Crisis Intervention in Social Work – Psychosocial Crises and Suicidality

The previous modules have shown how professionals understand crises, conduct conversations, raise suicidality openly and develop a safety plan together with the people concerned. In almost every one of these situations, a legal question arises sooner or later: May I inform the doctor even though my client does not want me to? Do I have to call the relatives? What happens when someone is ‘sectioned’ – and who decides? Questions like these leave many professionals uncertain, sometimes even afraid of doing something wrong. This uncertainty is understandable, because in acute crises two protected interests meet, both of which carry great weight: the person’s trust and self-determination on the one hand, their life and health on the other.

This module gives a structured overview of the legal framework within which crisis intervention operates. It explains professional confidentiality, justifying necessity and the two forms of involuntary admission – and it shows where the limits of your own role lie. An important point in advance: this module provides orientation knowledge. It does not replace legal advice in an individual case, and in practice your organisation’s procedures and consultation with your manager and team always take precedence over going it alone.

PART 1 – Introduction: why the law matters in a crisis

Two protective duties, one area of tension

Social work depends on trust. People tell professionals about debt, addiction, violence, shame and despair because they rely on this information not being passed on without their say. Without this confidentiality, many people seeking help would not come at all – or they would keep quiet about precisely the most important things. At the same time, the professional mandate requires professionals to protect people from serious harm when they can no longer protect themselves. In an acute suicidal crisis, this area of tension becomes especially clear: the person confides in someone, perhaps expressly asks for silence, and at the same time there is a serious danger to their life.

The law does not resolve this tension with a simple rule. But it does provide a graduated system: as a matter of principle, confidentiality applies; with the consent of the person concerned, disclosure is possible; without consent, it can exceptionally be justified if a present danger cannot be averted in any other way. And for the extreme case in which a person is in acute danger of harming themselves because of a mental illness and refuses help, federal and state law provide for the possibility of involuntary admission – with strict requirements and under judicial oversight. Those who know this system in outline can act more calmly and with better reasons in a crisis.

Key terms

Some terms come up again and again in this module and should be clear from the outset. By professional confidentiality we mean the duty of certain professional groups not to disclose without authorisation other people’s secrets that have been entrusted to them or have otherwise come to their knowledge; for social work professionals – for the group of persons named there – it is backed by criminal law in Section 203 StGB. Disclosing means making another person’s secret accessible to someone who did not previously know it – orally, in writing or electronically. Authorised is a disclosure in particular when the person concerned has consented or a ground of justification applies.

The justifying necessity under Section 34 StGB is one such ground of justification: it exceptionally permits an act that is in itself prohibited if that is the only way to avert a present danger to an important legal interest. Finally, by involuntary admission we mean a deprivation of liberty in which a person is held, against or without their will, in a closed facility, usually a psychiatric hospital. A distinction is made between civil-law involuntary admission by a legal custodian under the German Civil Code and public-law involuntary admission under the laws of the states (Arbeitsgruppe Psychiatrie der Arbeitsgemeinschaft der Obersten Landesgesundheitsbehörden [AG Psychiatrie der AOLG; Psychiatry Working Group of the Working Group of the Supreme State Health Authorities], 2023).

PART 2 – Legal fundamentals: confidentiality, necessity, involuntary admission

Professional confidentiality under Section 203 StGB

In Germany, breach of private secrets is a criminal offence for certain professional groups. For social work, Section 203(1) no. 6 StGB is the relevant provision. It states – reproduced here with omissions –: ‘Whoever without authorisation discloses another person’s secret […] that was entrusted to them or otherwise became known to them as […] a state-approved social worker or state-approved social education worker […] shall be liable to imprisonment of up to one year or a fine.’ The provision makes clear how much weight the legislator attaches to the relationship of trust in social work: it is protected by criminal law, as in other helping professions.

Three elements of the provision deserve particular attention. First, it concerns another person’s secret, that is, facts from another person’s sphere of life that are not generally known and whose secrecy the person has an interest in maintaining. Statements about suicidal thoughts, mental distress or family conflicts typically belong here. Second, the provision covers not only what was expressly entrusted, but also what has otherwise become known to the professional – for example through observations during a home visit. Third, only unauthorised disclosure is punishable. The decisive question in practice is therefore not ‘May I never say anything?’ but ‘When am I authorised to pass something on?’

