her daily meal after sitting and looking up at us. She knows this, too. Bayley pulls out all the stops to obtain her special dog treats.

In fact, the other day, Bayley wanted a treat so badly that she came to find me and nudged at me for 30 minutes before I finally got up and asked her what she needed. She led me to the dog treats. I told her no and left. She then ran into the bedroom where my husband was, nudged at him, and ran back to the kitchen. I went to the bedroom to share what she was doing, and upon seeing us both in the bedroom, Bayley stood at the end of the hall, tail wagging, ears perked up, and looked at us expectantly. So, my husband (I think just to mess with her) got up and began to walk toward her. She ran to the treats and when this didn't work, she sat down. When this didn't work, she ran into her crate. And then, when it still didn't work, she ran back to the treats. I'm pretty sure we could have had her do just about anything in that moment if we had just followed it by a treat. And that, my friends, is an awesome people trick.

Monday, May 30, 2011

Geocaching

Today, I had my first "hard core" experience with geocaching. My aunt and uncle are fanatically about this "lifestyle" and have wanted to expose my husband and I to the joys of this experience for quite a while. So, today, we fianlly got together for a day of geocaching fun.

To begin, let me explain the idea of geocaching for those who don't know. Essentially, geocaching is a global Easter egg hunt for grown ups. You look up "caches" and let use your GPS device to navigate to the location in which the cache is hidden. Once you arrive at the location of the cache, you explore the area, moving rocks, bushes, and sticks until you uncover the cache. Caches are usually camoflauged to allow them to blend in and they usually are either a film canister, a small pill bottle, or something like that. Once you find the cache, you open it up, collect any trinkets inside, replace those trinkets with some of your own, sign the "finder's log" and replace the cache for the next person to find. Some caches are easy to find and some are more difficult. There are caches in parking lots, parks, creeks, cemetaries, fields, forests... pretty much everywhere. Some are called "park and grabs" which means that you can just park, find the cache quickly, and leave again. Others take several minutes to find. Most are small but some are "micro" or "nano" caches and these seem to be hardest. Apparently, some times people make a cache look like something else, like a piece of a tree or a screw and then it is really hard to find it! So, this is geocaching.

Now, let me set the scene of the day for you. We arrive at Starbucks to meet my aunt and uncle and when they arrive, I observe my uncle in a T-shirt that says, "I (heart) Geocaching." Oh, and they also have a geocaching bumper sticker on their car. Oh, yeah, it's going to be an adventure. Next thing I know, we are in the parking lot of the Starbucks looking around a gigantic rock to find a "quick cache" in the parking lot before beginning our real adventure. And, so, the day went on from there in this type of fashion.

Here's the thing I learned about geocaching today. While looking for a cache, people (and actually, you) will do things that any sane person (and you, on a normal day) would never do when not looking for a cache. And, you will do it happily and willingly. Example: today, we pulled off the road, walked through a field, hiked through poison ivy, and dug around an overgrown tree for 30 minutes to find a "micro" cache that looked like a screw in a tree branch. Then, we sat in our car while we watched a police officer almost arrest a hitchhiker who just happened to drop a bag of "nothing" immediately before being stopped by the officer. My aunt actually called 911 to tell them that the man dropped a bag before being stopped so dispatch could tell this to the officer. She told him we had pulled over to pull stickers out of our shoes and this is why we were on the side of the road. Cause, um, how do you explain to 911 that you were actually geocaching.

Other things that you will do while geocaching that you would never otherwise do include wandering through parking lots digging around lamp posts, walking through a creek bed sticking your hands in ANY hole you find in the rock face, and picking up sticks and rocks to look underneath them. Um, see, generally I try to avoid encouraging snakes to find me, and yet, today I found myself happily inviting them to come visit me when I disturb their hiding holes.... crazy.

And here's the craziest part of it all. It's so much fun! Now that I am home, clean, and safe, I find myself thinking about all of the places where something might be hidden without me even knowing it. And, I feel quite accomplished for having such a fun adventure today. The best part of all of it is that I got to spend the day with some of my favorite people laughing and searching while hanging out in the great outdoors and I thinking about nothing other than finding the next cache. What a fun and peaceful day.

I can't wait to go again!

