Movie and TV presentations have, at times, touched on the concept of an intervention, a facilitated confrontation in which a person’s family and/or friends seek to compel them to pursue treatment, often for substance use and increasingly for mental health issues or both. Some public figures have even talked about their intervention experiences openly. Notably, comedian John Mulaney made his 2020 intervention a central component of a stand-up special, which first aired on Netflix in 2023. This level of openness has helped further destigmatize the need for interventions.

Unanticipated Challenges

As a mental health attorney who helps families navigate the complex legal landscape related to mental health and substance use, I’ve received many follow-up referrals from interventionists who possess real knowledge, skill, and passion for their work, but the challenges and comprehensive issues they confront may go further than originally sought. This can even lead to unanticipated, adverse events triggered by the confrontational nature of interventions, as well as symptoms and behaviors of those in crisis.

To best ensure that interventions guide individuals to treatment while keeping all parties safe, my team is comprised of a range of professionals, including:

• a mental health attorney to be sure of legal entry into the home and the protection of participant rights;
• a psychiatrist to evaluate and ascertain the level of symptoms, and whether we meet a legal standard for hospitalization, such as “danger” or “harm” the person poses to himself/herself and others;
• a case manager to assess the services needed immediately and later, on an ongoing basis, such as housing and outpatient treatment;
• a security detail to assure the safety of all the individuals and other participants, as well as to communicate effectively with law enforcement and emergency personnel, should it be required to call them.

Being Prepared

This full team meets with clients in advance to verify logistical information, confirm what participants will say and when, and even review such details as how an individual might try to flee using back doors, fire escapes, windows, etc. Preparation is a major component and is key to making these as successful as possible.

Advance preparations with appropriate facilities, such that interventions conclude with the individual immediately entering treatment—for example, a rehab facility or an inpatient psychiatric unit that has an opening reserved specifically for them at that date and time is also an important component.

Sometimes there is a need to bypass an intervention in favor of other measures. To illustrate, when faced with those who represent an imminent risk to themselves and/or others, a mental health warrant/court order to involuntarily direct them to a hospital emergency room for evaluation and, hopefully, admission may be necessary. This process requires a mental health attorney to petition the court and also guide loved ones through any necessary follow-up, such as discharge planning, housing placement, supportive services, or legal proceedings, including Guardianship, Orders of Protection (OOP), and court-ordered assisted outpatient treatment (AOT).

Big picture, it is critical to understand what can go right as well as wrong before or during interventions, evaluating potentially evolving situations, and managing expectations.

In the years I have coordinated, scripted, and choreographed interventions, it is clear there is a range of outcomes even among individuals with similar diagnoses. Being prepared through fact-finding, matching scenarios with mental health professionals, and going in with a primary then alternate plan goes a long way to achieving as successful an outcome as possible under those circumstances.