Crisis Guide to Help Someone

For a list of crisis resources, click here.

How to help someone going through a mental health crisis 

(Source: Government of Western Australia, Mental Health Commission)

  • Evaluate the situation. If you feel there is a danger to any person, call 911 and mention that there is a mental health emergency.
  • Remain courteous and non threatening, but be honest and direct. Use a calm, reassuring voice.
  • Have another family member secure any potential weapons, such as kitchen knives, baseball bats, etc.
  • Listen to the person in a non judgmental way.
  • Avoid confrontation at all costs – be prepared to “agree to differ” with the person’s perspective
  • If your relative is seeing, hearing or feeling things that are not real, do not argue, deny or reason with him at this time.  Instead, assure them that you love them, understand that what they are experiencing is real to them, and that you want to help them.
  • Clarify and address what the person sees as the major issues first (not what you, the helper, see as the major concerns).
  • Do not attempt to manhandle the person, except to prevent serious assault or suicide attempts.
  • Encourage / assist person to receive professional mental health help
  • Have the family member’s medical information on hand. Have with you written information about the family member’s diagnosis, medications, and the specific event or behavior that caused you concern. It may be useful to have several copies to give to the police and to mental health professionals.
  • If the person becomes extremely violent and you feel in danger, leave the premises.
  • Finally, if the incident was traumatic for you, or you feel anxious or distressed, discuss these issues with a friend or a professional service.

 

Strategies for Diffusing Family Situations

 (Source: NAMI Santa Cruz)

DO

DON’T
Do leave the room (unless your loved one will hurt themselves) Avoid direct and continuous eye contact or touching.
Do offer food – put it out for them or offer it verbally Don’t shout or criticize – It will only make matters worse.
Do breathe deeply – it really helps Don’t block the doorway.
Do – Use “I” phrases. Try to avoid “You” phrases.
Important Sentence:
“I need to calm down.  I’m going to leave the room and we can talk about this in a few minutes.”		 Don’t threaten or try to resolve anything- This may be interpreted as a power play and increase fear or prompt assaultive behavior.
Do – Keep your voice calm. Don’t squabble with other family members over “best strategies” or allocations of blame.  This is no time to prove a point.
Do – Use short sentences.

How To Be Help Someone Who Is Threatening Suicide

(Source: The National Suicide Prevention Lifeline)

  • Be direct. Talk openly and matter-of-factly about suicide.
  • Be willing to listen. Allow expressions of feelings. Accept the feelings.
  • Be non-judgmental. Don’t debate whether suicide is right or wrong, or whether feelings are good or bad. Don’t lecture on the value of life.
  • Get involved. Become available. Show interest and support.
  • Don’t dare him or her to do it.
  • Don’t act shocked. This will put distance between you.
  • Don’t be sworn to secrecy. Seek support.
  • Offer hope that alternatives are available but do not offer glib reassurance.
  • Take action. Remove means, such as guns or stockpiled pills.
  • Get help from persons or agencies specializing in crisis intervention and suicide prevention.

Emergency Situations

How do I know if it’s an Emergency?

The situation is an emergency when your family member or loved one is:
  • Inflicting or attempting to inflict serious bodily harm on another.
  • Gravely disabled: unable to provide for own food, clothing, shelter to the extent that death, bodily injury or physical debilitation might result without treatment.
  • Attempting suicide or behaving as though he or she intends to follow through with verbal threats.
  • Mutilating or attempting to mutilate himself/herself.
  • Acutely distressed by hearing or seeing things which do not exist.
  • Expressing serious thoughts about hurting themselves or someone else
  • Experiencing uncontrollable anxiety or anger.
  • Having a severe reaction to psychiatric medication.

What should you do in an Emergency?

(source: NAMI San Francisco)

Control Yourself – don’t shout into the phone or at arriving officers or medical professionals. They can’t understand you if you shout.

Be Precise – Be ready to give concrete examples of the dangerous behaviors and to support your contention that the situation is dangerous. For example, say, “My daughter pulled a knife” as opposed to “My daughter wants to kill me.”

State over the phone the following information and be ready to repeat it to arriving police officers and/or medical professionals:

  • Your name.
  • Your address.
  • Family member’s name.
  • Your relationship.
  • That the person is mentally ill and give the diagnosis.
  • State whether medications are being used, whether it was stopped and when was the last time the meds were taken.
  • Describe what your family member is doing now.
  • Say whether you feel threatened.
  • Say whether your family member is hearing voices or fears someone.
  • Say whether a weapon is in the house — to minimize further agitation, remove any guns from the house before the police arrive
  • Say where inside the house is your family member
  • Say whether there is a history of violence

Until professionals arrive, you must STAY CALM and:

  • Be polite, respectful, reassuring, low-key and direct with your family member.
  • Maintain on-going communication directly with the person and do not include others in side conversations.
  • Do not try to trick or deceive your family member.
  • Avoid immediately moving in close or touching the person unless necessary.
  • Remove all objects with which a person may do harm to self or others.

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.
  • State whether there is a history of suicide attempts.
  • State whether your family member is violent or delusional.
  • Have treating psychiatrist’s phone number handy