Saturday, April 30, 2011

The Choking Game

“The choking game is a dangerous practice of tweens and teens in which they self-strangulate in order to achieve a brief high. The high is the result of oxygen rushing back to the brain after it is cut off by the practice of strangulation.” (taken from http://tweenparenting.about.com/od/healthfitness/f/ChokingGame.htm)

Tweens and teens play this game in groups by physically choking each other and alone through use of belts, leashes, scarves, and ropes to strangle themselves. In a group, one teen chokes another until the “player” passes out. Then, the first teen releases the grip around the player. Alone, the player ties one end of a ligature around the neck and either pulls it tight or ties the other end around a door knob, bed post, curtain rod, or other object in an effort to strangle him or herself. The individual plans to release the ligature used to induce strangulation right before passing out. In some cases, the teen is unable to release the ligature from around the neck prior to passing out. In these instances, the individual dies from strangulation and/ or hanging.

The choking game is also referred to by several other names including the fainting game, Flat liner, Pass Out, Gasp, Suffocation Roulette, Blackout, and Hangman.

According to a recent study, 1/3 of all 8th graders reported knowing some one who had played this game. 6% of 8th graders reported playing it themselves. 40% of the kids surveyed said they saw no danger in playing this game. (from http://chokinggame.net/)

Many children who engage in this activity are intelligent, highly achieving adolescents who think this game is a safe alternative to using drugs or an easy way to achieve a high without getting caught using drugs. The game is usually played by teens age 9-16 but children as young as 6 have died playing it. It is suspected that 1% of all completed suicides are due to the choking game but in most causes this is a difficult distinction to make.
Risks associated with playing this game include seizures, broken bones, brain damage, memory loss, strokes, concussions, and death.
Signs and Symptoms include:
• Any suspicious mark or bruise on the neck, sometimes hidden by a turtleneck, scarf or permanently turned-up collar, or wearing clothing that covers the neck even in warm weather.
• Changes in personality, such as overtly aggressive, irritable, or agitated.
• Any kind of strap, rope or belt lying around near the child for no clear reason—and attempts to elude questions about such objects.
• Headaches (sometimes frequent and excruciatingly painful), loss of concentration, flushed face.
• Bloodshot eyes or any other noticeable signs of eye stress such as bleeding under the skin of the face or eyelids.
• Confusion or disorientation after being alone.
• A thud in the bedroom or against a wall—meaning a fall in cases of solitary practice.
• Any questions about the effects, sensations or dangers of strangulation.
• Wear marks on furniture (bed posts, door knobs, etc.)
• Linens or ropes tied around door knobs or furniture
• The frequent need for privacy
For more information: http://tweenparenting.about.com/od/healthfitness/f/ChokingGame.htm; http://chokinggame.net/; http://en.wikipedia.org/wiki/Fainting_game; http://www.gaspinfo.com/en/home.html

Sunday, April 10, 2011

My Hope

People often ask me why I do what I do for a living. It is no secret that I have a stressful job, and one that many people freely say they would not like to do. Some weeks are more stressful than other weeks and cause me to question for myself why I willingly subject myself to the heartache and pain I deal with every day. This past week has been one of those weeks. It's caused me a great deal of sorrow, anxiety, and more than a few tears. It's caused me to cry out to God and it's caused me to question my abilities. It's caused me to wonder, "Can I do this?", "Am I competent?", and "Am I crazy?" It's caused me to wonder what others think of me and my abilities, if I can ever really do any good for those I seek to help, and if I can trust God to make beauty from ashes.
Tonight, I was talking with some friends about the difficulties I encountered this week and I mentioned that I don't like to see people hurt. One of them said to me, "You're in the wrong profession." Because I have wondered this same thing more than once this week, I began to think about why it is that I am in this profession.
Counselors become counselors for many reasons. One of the things we learned first in school was to accept that one of the reaons why we chose the counseling profession is to meet some of our own needs such as the need to be needed, the need to help others, the need to be in control, and the need to find purpose and meaning in life. All of those resonate for me and this week I have been faced squarely with the knowledge that sometimes, the reason why I do what I do is less about helping my clients and more about meeting my needs for control, meaning, and purpose. When I feel lost and don't have answers to offer those that seek them from me, I question my role, my abilities, and my usefulness. I begin to criticize myself for my weaknesses and failures, and I become convinced that others see these weaknesses too and judge me for them.

