The signs of a mental health crisis differ from person to person. Still, there are ways you can be ready in an emergency.
A mental health crisis is when someone’s behaviors prevent them from functioning or indicate they might harm themselves or others.
A crisis can feel overwhelming, and it might seem as if the coping skills you usually have no longer work.
Psychiatric crises and emergencies are unique to the person, but they can look similar in how a person experiences and behaves during the crisis.
Many people are unable to take care of themselves, have worsened symptoms of preexisting mental health conditions, and threaten or attempt self-harm.
Though untreated mental health conditions can lead to a crisis, it’s a misconception that this is the only time they occur. Things happen — mental health crises can occur in people without a diagnosed mental health condition and in people following a treatment plan.
Are you currently in crisis?
If you feel like you’re having a mental health emergency, you can:
- Call the 988 Suicide and Crisis Lifeline at 988 for English and Spanish
- Chat with professionals at Lifeline Chat
- Text “HOME” to the Crisis Text Line at 741741
- Check out Befrienders Worldwide or Suicide Stop if you’re not in the United States and need to find your country’s crisis hotline
If you decide to call an emergency number like 911, ask the operator to send someone trained in mental health, like Crisis Intervention Training (CIT) officers.
There’s some disagreement over whether there’s a difference between a “mental health emergency” and a “mental health crisis,” but most people use these terms interchangeably.
The National Alliance on Mental Illness (NAMI) uses the terms “crisis” and “emergency” with the same meaning in its detailed guide to navigating a crisis. Many others (including Psych Central) follow suit.
Others define a mental health emergency as a life threatening situation in which someone is a danger to themselves or others, while a crisis is non-life-threatening, but the person is still severely distressed. Some others say an emergency is someone attempting suicide, while a crisis is someone thinking about or planning suicide.
Whether you call it a “mental health emergency,” “crisis,” or “mental breakdown,” people having these experiences need immediate support.
Any threat or attempt of suicide or self-harm is a mental health crisis and a medical emergency.
The reasons for your mental health crisis — just like your mental health — are unique to you. What a crisis is for one person might not be for another.
Some signs that you might be having a mental health crisis include:
- difficulty in functioning or being unable to function (e.g., it’s hard to get out of bed, go to work, or do daily tasks)
- having challenges or an inability to take care of your hygiene, such as brushing your teeth, changing clothes, and bathing
- intense or sudden changes in mood
- psychosis such as hallucinations or delusions
- feeling increasingly agitated, angry, or violent
- suicidal thoughts or making plans
- harming yourself or self-medicating
- isolating or withdrawing from others
In most cases, these signs and behavioral changes are severe.
If you already live with a mental health condition, these symptoms could sound like the status quo for you. The key is to figure out what your “normal” is so you can understand what being in a crisis means and when you need to reach out for support.
According to the American Psychological Association (APA), the most common sign of crisis is “a clear and abrupt change in behavior.”
So when your behaviors and moods are not typical for you, that might mean you’re approaching or are in crisis.
Like the signs of a mental health crisis, the causes of a crisis are also unique.
Something that leads to a crisis in one person might not in someone else. This is commonly seen in how different people respond and cope in natural disasters or losing loved ones.
Many potential stressors might contribute to a crisis, including:
- traumatic event
- changes in relationships (e.g., a divorce or breakup)
- feeling alone or like you don’t have a support system
- switching or stopping mental health treatments
- losing a job or failing a class
- natural disaster, violence, or terrorism
- substance use
- medical diagnosis
- people who’ve had economic losses
- those with preexisting conditions
- people living in crowded environments
If you believe you’re in crisis — whether or not you’re experiencing thoughts of suicide — you deserve help and support. You’re not a burden. Your mental health matters.
There are many crisis intervention services, but where you live might affect your options.
If you need support right away but aren’t sure about your options, you can call or text a crisis hotline or chat online. You can find a full list of crisis resources here.
You can also:
- go to a walk-in psychiatric urgent care center
- if you have one, call your mental health professional if it’s during their working hours or they have a line for emergencies
- go to an urgent care or emergency room
- call 911 if you believe you or someone else is in immediate danger
If there’s someone you trust to support you, you may also want to call them. They can help you make arrangements or look for services, whether in person or on the phone.
Things to keep in mind
- If you’re worried about being hospitalized, you don’t have to be. While a hospital stay can be helpful for a crisis, some people fear the stigma of being “committed” or fear the financial consequences. People are usually hospitalized if they’re an immediate danger to themselves or others. So if you’re in crisis but not in danger, there are outpatient and telehealth options that can get you support while you remain at home.
- If you call 911, try to be as clear as possible why you’re calling. Unless you know your county has a crisis intervention team, your area may not have professionals trained in handling mental health concerns. If you do need to call 911, you’ll want to tell the operator clearly that it’s a mental health crisis so officers can know to come with deescalation in mind.
What does treatment look like?
Crisis treatments will vary depending on your symptoms, medical history, and even the availability of services. Typically, treatments involve a combination of medication, individual and group therapy, and learning tools and skills to help you support yourself.
Where you get treated also depends on your condition and the severity of the crisis. You might get treated at:
- an outpatient facility you go to during the day
- an inpatient psychiatric unit (that may also be called residential care)
- an emergency room
How long you stay in a hospital or program will depend on if your stay is voluntary, involuntary, or part of an emergency hold (typically 72 hours in the United States).
With any crisis intervention, the aim is to set up an aftercare plan that will help you get back to your daily life and prevent a recurrence or crisis situation in the future.
If you believe someone you know is in crisis, you might feel pretty freaked out, depending on the circumstances. It’s important to remain calm (or at least pretend to be for them) and figure out the type of support they need.
You can first start by asking yourself if they’re a danger to themselves or others. This can help you figure out whom to call.
According to NAMI, the goal in a crisis is to de-escalate. There are several techniques you can try:
- Stay calm. Speaking calmly without raising your voice can help avoid inciting further panic. You’ll also want to avoid arguing with them or overreacting. NAMI even recommends that you move slowly.
- Listen. Listening can help you figure out what they need and understand their current symptoms.
- Ask how you can help. Expressing support and concern can help them feel like they’re not alone, especially if you’re not with them in person. See what you can do for them, but understand that they may not be in a state of mind to know what they need, so you may need to be specific. For example, you might ask, “Do you need me to call someone for you?” or “Do you need a ride to the hospital?”
- Offer them options. Though you may feel as if you need to take control of the situation, someone might get overwhelmed by that. So instead, you’ll want to offer them options and be patient.
- Give them space. You don’t want them to feel trapped or boxed in. You’ll also want to avoid touching them until they give you permission.
If there’s ever a point when you don’t feel safe, it’s important to leave the location immediately. You can still ensure they get the help they need while you remain safe.
The reasons for a mental health crisis can be unique to the person. What a mental health crisis looks like and how it’s treated will also vary from person to person.
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Understanding what mental health emergencies look like and how to seek help can make a difference. You can make a difference.
If you want to be prepared, creating a mental health crisis plan to prevent a situation from escalating and having resources within immediate reach can be valuable. Here’s a how-to guide to create your own crisis plan.