If you are with someone who is having a mental health emergency, do you know what to do? You know that if you are with someone who has a heart attack, you should call 911. If someone is bleeding profusely, you probably know to apply pressure and call for help. And if a child is struggling with croup, you might know to take them into a hot, steamy bathroom. But when the emergency has to do with mental health, there might not be those “life or death” symptoms that would lead you to seek emergency care. Here is a guide to what you can do during a mental health emergency situation, whether it is your own or that of a friend, relative, or stranger.
Identifying a Mental Health Emergency
A mental health emergency, sometimes called a mental health crisis, is when someone is behaving in a way that makes you believe that he or she is not safe or that others in the area are not safe. The specifics can vary. One example of a mental health crisis might be a person actively threatening to harm themselves or someone else. They might be exhibiting suicidal behavior. Another might be when an individual has hallucinations or rapid, irrational speech. Another example of a mental health crisis might entail someone feeling as though they are unable to get out of bed due to severe depression. The danger posed might not be immediate or imminent.
Try to De-Escalate the Situation
The first thing you should do if nobody is in immediate danger is to try to de-escalate the situation. One way to do this is to help the individual get centered. If their thoughts are running wild and they can’t control them, helping them to become centered can give them the control they need to manage the situation. Note that if the person is having hallucinations, is under the effects of drugs, or is having a severe crisis, de-escalating the situation might not be possible.
You can try speaking gently and slowly in a low tone of voice. Don’t make any sudden movements; try to sit still. Don’t touch the person in crisis. Stay with them but unless they behave in a way that is likely to cause harm, don’t attempt to restrain them. Ask them how you can help. You might offer the suggestion of relaxation techniques, but don’t try to force the issue. If they say they are not interested, let it go. Listen to what they are saying, but don’t challenge their thinking if it is irrational or delusional. Sometimes the person will know that their thoughts are irrational but at other times, they won’t.
If you are concerned that a person might be considering harming themselves or someone else, remove any weapons, medications that might be used for an intentional overdose, and other materials that could be used to cause harm.
Call 911 or a Hotline
It can be difficult to know whether to call 911. Be aware that if you do call, the police will come and they will be the ones in charge of the situation. This means that even if it is your minor child, the police will be the ones making the decisions about where they will go. An ambulance will also come, and the individual might be restrained in order to get them to go to the hospital. In some cases, the risk of the trauma of being restrained and forced to go to the hospital might be greater than the benefit of getting them immediate treatment. So consider whether the person is in danger before calling emergency services.
There are other options that can allow the person to get the help that they need. If the individual is not causing danger to him- or herself or anyone else, you could call their counselor or therapist if they have one. Even if it is after hours or on the weekend, they should have an answering service who can page the therapist to call you back. You can discuss the person’s symptoms and the therapist can help you decide what to do.
Another possibility is to call the National Suicide Prevention Lifeline at 1-800-273-8255. This hotline is staffed 24 hours per day to answer questions and give advice about what to do if someone is in a mental health crisis. They can send help if the person is deemed to be in danger or they can help you determine the right course of action to keep the person and others safe.
Stay With the Individual If Possible
If you go to the emergency room or call 911, you might or might not be able to stay with the individual. Let them know that you are there and if you are not allowed to go in the room with them, let them know that you will be waiting in the waiting room until you hear about their condition. In some cases, they might be held for up to 72 hours for observation and emergency treatment. You might not be able to see them during this time and it would not be reasonable for you to spend three days in the waiting room, but you can let the staff know how to reach you if needed.
If the person is going to be able to wait to see their therapist, see if you can stay with them or arrange for them to stay with you if you don’t live together. Offer to drive them to their appointment and to wait for them in the waiting room. In some cases, you might be able to go into the room with them if that is something they are interested in.
Help Them Get the Follow Up Care They Need
A mental health crisis is not usually something that happens one time and then is over and done with. The person will often need to have follow-up care with mental health professionals to help them learn how to cope with their thoughts. This could include cognitive behavioral therapy, other forms of psychotherapy, and/or medication. If finances are an issue, find out what community resources are available for those with mental health conditions.