And yet, one fact remains and this fact will forever be true. God is always the answer. When I feel lost and even when I don't feel lost, God is the answer. He is the reason why I do what I do. He is my hope. I do hate the hurting of this world. I do hate seeing depravity, sin, and Satan win the souls of some people. I do hate that the Enemy tells all of us lies and these lies bring hurting and pain and sorrow and sometimes this pain and sorrow causes people to take their own lives. It does seem completely meaningless to me. It does sadden me and impassion me to fight against it. That is precisely the reason why I do what I do. I do what I do because I hate the hurt within this world. It is a way that I have found to offer hope and healing for the Enemy's lies. I can never heal the wounds. I can never free a soul. I can never deliver someone from the pain that causes such suffering. I can never offer satisfying answers to the question of, "Why?" "Why does God allow this suffering, this pain, this hurt?", "Why does God sometimes allow young people to die?", "Why does God allow such trials to befall mankind?" I have no truly satisfying answers for this.
But, what I do find is that the one answer I have is enough for my soul and for the souls of all men. The answer that I have is that God is enough. God has the answers. God knows why. And all that He does is good. ALL that He does is good. He will always redeem, He will always restore, He will always heal. He will always weave a beautiful tapestry out of the darkness and pain. He will always bring glory to Himself and peace to His people. And in the end, He will return. He has conquered over death. He has conquered over sin. He has conquered over depravity. He has conquered over Satan. So, even though it seems in this moment like Satan wins some of the battles, my God will always win the war. ALWAYS. And I want to be a part of His working in this world. I want to be a vessel that He can use if He so chooses to bring hope and healing and comfort to those that are struck by the fractured reality that sin has created. I want to be used by Him to push back the darkness and the pain that so often transcends. I want to offer His light into that darkness.

And so on weeks like this one, when I struggle with questions and anxieties without any easy answers from a human point of view, I rest on the one thing I hope in: Christ alone. For I was dead in my transgressions, unable to save myself... but Christ saved me through no work of my own. And that is enough for me. That is enough to cause me to trust Him even when it is difficult and even when I don't know how. Sorrow will last for a night, but joy comes in the morning. My God will sustain me, love me, and see me through even the most difficult weeks. He sees me as He has made me, redeemed and transformed, rather than as the sinful, anxious, insecure, and depraved person I am now. He brings trials to increase faith. He brings pain to increase faith. He brings darkness to greater magnify His light. That is the hope that I have and the hope that I can offer to others.

And that makes it all worth it.

Saturday, April 2, 2011

Kids These Days

Everyone knows the old adage that kids grow up too fast. But, in today's world, kids are growing up faster than ever. We all want to believe that our kids are not being exposed to drugs, sex, abuse, bullying, violence, gangs,  and immorality. However, this is far from the truth and as we continue to pretend that our children remain innocent, they are dying. They are dying physically through suicide and homicide. They are dying emotionally through anxiety, grief, depression, anger, and trauma. They are dying spriritually through exposure to wicca, Satanic rituals, immorality, gangs, choices with lifelong consequences, abortions, and anger with the Living God.

In today's society, if you choose to put your child in public school or if your child has friends that are in public school then most likely, your child will know about sex by the age of 7. Kindergarteners are talking about sex. And, sometimes, they know what it means. Not only that, but kindergarteners sometimes experiment sexually. And this creates life long effects on children. In today's world, 1 in 3 children are abused sexually (and this includes boys) and physically. And these children don't speak up because often they are threatened and told that if they speak up, they will break up their families, be abused further, be placed in foster care, and all of this will be their fault.

By the time your children are in their tweens (10-12), they will likely be exposed to drugs at school. If you're lucky, this will be marijuana, cigarrettes, and alcohol. If you are less fortunate, your children will be exposed to huffing, and in later teen years, cocaine, mushrooms, and prescription pills. Not only that, but your children will either be exposed to children who chase highs or will chase a high themselves through reckless and dangerous means. Right before you asphyxiate, there is a natural high that occurs. So, yes, teens today intentionally asphyxiate themselves to try to catch this high. The idea is that they will stop this behavior before they actually die. Sometimes, teens do this by placing plastic bags over their heads. Other times, teens do this by playing a particular game called the choking game. The idea of this game is that teens challenge each other to hang themselves fastest, longest, and best. They take anything that they can use to hang themselves and they put it around their neck and then around a door handle or a bar in the closet or anything they can. And then, they choke themselves. They intend to stop this choking right before they pass out. But, sometimes, they pass out before they can get the item that is choking them off of their neck. And, they hang themselves. Yes, they die. Also, female teens today chase highs by soaking tampons in alcohol and inserting them into themselves. And before you say, "My child is too young for this" let me be clear. Children are young as 11 or 12 are doing this.

