How to Help Someone in a Mental Health Crisis: Key Signs, What to Do, and Emergency Helplines

There are many reasons why someone may have a mental health crisis. Ongoing or severe depression, for example, may escalate into a crisis situation, leaving family and friends feeling helpless or unsure of how to provide the proper support.

Jonathan Rottenberg explores how to help someone in a mental health crisis and the key signs to look for in recognising one. You'll also find helplines for mental health emergencies and crisis interventions.

If you or a loved one are in immediate danger, call 999 now for emergency help.

Remember, what may not seem like a crisis to you can feel all-consuming to someone else. You may feel ill-equipped to help. You might feel powerless and have no idea what to say. But though dealing with a mental health crisis will never be easy, how you recognise and respond to a crisis could save a life.

Signs of a mental health crisis

A mental health emergency or mental health crisis is when someone may hurt themselves or someone else due to their condition increasing in severity.

Here are a few warning signs to look out for:

Someone in a mental health crisis may say:

• They’re in unbearable pain
• They feel trapped
• They have no reason to live
• They want to kill or hurt themselves, or they make other allusions to suicide ideation, such as, “After I’m gone”
• They feel violent thoughts or want to take violent actions towards another person
• They feel hopeless or make other references to despair, such as "I can't take it anymore”

Behavioural signs of a mental health crisis:

• Increased alcohol and/or drug use
• Looking for ways to hurt themselves, like researching suicide methods or stockpiling sharp objects, medications, etc.
• Panic attacks
• Declining personal hygiene
• Withdrawing from other people and activities, i.e., becoming uncontactable
• Giving away important possessions
• Visiting or calling people to say goodbye
• Sleeping too much or too little
• Extreme mood swings
• Acting aggressively, recklessly, or with shame
• Delusions (having a fixed belief despite having no evidence or the evidence proving them wrong)
• Hallucinations (seeing or hearing things that aren’t there. Smell, touch, and taste-related hallucinations are also possible)

An unexpected sign of suicidal ideation:

• Suddenly seeming very happy, relaxed, or carefree despite no noticeable change in circumstances

Although we want our loved ones to become better, a 180 degree turn in mood (from extreme sadness or depression to extreme happiness) can be a cause for worry, rather than relief. In some cases, people considering suicide may change their outward demeanour to hide their intention to die from loved ones, colleagues, or mental health professionals. In other cases, they may be acting happier because they think that ending their pain will give them relief.

Ways to help someone in a mental health crisis

If someone says they’re considering suicide, this is always considered a mental health emergency, even if you don’t think they would go through with it.

Talking can help you to understand the severity of the situation. Assume you’re the only person who will reach out for help. Don’t wait for others to take action for you.

It’s okay if you feel nervous. Try to speak to your friend, family member, or colleague calmly and with a reassuring tone. Tell them that you’re concerned for their well-being and that you’re there to offer emotional support for depression or whatever they need.

Here are a few tips on how to help someone in a mental health crisis:

1. Find a private space

Provide a non-judgmental space with few distractions and where you're unlikely to be interrupted.

2. Let them talk

Let them talk at their own pace without pushing for more or trying to quiet them.

Try not to judge what you hear, even if you think what they say is untrue or unfair.

Most importantly, don't tell your loved one their feelings are wrong or bad – now is not the time.

3. Ask if they’re thinking about suicide

You may be frightened to ask someone if they've thought about suicide. You may not feel ready to handle the answer, or you could be worried that mentioning suicide will give someone the idea to do it. In the latter's case, research shows this is a common misconception.

Asking someone if they've thought about suicide can actually bring some relief. Your loved one may have been apprehensive about bringing it up, as they may worry about hurting those close to them.

But asking is a way of acknowledging how bad they're feeling and shows you understand the severity of the situation.

“Have you had thoughts of suicide?” or “Are you thinking about suicide?” are simple and direct ways to ask.

4. Don’t try to “problem solve,” minimise, or argue

We go into problem-solving mode when we feel uncomfortable and want to escape whatever’s bugging us. It also gives us a feeling of control over the situation.

