Crisis Guide

IF YOU ARE IN CRISIS OR NEED IMMEDIATE HELP, DIAL 911

Ask for Crisis Intervention Team  or an officer trained in handling mental health cases. Click here for our helpful 911 Handout.

For a list of crisis resources, click here.


 

How do I know if I need help?

(Information adapted from Mindyourmind at mindyourmind.ca)

If you are:

  • Feeling desperate and hopeless
  • Worried you might hurt yourself or someone else or attempt suicide
  • Alone with no one to talk to

If you have:

  • Made a plan
  • The means to hurt yourself or someone else (e.g. pills or a weapon)
  • Attempted suicide or hurt yourself before
  • Harmed yourself

Calling 911

Remember that you are doing the right thing by reaching out for help. You deserve to feel better and get the help you need.

When you call 911, tell them exactly where you are calling from so they can come and talk to you. Inform them of what has happened so far and what plans you have thought about. Even if you have already harmed yourself, it is best to call.  It’s never too late to ask for help. If you already have a mental health diagnosis, inform the dispatcher about it so that they know how to best help you. Click here to access our helpful 911 Handout to guide you.

Should I call a crisis line?

Talking to someone at a crisis line will:

  • help to calm you down
  • help you assess your situation
  • give you some perspective
  • help you figure out your options and next steps

You can call a crisis line any time, for any reason.

  • Crisis centers are staffed by professionals who have been trained to help people who are in a mental health crisis like you may be
  • Crisis centers can help to identify if you are in an emergency situation and help you get the immediate attention you may need. Some crisis teams may even come to your home if it’s the right for your situation.
  • Crisis centers will help you find resources in your community (including doctors, counselors or therapists) for further help. They may even help you set up initial appointments.

Why call a crisis line? Some reasons people have called in the past include:

  • Feeling depressed for a week or longer or if your depression is becoming worse (including more or less sleep than usual, , over- or under-eating, poor concentration, no energy, no motivation, not doing well at school or work, isolating self, feeling no one understands or cares)
  • Experiencing things that may be unreal or bizarre (seeing, hearing or smelling things, and questioning whether others have the same experience).
  • Experiencing anxiety attacks and looking for ways to cope.
  • Having frightening thoughts of suicide or violence, without any plans to carry it out.
  • Needing information about other services in the community.

Should I call a Crisis Hotline?  Click here for videos of people sharing their reasons for calling a Crisis Hotline.

For a list of crisis resources, click here.


 

Should I go to the Emergency Room?

The decision to go to ER can be overwhelming and frustrating. It’s not an easy step, but it can be your first step to regaining control of your life.
Some reasons people have gone to the hospital include:

  • They have injured themselves
  • They are having serious thoughts of hurting themselves or others, or committing suicide (including a plan on how to carry it out)
  • They are seeing, hearing, smelling or feeling things that are bizarre and frightening (and they feel unable to cope with these experiences).
  • Hearing voices that tell them to do something dangerous.
  • Using heavy drugs or alcohol, or when coming down from drugs or alcohol (which can be a life-threatening situation).
  • Experiencing distressing side effects from prescribed medication.
  • If you are experiencing any of the above, get yourself to the hospital.

How can I wait for help safely?

You’ve called for help and now you’re waiting for it to come. Use these tips to keep yourself grounded while you wait.
If possible, find someone to wait with. If you can’t:

  • Find comfort in a pet or stuffed animal.
  • Call a friend or crisis line to talk to you until help arrives.

If you’re at home:

  • Get out your health card or ID, if you have it, and a purse or backpack.
  • Crawl into bed or on the couch and pull the blankets up.
  • Pack yourself a bag of essentials you might need at the hospital (e.g. a jacket because sometimes the ER can be cold, a book, your medications, etc).
  • Avoid places where there are things you could hurt yourself with (e.g. the kitchen, bathroom, garage, etc).

Watch some Videos about stories of people who went through a hardship like yours and their navigation to recovery (Provided by the National Suicide Prevention Lifeline)

If you are not at home:

  • Find a safe space to wait (make sure to tell the 911 dispatcher where you plan on going)
  • Find a chair to sit in or a safe place to walk.
  • Stay there and stay safe until help arrives.

Keep breathing

When we’re stressed out, we can hold our breath without realizing it. This then causes us to feel panicked, adding to the stress. So it’s important to breathe deeply to help you calm down. Concentrating on breathing in and out slowly can allow you to relax.

  • A useful app is the BellyBio app, which is a Free app that teaches a deep breathing technique using biofeedback to monitor your breathing.

When professionals arrive

  • Have all the lights on inside the house.
  • Identify yourself.
  • Carry nothing in your hands especially coming outside to meet them, in which case walk, don’t run to meet them.
  • Don’t ramble.
  • Be prepared to repeat the information you gave over the phone.

What can I expect when I go to the Emergency Room?

People at the ER will help you. They will provide support, problem-solving and help in managing a crisis. Above all, they will work to keep you safe. All ER services are confidential and based on your needs. ER support is generally limited to one visit, but they will give you referrals to other community resources. Whenever possible, the ER staff will try to avoid hospitalization.

Waiting to Talk

The ER can be an overwhelming place. You may wait a long time, which can be distressing and frustrating. You’ll talk to nurses, the ER physician and possibly, but not always, the psychiatry team. A crisis nurse may be there to talk to, especially in the evenings. You may also see security guards in the ER, working to ensure the safety of patients and staff.

Assessing your situation

Questions in ER will focus on the crisis happening now. Nurses will ask about your mood, sleep patterns, appetite, psychiatric history, medications, substance use, family history of mental illness, stressors/supports, past history/childhood factors and legal involvement. They will also need to know whether you’ve had thoughts or suicide attempts, or instances of hurting yourself or others.

Creating a plan of care

After meeting with the doctor, a plan of care will be set up for you. It lists the formal and informal strategies (worked out by you and the staff) to keep you safe and support your recovery. The plan might include an appointment for further assessment in a community setting. Hospitalization is usually avoided, unless necessary for safety reasons or for the treatment of severe symptoms.

Medications

You may be given medication in the ER to calm anxiety or panic, to help with sleep, or to clear confused thoughts. These medications usually act fast and address the immediate symptoms. You may take the medication while in the ER, or you may receive a prescription to fill at the pharmacy as soon as possible.

ER doctors don’t usually prescribe long-term treatment medications (i.e. for mood disorders) because they cannot monitor how the medication will work over time. If you need this kind of monitoring, the ER doctor/social worker will refer you to psychiatrist as soon as possible.