Regardless of whether a professional falls within the scope of the criminal provision in an individual case, it is advisable to treat confidentiality as a professional standard. Employment contracts and the rules of provider organisations (Träger) as a rule also provide for confidentiality. For clients it makes no difference on what basis confidentiality rests – they rightly expect that their openness will not be used against them.

Consent as the first route

The simplest, legally safest and at the same time professionally best route to disclosing information is the consent of the person concerned. A person who consents remains the subject of events: they have a say in who learns what, and they experience that their self-determination is respected even in a crisis. This strengthens the working relationship rather than endangering it. Justifying necessity too presupposes, in principle, that an attempt is first made to obtain consent, because disclosure without consent comes into question only if the danger cannot be averted in any other way (Section 34 StGB).

In practice this means: in the crisis conversation, professionals should say openly why they consider it important to involve another service, and clarify together with the person who is to be informed, what information is passed on and how this happens. A graduated solution can often be found: the person calls the medical service themselves while the professional sits next to them; or they agree that a particular trusted person is informed, but not the family. Consent should be as specific as possible and documented in a traceable way. It is also important that the person knows they can withdraw their consent.

Justifying necessity under Section 34 StGB

But what if the person refuses any disclosure and at the same time there is an acute threat to life? This is where Section 34 StGB comes in. Under this provision, a person does not act unlawfully who, in the face of a present danger to life, limb, liberty or another legal interest that cannot be averted in any other way, commits an act in order to avert the danger from themselves or another – provided that, when weighing the conflicting interests, the protected interest substantially outweighs the one impaired and the act is an appropriate means. Applied to professional confidentiality, this means: the disclosure of a secret can be justified in an individual case if that is the only way to protect a person’s life (Section 34 StGB; Section 203 StGB).

The requirements are deliberately narrow. Present describes a danger where harm is imminent or the danger can turn into harm at any moment – vague fears or general distress are not enough. Cannot be averted in any other way means that milder means, in particular seeking consent or help that the person agrees to, are not available or not sufficient. The weighing-up of interests requires that the protected interest – here life – substantially outweighs the impaired interest, that is, the interest in secrecy. And the disclosure must be an appropriate means – only as much is communicated as is necessary to avert the danger, and only to those who can actually help, such as the emergency medical service or medical staff.

Civil-law involuntary admission under Section 1831 BGB

Custodianship law regulates the conditions under which a legal custodian may arrange for the person under their care to be admitted involuntarily with deprivation of liberty. Under Section 1831(1) no. 1 BGB, such admission is permissible, among other things, for as long as it is necessary because, owing to a mental illness or a mental or psychological disability, there is a danger that the person under custodianship will kill themselves or inflict considerable damage to their health. The law thus ties involuntary admission to a danger to oneself that is caused by the illness or disability, and to necessity – it is permissible only for as long as it is actually needed.

Equally important is the procedural safeguard: under Section 1831(2) BGB, involuntary admission is permissible only with the approval of the custodianship court. Without prior approval it is permissible only if delay would involve danger; the approval must then be obtained without undue delay. The decision thus does not rest with a single person but is subject to judicial oversight. It should be emphasised that civil-law involuntary admission serves to protect the person under custodianship themselves: protecting third parties is not sufficient as a ground (AG Psychiatrie der AOLG, 2023). It also presupposes that legal custodianship (rechtliche Betreuung) exists with a corresponding area of responsibility.

Public-law involuntary admission under state law

Alongside custodianship law there is public-law involuntary admission. It is regulated in the states’ acts on mental illness (Psychisch-Kranken-Gesetze), acts on help for people with mental illness (Psychisch-Kranken-Hilfe-Gesetze) or acts on involuntary admission (Unterbringungsgesetze), and applies when, as a result of a mental disorder, there is a specific danger to oneself or to others. There is no uniform federal act for this; the states regulate procedure and enforcement differently (AG Psychiatrie der AOLG, 2023). Unlike civil-law involuntary admission, public-law involuntary admission does not presuppose legal custodianship, and it can also serve to protect other people. Two states serve as examples below – they are expressly not transferable to other states.

