How to Help During a Loved One’s Mental Health Crisis

It’s scary when someone we care about feels distressed or has thoughts of suicide. In this Insider article, Mindpath Health’s Zishan Khan, MD, offers tips to offer support, provide empathy, and even save a life.

It’s natural to feel worried or even frightened when someone you care about is going through a mental health crisis, but you can do a lot to help them.

A mental health crisis can happen in response to trauma or overwhelming stressors that make it difficult to navigate everyday life. Facing this level of intense distress may, in some cases, lead to thoughts of self-harm or suicide, though not everyone in crisis will have a plan to die.

One important first step toward offering compassionate support involves remembering your loved one didn’t choose to experience this distress. In short, a mental health crisis isn’t their fault.

Another important step in recognizing when to offer support? Knowing the signs of a crisis.

According to Dr. Andrew Davis, a psychiatrist at Kaiser Permanente in Maryland, some signs that may suggest a mental health crisis include:

• Rapid changes in mood and increased agitation
• Self-harm
• Increased substance use
• Isolating or withdrawing from others
• Psychosis, or losing touch with reality, which might include hallucinations or delusions
• Paranoia
• Inability to perform daily tasks and do basic self-care, like eating, showering, and getting enough sleep

Below, find eight tips from mental health experts you can use to support your loved one in coping with distress and finding care.

Help them connect with crisis support

If your loved one has expressed thoughts of hurting themselves or others, or you’re just genuinely worried about their health and well-being, you can start by helping them reach out to a crisis counselor.

According to Tavi Hawn, a licensed clinical social worker and founder of Reclaim & Rise, crisis counselors are trained to:

• Listen with compassion
• Talk through in-the-moment strategies for easing distress, such as calling a friend, taking a walk, or listening to music
• Provide information on local resources
• Help your loved one practice grounding techniques, such as doing some gentle stretching or bringing attention to their breath

Crisis hotlines include:

• The National Suicide and Crisis Lifeline: Call 988
• National Alliance on Mental Illness (NAMI) HelpLine: Call or text 800-950-6264
• Crisis Text Line: Text “HOME” to 741-741
• The Trevor Project hotline for LGBTQIA+ youth: Call 1-866-488-7386, or text “START” to 678-678
• BlackLine crisis call line for BIPOC: Call or text 1 (800) 604-5841
• Trans Lifeline crisis hotline: Call 877-565-8860

Some cities and towns also have local mental health crisis response teams, which can send counselors out to help de-escalate the situation, assess whether or not your loved one is safe at home, and connect them with helpful resources.

You can check with your state’s local mental health department or local police department to find out if there’s a response team in your area.

Offer distractions

Davis recommends helping your loved one find a distracting activity, which can create some mental distance from their source of distress and help them stay grounded in the present.

• A few ideas to try include:
• Putting on a feel-good movie
• Painting, drawing, or working on another creative project
• Going out for a comforting meal, or preparing one together
• Taking a walk together outside

The same distractions don’t work for everyone, which is why Dr. Zishan Khan, a psychiatrist with Mindpath Health, advises asking your loved one what might feel good to them at that moment. If they say they don’t know, it’s OK to offer some suggestions — or ask them whether it might help more to just sit and talk.

Ask what they need

Rather than assuming you know what your loved one is feeling or what they need from you, just ask. For example, you might ask:

• What can I do to make your life easier at the moment?
• Is there anything I can take off your plate to make things feel less overwhelming?
• I’d love to spend some time with you — is there a specific activity that would feel really good to you right now?

“Maybe they need someone to provide accountability for some steps they want to take to help themselves, like checking in after therapy appointments,” says Stephani Jahn, a licensed mental health counselor in private practice.

“Or maybe they’d find it helpful to grocery shop or batch-cook together once a week to make their life easier,” Jahn says.

Note: Just keep in mind that sometimes, intense distress can make it hard to know what might make a difference, so they may not be able to answer right away.

Check in about suicidal thoughts

It may feel scary to bring up the subject of suicide, but always make it a point to ask if your loved one has considered ending their life.

The idea that talking about suicide can increase the risk of a suicide attempt is just a myth. As a matter of fact, experts have found talking about suicide can both reduce thoughts of suicide and improve mental well-being.

The National Alliance on Mental Illness (NAMI) recommends saying something along the lines of, “Sometimes when people are going through what you’re going through, and dealing with such intense emotional pain, they think about suicide. Has that ever crossed your mind?”