You may feel uncomfortable because you hate seeing your loved one in pain. However, unsolicited advice – even from an empathetic place – is still more about soothing you than helping them.

Likewise, minimising someone’s problems by saying, “It’s not so bad,” or “You’ll be okay,” may make the other person feel dismissed or misunderstood. It also signals that you're not listening or want to end the conversation.

If someone is showing symptoms of psychosis, such as hallucinations or delusions, don't dismiss or argue over them. Remember, to someone experiencing psychosis, the hallucinations or delusions are their reality. It would be like if someone insisted that your eyes are green when you know they're brown.

Instead, keep calm, validate the person's experiences, and treat them respectfully.

5. Try not to take their actions or words personally

People going through a mental health crisis may be rude, blunt, or even accusatory.

If a loved one has distanced themselves, refuses to talk to you, or has become uncharacteristically rude during a crisis, it doesn’t mean you’re a bad friend or partner.

If they say, “No one cares about me,” now is not the time to list everything you’ve ever done for them.

What to do if you feel in danger:

If the situation escalates to verbal or physical abuse, give the person some physical space and contact the emergency services as soon as possible.

6. Show them you care

Although your loved one can see you there, frequent verbal confirmations will give them the reassurance they need. Say things like, “I’m here,” “I care,” “I want to help,” and “How can I help?”

7. Use body language to prove they have your undivided attention

Eye contact, leaning forward, and pointing your body towards someone shows you're listening and they are the focus of your attention.

Mental health crisis helplines

Seek emergency help immediately if you think a person is at risk of hurting themselves or another person. You don’t have to handle a crisis alone.

Take whatever your loved one tells you seriously. Stay with the person. Remove any means of potential harm. Call for help and consider escorting them to an emergency room if necessary.

Any of the following crisis hotlines can help:

999 – Emergency

In the event of a mental health crisis, call 999 or go to A&E immediately if:

• They have seriously injured themselves
• They have taken an overdose
• You don't feel like you can keep yourself or someone else safe

A mental health emergency will be taken as seriously as a physical one. You will not be wasting anyone's time.

112 – Emergency

112 works the same way as 999. It was introduced across Europe as a standard number to call across the EU. Calling this number will connect you to the same services as 999.

111 - NHS

If the person having a mental health crisis isn’t in immediate danger, you can still ask for urgent help. Call 111 and select the mental health option. Or you can try 111 online.

Samaritans

Samaritans can offer emotional support to callers struggling to cope.

Support Forum: Samaritans
Telephone: 116 123. Lines are open 24/7, 365 days a year.
Email: jo@samaritans.org. Please note that a reply via email may take several days.

SANE

SANE services provide practical help, emotional support and specialist information to those affected by mental health problems, their family, friends, and carers.

Support Forum: www.sane.org.uk
Saneline: 0300 304 7000 (4pm to 10pm, 365 days a year)
Textcare: https://www.sane.org.uk/how-we-help/emotional-support/textcare
Email support: support@sane.org.uk. Emails are responded to individually, with a response within 72 hours.

Rethink Mental Illness

Rethink Mental Illness supports individuals affected by severe mental illnesses like schizophrenia and bipolar disorder, helping them improve their quality of life through services, assistance, and advocacy for greater awareness and understanding.

Support Forum: www.rethink.org
National Advice Service: 0300 5000 927 (Open 9:30am to 4pm, Monday to Friday)
Email: advice@rethink.org

It can be scary to take the first step if someone you love is going through a mental health crisis. Know that support isn't limited to the one struggling, and you can also find someone to help you through this upsetting time. Also, know that you're doing the right thing - you can save a life by connecting a person to the help they need.

For more information on managing depression or supporting a loved one during a mental health emergency, contact your doctor or healthcare team.

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Date of preparation: October 2024
D: COB-GB-NP-00513 (V1.0) / T: COB-GB-NP-00515 (V1.0) / M: COB-GB-NP-00514 (V1.0)