In today's world, self injury is common place. "Everybody does it." Teens and even children as young as 7 or 8 cut themselves with razors, knives, and box cutters. They also burn themselves and scratch themselves. They do this to "relieve pain" or to "fit in". They do this when they are angry, when they are sad, when they are confused, or when they want to be accepted at school by their peers. Sometimes, this is a fad and other times, it turns into a life long coping mechanism. Teens today also starve themselves and make themselves throw up in order to gain control over some part of their lives and, you guessed it, "fit in" and "look pretty". They exercise too much, they abuse laxatives, they gag themselves, they throw away their lunches without eating them and tell their parents they ate. They skip breakfast but pretend they didn't. They eat dinner at their friend's (but not really). Or they already ate (but not really).

Teens today stay home alone. They play XBox and Wii and Kinect and computer games. These games are violent.  They expose our children to things that we wouldn't even want to see. They desensitize our children to violence. They allow children to take out their aggression on others and then this transfers to real life. Teens today also watch television shows that expose them to sexual immorality, violence, homicide, and suicide. Teens today utilize social media. They get into fights on facebook, they bully each other on facebook, they threaten suicide on facebook. And parents have no idea.

Teens today are bullied. Heavily. This can be from peers calling them names that you would not believe these children even know, pushing, shoving, threatening to fight, threatening to kill, and actually fighting. This can be stalking and harassment. This can be by one peer or several peers. And this is one of the leading factors in teen suicide today. I promise you that if your child goes to public school, they are either being bullied, bullying, or have a close friend who is being bullied. And guess what, the administrators of these schools do not address this. They say they will but they don't. They say things like, "There's nothing we can do" and "It's just kids being kids" and "It's no big deal". But it is a big deal. It is one of the main reasons why teens do all of the things listed above. This occurs in elementary school, middle school, and high school. And, it lowers your children's self esteem greatly. Please hear me when I say that bullying is damaging.

Today's teens get abortions without parental knowledge or consent. They have unprotected sex. They think about suicide. They think about homicide. They attempt suicide. Sometimes, they take guns to school and kill others before they kill themselves. And parents have no idea. Teens today are depressed, anxious, scared. They do not know what to do or how to navigate these years. They do not know how to help their friends or handle the crises that occur in their every day lives. Let's face it, the crises that our children face every day, most of us would not know how to handle. In today's society, suicide is one of the leading causes of death among teens and teens are one of the two groups that are at highest risk for suicide. Teens are impuslive, think they are invinceable, and cannot see past their momentary struggles. They do not realize how lethal some means of suicide can be and they want someone to know how badly they are hurting, so they attempt thinking they will survive, but they don't. Or they attempt because they don't want to survive. Either way, they die. If your teen (or tween) is in public school, they likely have a friend who is considering suicide if they are not considering suicide themselves. Let me be clear- children as young as 6 have thought about suicide and even attempted suicide. Children as young as 8 or 9 have completed suicide.

And here's the worst news of it all: Teens today do not talk to adults. They sure do not talk to their parents. Why? "They don't care about me"; "They don't have time for me"; "they wouldn't understand"; "they won't listen"; "they will get mad.; "they won't believe me". And so, teens today are exceptionally vulnerable to the influence of their peers. If a friend of your teen or tween self injuries, your teen or tween is likely to begin this. If their friends starve themselves or purge, your children likely will too. If a friend commits suicide, yours will likely try it or at least consider it. And this one is especially scary because now you have a grieving teen that is open to influence and has no idea how to handle the feelings of grief and confusion. And, so, sometimes, children make suicide pacts. Teens influence other teens.

