Are We Aware of Religious & spiritual Experiences in mental health crisis care?
The A.W.A.R.E. coalition puts a framework in the first responder's pocket: to recognize when a crisis is religious or spiritual, to ask beginning questions instead of reaching for restraints, and to route a human being toward care instead of trauma.
Our goal is to provide the Mobile App that guides a beginning response with respect for religious or spiritual experiences in mental health crisis calls that can lead to better choices, treatment & outcomes.
Our orientation & training programs, along with the A.W.A.R.E. APP, position first responders with
A.W.A.R.E. App is a live prototype, installable mobile app, no app store required. Built from a pocket card refined over years of orientations with first responders across the United States.
Pocket cards previously introduced in CIT training in Monmouth County NJ can be purchased in bulk.
Recognize the signs
An at-a-glance reference for the behaviors a responder might see: ecstatic or withdrawn states, voices or visions, religious or mythological themes, an altered sense of reality.
Know what to do
A three-step field protocol: de-escalate, listen without judgment, ask. Lower the voice, slow the pace, reduce sirens and lights. Never dismiss the religious or spiritual content.
Ask the right questions
Vetted, non-diagnostic questions that open a door instead of forcing one.
Document for handoff
One reference to the Z65.8 code. Noted in the record, it follows the person to the ER or intake screening center. The receiving staff flag for clinical attention.
Ask the AI guide, hands-free
An embedded assistant, grounded in the AWARE protocol, that a responder can talk to on the way to a call. Calm, specific, mission-aligned, and it never replaces their training or their safety.
Access to the A.W.A.R.E. app is by scheduled introduction. Contact us to learn how to purchase and apply the app in your organization.
Three questions. No diagnosis required.
We are not asking first responders to diagnose. We are asking them to observe behavior, ask three questions, and flag the record. Clinicians can barely make these distinctions. Responders don't have to. They just have to open the door.
The responder might also ask: “Do you have a Psychiatric Advance Directive (PAD)?”
A PAD is a legal document in which a person states their mental-health treatment preferences in advance — who to contact, what care they want or refuse — for a time when they may be unable to speak for themselves.
Spiritual content is read as a symptom.
The behavior gets labeled hyper-religiosity, fanaticism, or "out of touch with reality." The encounter escalates because no one knows it doesn't have to.
- Religious language is logged as delusion
- Involuntary hold; restraints; the ER
- $10,000–$30,000 or more per stay, and lasting trauma
- A natural, often positive experience is pathologized
The responder recognizes what they're seeing.
They de-escalate, listen without judgment, and ask three vetted questions. The spiritual dimension becomes a clinical data point, not a trigger for force.
- Calm, lower the stimulus, create space
- Ask the three questions, no diagnosing
- Offer clergy or a peer-support specialist
- Note Z65.8 in the record for a proper handoff
Three levels of training.
Currently available as a supplement to Crisis Intervention Team (CIT) training,* where the basics of mental health issues, crisis intervention strategies and de-escalation are established first.
1 A.W.A.R.E. APP Orientation
For first responders (30 minutes, virtual), facilitated by a first responder and a person with lived experience in mental health crises of a religious or spiritual nature.
These pocket cards are intended to raise AWAREness & encourage inquiry. They are available for bulk purchases.
2
Spiritual Emergency Assessment & Care:
Clinical Training
For social workers, clinical chaplains, screeners, emergency room staff, and any behavioral healthcare professional assessing and treating mental health crisis situations that include religious or spiritual components.
3
Spiritual Emergency Assessment & Care:
Clinical Training for Medical Staff
For medical staff in psychiatric hospital facilities.
We subscribe to the H.E.L.P. framework
Built for the people who arrive first.
Conceived for patrol officers. The people who encounter spiritual crisis first are a wider circle — and many are already oriented toward compassionate response.
Law Enforcement & CIT
Officers and crisis-intervention teams who need a fast, in-field reference for a situation training never covered.
988 & Crisis Lines
Dispatchers, screeners, and mobile crisis teams, a smaller behavior change for staff already trained to listen.
ER & Stabilization
Intake and emergency staff who receive the handoff: the Z65.8 flag tells them where to start.