Example: North Rhine-Westphalia: Under Section 11 PsychKG NRW (the state mental health act of North Rhine-Westphalia), involuntary admission is permissible if, as a result of illness-related behaviour, there is a present, considerable danger to oneself or a considerable danger to significant legal interests of others that cannot be averted in any other way. Here too, then, we find the idea of immediacy and of being a last resort after milder means. For urgent cases, Section 14 PsychKG NRW provides that, where delay would be dangerous, the local regulatory authority (Ordnungsbehörde) can order immediate involuntary admission on the basis of a medical report; it must then apply without undue delay for a court decision (PsychKG NRW).

Example: Bavaria: The Bavarian Act on Help for People with Mental Illness (BayPsychKHG) expressly combines help and protection. Under Article 1 BayPsychKHG, the districts (Bezirke) set up and run crisis services consisting of control centres and mobile professionals; the control centres can be reached around the clock on a single, uniform telephone number. The requirements for involuntary admission are regulated in Article 5 BayPsychKHG, and immediate provisional admission in urgent cases is regulated in Articles 11 to 13 BayPsychKHG. Among the bodies responsible are, for example, the district administrative authority, the police and the facility itself (BayPsychKHG). The Bavarian example shows that state law does not only regulate compulsory measures but can also anchor low-threshold support that, in the best case, makes involuntary admission unnecessary.

Minors: a brief note on taking into care

For children and young people in acute crises, a further instrument applies. Under Section 42(1) sentence 1 SGB VIII, the youth welfare office (Jugendamt) is entitled and obliged to take a child or young person into care, among other situations when the child or young person themselves asks to be taken into care or when an urgent danger to their wellbeing requires it. For professionals outside the youth welfare office, this above all means: in the case of an acute danger to minors, the youth welfare office should be involved early, and young people can also turn to the youth welfare office themselves. The procedure and details of taking into care are covered in more depth in a separate course and are not part of this module.

PART 3 – Practice I: passing on information – a structured decision route

From gut feeling to a reasoned decision

In an acute crisis, the professional is under time pressure and emotional strain. It is precisely then that a clear mental sequence helps, preventing you from acting hastily or, out of uncertainty, not acting at all. The following decision route is a teaching aid derived from the structure of Section 203 StGB and Section 34 StGB. It replaces neither the organisation’s procedures nor consultation with the manager, but it makes visible which questions need to be clarified, and in what order.

The first step calls for as objective a description of the situation as possible. This is where the insights from the previous modules come in: how concrete are the suicidal thoughts that have been expressed? Are there preparations or a point in time? Are protective factors and supporting people reachable? The professional does not make a diagnosis; they describe what they perceive and what the person says. In the second step, consent is sought – not as a formality but as a genuine offer of relationship. Many people in crisis agree to help when they are taken seriously and can have a say in what that help looks like.

The third step underlines that professionals do not have to, and should not, decide alone. Consulting the manager or colleagues is not only sensible legally but also provides emotional relief and improves the quality of the decision. In an acute emergency this can happen in parallel, for example when a colleague informs the manager while the professional stays in contact with the person. Only in the fourth step does the question of disclosure without consent arise. Here the elements of Section 34 StGB are run through mentally. If there is an acute threat to life, the emergency medical service is to be called via the emergency number 112 (Land Niedersachsen, 2025). Finally, the fifth step links action with traceable documentation: what was perceived, which alternatives were tried, why and how was the decision made, who was informed?

Documentation as protection for everyone involved

Careful documentation in crisis intervention is not a bureaucratic add-on. It makes your own decision traceable, protects the professional if questions are asked later and ensures continuity of support when other colleagues take over. What should be recorded are the perceived indications of danger, with statements reproduced as literally as possible, the alternatives offered and the person’s response, the question of consent, consultations within the team, the weighing-up, and the type, extent and recipients of any disclosure. Evaluations should be recognisable as such and kept separate from observations. The exact form depends on the organisation’s requirements; the topic is covered in more depth in the last module of this course.

PART 4 – Practice II: involuntary admission – role, limits and cooperation

Two routes to involuntary admission compared

In practice it is helpful to keep the two forms of involuntary admission clearly apart. They differ in the trigger, the decision-making route and the bodies involved. The following overview summarises the differences; at state level, only the two examples of North Rhine-Westphalia and Bavaria are given.

