A.W.A.R.E. NJ

A.W.A.R.E.

New Jersey

Spiritual Emergency First Responder Reference

Am I Seeing Behaviors?

Tap signs you observe. Two or more may indicate a Spiritual Emergency.

Ecstatic mood or rapid speech with religious/spiritual language

Quiet or withdrawn while performing religious/spiritual rituals

Hearing voices or seeing visions of a religious/spiritual nature

Sharing ideas, drawings, writings, etc., linked to mythology, religion/spirituality

Demonstrating an altered sense of reality

The person finds it hard to explain the experience

Possible Spiritual Emergency

Do not dismiss spiritual content. Proceed to protocol.

Often referred to as:

Hyper-religiosity Religious preoccupation Religious fanaticism Out of touch with reality

What Do I Do?

1

DE-ESCALATE

Lower your voice. Slow your pace. Create calm space. Reduce sirens, bright lights, and crowds where possible.

2

LISTEN

Without judgment. Do not dismiss or challenge spiritual content. Be fully present. Let them speak.

3

ASK

Ask the 3 key questions calmly and without judgment.

What Do I Ask?

Ask these 4 key questions calmly, without judgment.

Question 1

"Do you sense something religious or spiritual is occurring?"

Opens the door. Validates their experience without diagnosing.

Question 2

"Would you like a clergy member to be called for support?"

Respects their tradition. Bridges to appropriate spiritual care.

Question 3

"Would a peer-support specialist familiar with your religious, spiritual, or cultural traditions be beneficial?"

Connects to culturally competent care.

Question 4

"Do you have a Psychiatric Advance Directive (PAD)?"

A PAD is a legal document stating a person's treatment preferences. If they have one, it should guide what happens next.

Quick Reference

DSM Z Code

Z65.8

Moral, Religious or Spiritual Problem

APA Board & DSM Steering Committee approved definition, December 2024. Use this code in ER documentation.

What is a Spiritual Emergency?

A spiritual emergency is a profound encounter with the sacred — a mystical state, an awakening, a crisis of meaning — intense enough to overwhelm a person, yet not, in itself, a mental illness.

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AI Guide

I'm your AWARE NJ guide for spiritual emergency response in the field. Ask me about signs, protocol steps, the 3 key questions, or documentation. Ask me, "What is a spiritual emergency?" and then let me know, how can I help?