Chaplains & Clergy
Multi-faith chaplains and clergy, already on payroll, already trained to be present, ready to be called in.
Spiritual emergencies are real.
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.
Spiritual Emergencies are well-documented across every tradition: Christian ecstasy, Jewish mystical experience, meditation-induced states in Hindu and Buddhist practice. They are among the experiences most likely to be misread as psychiatric emergency by a first responder who has no framework for understanding them.
Do you know the DSM now includes “Moral, Religious, or Spiritual Problem”?
In December 2024 the APA Board & DSM Steering Committee added the term moral to the existing Religious or Spiritual Problem code (V62.89). Effective October 1, 2025, the DSM-5-TR revised text reads Z65.8 — Moral, Religious, or Spiritual Problem: used when the focus of clinical attention is a moral, religious, or spiritual problem.
Do you know 45% of American adults report a spiritual or mystical experience?
Some people with spiritual or mystical experiences end up misdiagnosed and hospitalized.
Pew Research Center ↗Do you know first responders already notice this in the field?
Many first responders do observe behaviors of a religious or spiritual nature on crisis calls.
Ernest Stevens speaking ↗Do you know psychedelics can trigger a spiritual experience?
... can induce profound religious or mystical states.
Position Statement on the Use of Psychedelic and Empathogenic Agents for Mental Health Conditions ↗Do you know about MCORT in New Jersey?
…988 Mobile Crisis Outreach Response Teams (MCORTs) respond to non-life-threatening mental health, substance use, and suicidal crises. MCORTs are currently only available in New Jersey (two-person field teams that respond without involving law enforcement when safe).
NJ Dept. of Human Services ↗Do you know family and friends can respond too?
Anyone who arrives first — including family and friends — can offer an honoring response to a religious or spiritual experience.
Start with our H.E.L.P. framework and see our Video resources from A.W.A.R.E. NJ, USA & Global
Do you know CIT is an international police model for mental health crisis response?
*CITNJ ↗
The Crisis Intervention Team (CIT-NJ) program is an innovative international police model that incorporates collaboration between the community’s law enforcement system and mental health system to respond to the needs of those in psychiatric crisis. This partnership develops and sustains a 40-hour CIT certification program for its police departments and mental health providers in order to provide them with knowledge about mental illnesses, crisis resolution skills, and access to community-based services.
*CIT International ↗
CIT International, Inc. envisions a community where every person in a behavioral health crisis receives a compassionate response that promotes their well-being.
Hear from a veteran police officer.
“I’ve never seen anything like that (App) before; this would have been nice to have on duty.”
“Spiritual Emergency is not a topic that’s covered in crisis intervention training, but these situations do exist.”
“I wish I would have known to ask that during my career. I asked the typical de-escalation questions, but not the spiritual-specific.”
“Looking back, there were so many times I just didn’t know what to say. Had I had that app with those questions, it probably would’ve been a game changer.”
Video resources from A.W.A.R.E. NJ, USA & Global
- Colleen DeJoseph, Ph.D. speaks on Spiritual Emergency ↗
- Chaplains & Clergy Make THE Difference in Mental Health Crisis Care ↗
- Spiritual Encounters are Real — Lived Experiencers Speak (V3, 2025) ↗
- Moral Injury in the DSM — by Josh Roberts ↗
- Ernest Stevens on religious & spiritual experiences in crisis calls ↗
Self-study on Spiritual Emergency
- Episode 2.2: Spiritual Emergency — Dr. Stan Grof ↗
- Self-study with CEUs: Spiritual Competency Academy ↗
- Coming soon: Resource Directory for individual coaching & counseling on Spiritual Emergencies
Psychiatric patients have rights.
Psychiatric patients have the right to humane treatment, informed consent, privacy, legal representation, and protection from abuse or discrimination.
Contact us to learn more about how to purchase & apply the app in your organization.
“New Jersey is uniquely positioned to lead this moment. With its history, its cultural infrastructure, its proximity to global media, and its lineage of moral leadership, the state has the opportunity to become a national model for mental health innovation.”
President, U Have My Word LLC · Co-founder, A.W.A.R.E. project