And mostly, I blame adults for all of this. If you are a parent, the best thing (and absolutely necessary thing) to do is talk to your kids. And when I say to talk to your kids, I don't mean to beat around the bush and ask vague questions. If you ask vague questions, you will get vague answers. If you ask questions in a harsh or angry way, you will get no answers. Talk to your kids honestly. You are not going to expose them to more than they have already been exposed to (again, unless you have done a great job of sheltering your children through the past several years of their lives, and then you might expose them to things they did not already know. And, also, if this is you- good job. Keep it up!). But, if you know you have not done a great job of protecting your children for the past several years, talk to them. Tell them how much you love them and care for them and want to help them. Let them know that you are going to help them and not get angry with them. Let them know that they are not in trouble and that you will not punish them. Ask them if they are thinking of suicide. Ask them if they are being bullied. Ask them if they have been sexually active. Ask them if they have been exposed to drugs. Ask them if someone has touched them inappropriately. Ask them if they have a boyfriend/ girlfriend. Ask them specifically using the words they use- sex, drugs, suicide, cutting, abuse. These words are important. Use them. If your child is young and you are concerned about them, talk to them using language they understand but still be direct. You can ask your 6 year old things like, "Do you ever think about dying?", "Do you ever wish you were dead?", "Has someone ever touched you in your private places?" and things like this.
Pay attention. Get to know your children's friends. Get to know their lives. Know where they are going. Know what they do on the internet. Be your child's friend on facebook. And check their facebook page often. Block chat rooms. Set specific rules for your children about internet usage. Don't let your children be victimized by predators by allowing them to post intimate details of their lives online or visit chat rooms. Know what your children are watching on television. Know what your children talk about with their peers. Know what your children struggle with daily. Invest in their lives. Set aside some time every night or at least once a week to listen to your children. Truly listen. When I say listen, I do not mean to say to your kids, "It'll be okay" or "It's not a big deal". Try to understand what they are feeling, what they are thinking, and don't minimize their pain.

And for gracious sake, if your children tell you they are having dark thoughts, struggling with pain, or thinking of suicide and you do not know what to do- GET HELP FOR THEM! If they are being bullied, do something. And once you do something, make sure that took care of the problem. And if it didn't, do something else. Fight for your kids. Advocate for them. They need your help even if they don't think they do. Ask your kids which of their friends they are worried about and why. And then be there for those friends. Tell the parents or school staff of those friends about the concerns. Be involved.

Your children's lives depend on it. And I am not being melodramatic here. The difference between you taking time to truly invest in your children can mean the difference between your children living through the teen years and your children dying before they are 18.

Thursday, March 24, 2011

My "Cat"

I don't like cats. I know this is shocking. Actually, I really love the big, big cats. The ones that eat you. Or at least they could eat you if they desired. I like those cats. From a distance. Not up close. Never up close. But, the little cats, the ones that stay inside your house and generally ignore you until it's convenient for them to be your friend- I don't like those cats. For one, they climb up on everything. And secondly, they catch mice and bring them to you as if they've brought you the best present ever. Also, they do their business in a box that ends up stinking up the joint. And, they are moody. Some cats are like dogs. They are cuddly, sweet, and playful. These cats, I truly enjoy. This is why I have a dog. Dogs are playful and sweet and cuddly and they want to hang out with you. Dogs don't bring in dead vermin and they don't climb on everything in sight.

At least that's what I thought was true of dogs. Then, we got Bayley. Bayley is one of those dogs that thinks she's a cat. She has many dog traits: she cuddles (when she wants to), she plays, and she does her business outside. But, she also does many cat like things. She climbs on tables- all of them, not just some of them. She climbs into the window sills as well. If I put the blinds up, she'll stand in the window sill and look outside. She even climbs on the bricks outside that stick out at the bottom of the window. She chases bugs and she has moments of moodiness.

But, the worst, most cat like thing Bayley ever did happened one morning when I let her outside. She found something truly wonderful and delicious and began playing with it. Bayley loves to eat bark. So, when she came to the door, tail wagging and eyes filled with delight, I assumed she had found a piece of bark that made her day. I opened the door saying, 'hey girl, what did you find?" and then immediately shrieked and slammed the door in my poor dog's face. Much to my dismay, Bayley had a full grown grasshopper in her mouth which she was completely intending to bring inside. I told her to leave that nasty thing outside, so she put it down and sat at the door calmly. I opened the door again and she ran to retrieve her prize and carry it into the house. Only, much to her chagrain, she found the door once again slammed in her face. I began to lecture her through the door as if she could understand me, "you are not bringing that thing in my house. Forget it!" Finally, dejected and sorrowful, Bayley came inside leaving the grasshopper on the porch.