What professionals do – and what they do not do

A common misunderstanding is that social workers can have someone ‘sectioned’. This is not the case. Social work professionals do not order involuntary admission and cannot consent to involuntary admission on someone’s behalf. The only exception is the situation in which a professional has themselves been appointed legal custodian for a person – in that case they act in that capacity and are bound by the approval of the custodianship court (Section 1831 BGB). In all other roles – in counselling, in hospital social services, in homelessness services or integration assistance – the task is to notice dangers, inform the responsible bodies, provide factual information to the extent necessary and accompany the person in a humane way.

This clarity of role is not a weakness but a strength. Precisely because social workers have no powers of compulsion, they can remain a trusted point of contact for the person – even when other bodies take compulsory measures. They can make sure that the person’s perspective is heard, that relatives are involved with the person’s agreement and that the return to everyday life is prepared after an involuntary admission. Where regional crisis services exist, such as the crisis services of the districts anchored in law in Bavaria (BayPsychKHG), it is worth knowing in advance when they can be reached and how they work, because mobile crisis support can in some situations help to avoid involuntary admission.

PART 5 – Critical perspective: areas of tension, limits and open questions

Self-determination and protection

The central area of tension in this module cannot be resolved, only shaped responsibly. On the one hand there is every person’s right to decide for themselves about their life and about the disclosure of personal information. On the other hand there is the protection of life in situations in which a mental crisis or illness can limit the capacity for free decision-making. The law responds by tying interventions to narrow requirements, to proportionality and to judicial oversight. That the federal government and the states regularly address the protection of people in the psychiatric support system before and during interferences with fundamental rights is shown by the report of the Psychiatry Working Group to the Conference of Health Ministers (AG Psychiatrie der AOLG, 2023). Involuntary admission is a considerable interference with liberty – and it must therefore always remain the last resort.

For social work, this results in a dual mandate: it should take dangers seriously and not remain inactive out of misplaced reticence, but at the same time prevent compulsion from being used where relationship, counselling, involvement of the person’s network or low-threshold crisis support would be enough. Human-rights-oriented practice means seeing the person, even in a crisis, as a bearer of rights and bringing their perspective into every step.

Uncertainty, overreaction and failure to act

In practice, two opposite kinds of error can be seen. Some professionals hesitate too long, out of concern about breaching confidentiality, even though there is an acute threat to life. Others, out of uncertainty or a wish to cover themselves, pass on information too quickly, for example to relatives, without there being consent or the requirements of Section 34 StGB being met. Both can harm people: hesitation, in the extreme case, their lives; hasty disclosure, their trust and their willingness to seek help in future. Justifying necessity is therefore neither a free pass nor a taboo, but an instrument for the justified exceptional case.

It helps to become aware of this tension in advance and to discuss it in the team. Those who use case discussions, become familiar with the organisation’s procedures and mentally rehearse typical situations act more confidently in an acute situation. Legal certainty in the sense of a guarantee does not exist in such situations; what does exist is the possibility of acting in a traceable, reasoned way and in line with professional standards.

Federal diversity and ongoing reforms

A further challenge lies in the federal structure. Because each state has its own act on help and involuntary admission in cases of mental illness, requirements, responsibilities and procedures differ (AG Psychiatrie der AOLG, 2023). The examples from North Rhine-Westphalia and Bavaria show typical structures but must not be transferred to other states. Anyone working in another state should become familiar with the act that applies there and with local procedures – ideally together with the manager and using the organisation’s documents.

The legal framework is also in motion. State laws are amended regularly, as the most recent amendments in North Rhine-Westphalia and Bavaria show. At federal level, new rules are being discussed, for example on compulsory medical measures; such drafts, however, become relevant only once they have been adopted and have entered into force. For professionals this means: knowledge of legal bases has a shelf life and should be refreshed at regular intervals – without every professional having to become a lawyer.

Consequences for practice

Several consequences can be drawn from the considerations in this module. At the level of the individual professional, the aim is to know the basics of confidentiality, consent and necessity and to be able to recall a clear mental sequence in a crisis. At the level of the team, it is about reliable agreements on who is informed and when, and about a culture in which uncertainty may be voiced openly. At the level of the organisation, finally, crisis protocols are needed that summarise legal questions, availability and documentation requirements in an understandable way, as well as the option of obtaining legal expertise in difficult cases. In this way the legal framework is experienced not as a threat but as a scaffold that supports professional action in a crisis.

Self-reflection – 5 questions

Voluntary · not evaluated – your answers are not saved and are not evaluated by anyone. Click an answer; the explanation helps you assess your own understanding.