How do I know if someone is having a mental health crisis?
Indicators of someone experiencing a crisis can include threats to harm themselves or others, an inability to care for themselves, and extreme behaviors or emotions. Someone experiencing psychosis may also talk to themselves, either coherently or incoherently.
But these are not necessarily a sign that the person is in immediate danger, said Jessica Isom, a psychiatrist based in Boston. “It is important to get a sense of what the level of distress is for the individual and not to react solely based on your own lack of familiarity with a person’s behavior or statements,” she said.
I am pretty sure this person IS in crisis. Should I call the police?
Calling 911, particularly when you don’t have a full picture of the person’s condition, could potentially exacerbate the situation. This is especially true if the person is Black or brown.
“The police officer might be perceived as threatening and/or symbolic of an arrest rather than help,” Isom said.
Officers can also make the situation worse. “Not all police officers are trained and competent to provide critical intervention services,” she said. Some first responders may also use stigmatizing language, which can further exacerbate the situation.
Consider calling a crisis hotline first. The National Suicide Prevention Lifeline can direct you to a local crisis center. You can also call the state or county mental health services available near you, which often include a mental health crisis helpline.
Isom also recommended asking the person if there’s a family member or friend they trust who you can call for them, which “can be useful to avoid confusing instructions and overwhelming chatter for the individual who likely has a limited ability to process information during the crisis.”
What if the person in distress is someone I know?
If it’s a partner or your child, calling their doctor should be the first step, said Jack Rozel, the medical director at resolve Crisis Services, which is available to residents of Allegheny County, Pennsylvania. If it’s a relative or a friend, ask them if they’re seeing a mental health professional and offer to contact their provider with or for them. You can also call a mental health crisis line and ask the counselor for help.
If someone you know posts an alarming status on social media, you should also check in with them directly. If you are not comfortable doing that, Facebook, Instagram and Twitter also have options to flag the post for mental health concerns as well; the company will reach out to the person with resources and can involve emergency services as needed. (Just keep in mind this may lead to police involvement.)
What if I’m scared this person is going to hurt me or another person?
Mental illness does not equal violence. If a person is not actively threatening you or others, do not assume they’re dangerous because they’re in crisis. People with a mental illness are far more likely to harm themselves, and that’s why proper intervention is important.
If someone is in a dangerous location, such as in the middle of the street on a bridge, “calm encouragement and avoiding sudden movements can result in a trusting environment where continued conversation has the chance to be more helpful,” Isom said.
If it’s abundantly clear that a person in distress is a threat, calling 911 “is important as a measure of reducing the chances of unfortunate consequences,” according to Isom.
“However, do try to elicit information about the person’s mental health background so that you and others can communicate to the police or EMS why the person is in distress and what limitations may be present for following commands,” she added.
How can I help advocate for people living with a mental health condition?
Even simple acts of kindness like “asking if they would like food or water can be a humanistic gesture,” Isom added.
Getting involved with mental health organizations ― particularly local ones that focus on improving access to treatment ― is also a long-term step. Try connecting with a community chapter of a national organization like Mental Health America, the National Alliance on Mental Illness or the American Foundation for Suicide Prevention.
You can also be more open about mental health in your own life. Share your experiences, encourage people to try therapy and correct someone if you hear them use a term or say something that’s offensive to those dealing with a mental illness.
Where can I go for additional resources or information?