Later in the day, we let Bayley out again. She found her delightful toy and began to play with it. Then, as I stood there watching, things went from bad to worse when she ate that dreaded grasshopper. Yep, she ate it. Legs and wings and all. Gross. Pleased as punch, the dog came back inside and immediately proceeded to burp. Guess it was a tasty meal. All I know is that I did not let that creature's mouth anywhere near me for the next several days. Grasshopper cooties... yuck!

Thursday, March 10, 2011

A Day in the Life

One of the best conversation topics of all time is the topic of work and career choice. Usually, people will ask me what I do for a living and I answer, "I am a crisis counselor". Then follows the blank stare, awkward silence, and finally... "Oh. Cool?" After the awkward wears off, the conversation most frequently turns to questions about what my job actually entails. Today, I have decided to answer this question for my small but loyal following of readers.

I am a crisis counselor. This means I work with individuals who are in a crisis situation. The broad definition of crisis services from which I usually work is that I assist any individual who is suicidal, homicidal, or psychotic in some way. Generally, we also help people who are depressed and thinking of dying a passive death but not actively killing themselves. And, we help people who are experiencing anger to the point of aggressive behaviors that could harm someone but that are not homicidal. In the realm of psychotic, we help anyone who believes they are Jesus, believes they are on a mission from Jesus, believes the FBI is watching them, disrobes in public thinking it's okay, thinks aliens are after them, hears "the voices", believes a sniper is at the window, defecates in inapproriate places, believes they are being poisoned, thinks others can hear their thoughts, or generally does not make sense but thinks he or she does.  Some of the most common things I see that contribute to the above crises are trauma resulting in depression, anxiety, and thoughts of death (i.e. PTSD), domestic violence or abusive relationships, general relational difficulties, substance use, sexual assault or past abuse, grief, and unmedicated mental illness including depression, Bipolar, and Schizoprenia.
I become involved with an individual because I get a phone call asking for a psychiatric evaluation on someone who has presented to law enforcement or medical staff either at a private residence, a hospital, a jail, a school, or some other location with one of the above concerns. Once I get called, I go with a partner to the scene and assess the individual for threat of harm to self or others including thoughts of suicide, passive thoughts of death, past suicide attempts, thoughts of homicide, self harm, aggression to others, and psychosis. Once we complete our assessment, we determine one of two things: does this person need inpatient treatment at a psychiatric facility or can they remain safe enough to engage in outpatient treatment.
If we determine that someone needs inpatient treatment, we further assess several things. The first thing we ask is if this person is agreeable to signing him or herself into the hospital. We then determine if the person is oriented enough (knows who he or she is, what date it is, what the situation is, and where he or she is) to sign him or herself in to the hospital. If the answer to both of these questions is yes, we facilitate the client getting to and signing in to a mental health hospital. If one of the above answers is no, we seek an involuntary commitment to the hospital.
In order to involuntarily commit someone to the hospital, we contact another authority, namely our mental health deputies. These folks are part of the sheriff's office and have the right to take someone into protective custody if the person is in immediate danger to self or others. The deputy completes an assessment and either takes the client to the hospital or determines the client can remain safe on an outpatient basis. If the deputy decides for the hospital, the client attends a court hearing the next day to determine length of hospital stay. If the deputy refuses to take the client to the hospital, we work on safety planning for outpatient services.
Now, if we decide on outpatient services, we typically look for a number of things. First, we determine if the person has any social support to help keep him or her safe. Second, we explore if the client is willing to participate in treatment to begin to improve in condition. We also aid the client in developing a safety plan including coping skills as well as removing access to anything the person can use to harm self or others.
If we recommend outpatient for an individual, then they can receive counseling services and medication as well as case management services to increase community supports for the person. If they want counseling services, then either myself or one of the other counselors on staff begins to work with them in counseling. We each have 2 days of the week set aside for counseling clients and the other 3 days of the week are set aside to do psychiatric assessments. We do not counsel psychotic individuals cause, well, it's not terribly effective.

And that, in a brief nutshell, is what I do for a living.