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It can be frightening when you or a loved one is experiencing a mental health crisis. You may not know what to do. Below are some ideas for navigating a crisis that you or someone you support is experiencing.
Download this information in pdf format (opens in a new window).
If you have experienced a mental health crisis in the past, you may want to plan ahead in case a crisis happens again. Planning ahead helps ensure that your preferences are honored during the crisis, and can sometimes help interrupt things before they get to a crisis level.
Resources for Crisis Planning
Need help finding tools and supports to include in your wellness or crisis plan? Reach out to the COMPASS Helpline! We provide information and resources to help people navigate the mental health system and problem solve in difficult circumstances.
A mental health crisis is when someone is experiencing symptoms that make them feel out of control or prevent them from being able to care for themselves. It can look very different for different people. For example thinking about suicide, hearing voices, or having unusual thoughts can be part of a mental health crisis for some people, but other people are able to well manage these experiences.
You get to decide when what you’re experiencing has reached a crisis level for you.
Ask yourself what you need (or don’t need) right now. Is there something you can do to make yourself feel better or distract yourself? Do you need the company of someone else, or would time alone be helpful?
Also ask yourself when the last time you ate or slept was. Sometimes we neglect basic needs when we are not doing well, and that can worsen what we are experiencing.
The focus is on you. Your number one priority right now is taking care of yourself.
You can try doing something that makes you feel good or that distracts you from what you’re experiencing.
Need some ideas?
Know that self care looks different for different people, and your self care needs can change moment to moment. Do what works for you right now.
If you think that you can’t manage this alone, reach out to a friend, family member, peer supporter, or other person you trust for support. Not sure what to say when you reach out? Read 10 Ways To‘”Reach Out” When You’re Struggling With Your Mental Health (opens in a new window) for ideas.
If you don’t have someone to reach out to – or think that talking with someone anonymously would be helpful – you could try a crisis call, text, and chat service. Their operators are trained to provide support, resources, and referrals to people who are experiencing a crisis.
Crisis Call, Text, and Chat Services
National Suicide Prevention Lifeline (opens in a new window)
1-800-273-8255
available 24/7, talk or chat online
Crisis Text Line (opens in a new window)
text HOME to 741741
available 24/7, text only
Samaritans Statewide Helpline (opens in a new window)
1-877-870-4673
available 24/7, talk or text
Call 2 Talk (opens in a new window)
508-532-2255
available 24/7, talk or text
Get a list of additional crisis call, text, and chat services (pdf – opens in a new window)
If you’re already getting care from a mental health provider, like a therapist or psychiatrist, you may want to reach out to them for support. Many mental health practices offer urgent care for their patients, either with the patient’s provider or an on-call provider.
Peer-based crisis alternative programs are a support option for people dealing with a crisis, or to help prevent times of crisis.
If you you need to speak with a mental health provider urgently about what you are experiencing, you can call your local Emergency Services Program (ESP). ESPs – often called crisis teams – are staffed by mental health clinicians. They can talk to people who feel they are in or near crisis, and try to help them find the supports they need to manage the crisis.
ESP services are available 24 hours a day, 7 days a week, 365 days a year. You can find the ESP serving your area, by calling 1-877-382-1609 and entering your zip code. You can also check out this list of ESPs by location (pdf – opens in a new window).
Note that ESPs may not support people who have recently used substances. If you need urgent substance-related care and cannot get support through your local ESP, you can try the following:
If you need to speak with someone urgently about what you are experiencing and other options are not available (or your crisis involves a medical emergency) you can go to your local hospital emergency room.
Like Emergency Service Programs (ESPs), emergency room providers will give you an assessment to help determine next steps. Know that the care options that can be offered in the emergency room are often more limited than what an ESP can offer, and your ability to choose the care that you think will work best may be limited.
If the person you are supporting has experienced a mental health crisis in the past, you can encourage them to plan ahead in case a crisis happens again. Planning ahead helps ensure that their preferences are honored during the crisis, and can sometimes help interrupt things before they get to a crisis level.
Find resources for wellness and crisis planning here: https://namimass.org/in-a-crisis/#1573739874479-c5f577f9-3085.
A mental health crisis is when someone is experiencing symptoms that make them feel out of control or prevent them from being able to care for themselves. It can look very different for different people. For example thinking about suicide, hearing voices, or having unusual thoughts can be part of a mental health crisis for some people, but other people are able to well manage these experiences.
Try to rely on the wisdom of the person you are supporting and how they interpret what they are experiencing.
It’s natural to feel scared or overwhelmed when someone you love is experiencing a mental health crisis. It can be hard to know what to do. Here are some general things to keep in mind:
Having thoughts about suicide is common. When someone is thinking about ending their life, they may be:
Getting Support
Many people with thoughts about suicide don’t have someone they can talk to about the thoughts. This can include people getting ongoing mental health treatment. When people ask for help with thoughts about suicide, involuntary hospitalization is often the response. Being in the hospital is not always helpful to people who are thinking about suicide, and can even be damaging. This response can also make it harder for people to reach out again in the future. Yet for many people, talking about it can help them move past the thoughts.
When someone tells you they are thinking about suicide, they almost always are looking for your support to deal with and get past those thoughts. By being willing to listen to them, you can help them with their healing.
What You Can Say and Do
It can be hard to know what to say or do when someone tells you they are thinking about suicide. Here are some ideas…
Some things you can say when someone tells you they are thinking about suicide:
Some things you can offer when someone tells you they are thinking about suicide:
Some things you should try not to do when someone tells you they are thinking about suicide:
Self harm means hurting yourself in an intentional way. Self harm is common. It can include things like cutting, burning, or hitting oneself, driving in a way that is intentionally reckless, and ingesting harmful substances. People use self harm to for many reasons:
Responding to Self Harm
It can be scary when someone you know uses self harm. People often have a strong negative reaction to someone else’s self harm. They may think that it is something that needs to be stopped right away. But responding to someone who self harms in a shame-based way can be damaging. Self harm can be an effective coping technique, and simply stopping it can make the feelings the person is dealing with more intense.
Instead try responding to the person with compassion. Know that the pain they are experiencing is intense. Here are some ideas for how to respond:
Harm Reduction
Self harm can be an effective coping tool, so someone may not want to simply stop. Harm reduction techniques may be more useful. Harm reduction is finding ways to reduce the risk and make the self harm safer. A harm reduction approach for people who cut themselves could include having bandages and ointment at hand when the self harm happens.
When talking to someone about self harm, you can say something like… I get that this may be helpful to you. Are you being careful when you do it? Deciding to reduce harm, and how to do so, should always be the decision of the person who is using self harm unless they ask for your help.
Sometimes the person you are supporting will want other kinds of support. You can help them figure out what would be helpful. Here are some potential support options:
Supporting someone who is experiencing a crisis can take a lot of energy. It’s important to also think about your own needs. Make sure you’re taking care of your basic needs, like eating and sleeping. You may also want to try doing something that is positive or relaxing. You can find other ideas for self care here: https://namimass.org/in-a-crisis/#1553104810357-c5e3d337-a2db.
You can also try family support, if you think that would be helpful. Know that most family support options also welcome partners, friends, and other supporters. You can find support options here: https://namimass.org/family-support/.