Asking this question lets them know that they can safely talk to you about their suicidal thoughts.

Important: If they do have active suicidal thoughts and a plan to die, call 988 right away for more support.

Listen and validate

Just listening to your loved one share their experiences without judgment is an invaluable way to offer support, Khan says.

You might try starting a conversation with, “I’ve noticed [XYZ behavior] lately, and I just want to make sure you’re OK because I know you’ve been going through a lot lately. How have you been feeling?”

Then, give them your undivided attention and hold space for whatever uncomfortable emotions they’re grappling with, advises Anisha Patel-Dunn, a licensed psychiatrist and Chief Medical Officer of LifeStance Health.

While your gut reaction may be to try and fix the problem or cheer them up, Patel-Dunn says this approach can end up inadvertently invalidating their feelings.

You can, however, help normalize their experience by offering validating statements like “It makes sense that you would feel overwhelmed,” or “That sounds really stressful,” Khan says.

Help them search for a therapist

If your loved one already has a therapist, you might encourage them to reach out during a time of crisis. If they don’t have a therapist, Khan advises offering to help them find one.

To get started, you can search for local licensed mental health professionals using online databases like:

• PsychologyToday
• GoodTherapy
• Mental Health Match
• TherapyTribe

Quick tip: You can also contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline by calling 800-662-HELP (4357).

SAMHSA offers 24/7 confidential support and guidance with treatment referrals.

You can also help by contacting potential therapists to find out if they’re taking new patients and accept your loved one’s insurance, or by making appointments for them. Davis also suggests providing a ride to their appointment or offering to help with child care, if that’s an obstacle.

If your loved one can’t access therapy for any reason, you can also help them search for peer-led crisis programs. For example, NAMI runs virtual 8-week recovery programs as well as virtual connection groups — both of which are completely free to participate in.

The recovery program covers a range of discussions and activities, like building a support network and crisis plan, while the virtual connection groups involve sharing experiences in a supportive setting and learning new coping skills.

Stay connected

It’s crucial to stay in touch with a loved one going through a mental health crisis — not only so you can pay attention to any signs they’re considering suicide or self-harm, but also just to remind them you care. Even just a quick phone call or text to say, “Hey, I’ve been thinking about you today, how are you feeling?” can go a long way.

“Many people won’t reach out for help, either because they’re worried about possible judgment, they feel ashamed or embarrassed, or they fear being ignored and rejected. They need reassurance that they are not alone, and expressing concern and empathy shows them they are worthy of love,” Khan says.

You can also build up your loved one’s support system by encouraging other friends and family to check in — especially on days when you know you won’t have the chance.

Know when to get emergency medical assistance

When your loved one experiences suicidal thoughts, your instinct may be to take them to the ER — but police officers and emergency room staff don’t always know how to handle mental health crises.

Hawn says engaging the police during a mental health crisis can be traumatic or even deadly in some cases, especially for Black people and Indigenous people.

In most cases, Davis recommends skipping the ER and instead reaching out to a local mobile crisis intervention unit, your loved one’s therapist, or a crisis hotline.

However, you may need to seek immediate care at the ER if your loved one experiences:

• Hallucinations, delusions, or other symptoms of psychosis.
• A suicide plan, the intent to die, and the means to take their life.
• Potentially life-threatening physical symptoms, such as wounds from self-harm or irregular breathing from using alcohol or other substances.

If you do call 911, Khan recommends notifying the operator right away that you’re calling about a psychiatric emergency and requesting an officer trained in crisis intervention. You can also contact local crisis resources to ask for a mediator who can  be present for the encounter with the police.

Note: Many emergency departments now have EmPATH units, where EmPATH stands for emergency psychiatric assessment, treatment, and healing. These units are specifically designed to offer compassionate care for behavioral health symptoms — and evidence suggests they can effectively treat people with suicidal thoughts.

Takeaway

When someone you care for experiences deep and overwhelming pain, you might feel lost, scared, and unsure of how to help.

Remember, though, they didn’t choose to feel this way, and you can do a number of things to support them as they navigate this difficult time. For example, listening to their concerns with empathy and without judgment may offer some much-needed comfort.

“Acceptance and support from loved ones are incredibly valuable in helping someone recover from these crises,” Jahn says.

While some people may want extra help in finding a therapist and making day-to-day responsibilities easier to manage, others may need some quality time with you or some engaging distractions.

When in doubt about what your loved one needs from you, just ask.

Read the full Insider article with sources.