Mental Health Crisis

A mental health crisis can be very overwhelming. Understanding how to recognize the warning signs of mental health crisis and what to do is very important and, potentially, life-saving.

The National Institute of Mental Health estimates that nearly one in five adults in the U.S. lives with a mental illness, yet studies suggest that only half of the people with a mental illness receive treatment. Individuals with diagnosed mental illness are at increased risk for a mental health crisis, but those at greatest risk are individuals who go undiagnosed or untreated.

A mental health emergency can be overwhelming – both for the person experiencing the crisis and for the people who care for them. These high stakes underscore how important it is to recognize the warning signs of a mental health crisis and know what to do during a mental health emergency.

What is a Mental Health Crisis?

The definition of a mental health crisis encompasses any situation in which a person’s feelings, behaviors or actions can lead them to hurt themselves or others, either through physical harm or lack of care. Examples include depression, eating disorders, trauma, alcohol or substance abuse, self-injury, and suicidal thoughts. Improper management of existing mental health conditions or situations like increased stress due to relationship conflicts, environmental stress from work or school, or exposure to trauma and violence can lead to a mental health crisis.

Warning Signs of a Mental Health Crisis

Although there are a variety of potential mental health crisis symptoms, the warning signs can vary greatly from person to person. Even though there is no one indicator that a person is experiencing a mental health emergency, there are some important signs and behaviors that may be present.

The possible warning signs of a mental health crisis can include:

• An inability to perform daily tasks like brushing teeth, brushing hair, bathing, changing clothes
• Rapid mood swings, including bursts of energy or inability to stay still, sudden depression/withdrawal or conversely, sudden bursts of happiness and calm after a period of depression
• Increased agitation, including verbal threats, violent, out-of-control behavior or destruction of property
• Abusive behavior to one’s self or others, including substance use or self-harm, such as cutting
• Isolation of oneself from school, work, family, friends
• Losing touch with reality (psychosis) or developing an inability to recognize family or friends
• Paranoia, suspicion, and mistrust of people or their actions without evidence or justification

Warning Signs of Suicide

The most serious mental crisis is one that involves thoughts to injure oneself or someone else. If you suspect that a loved one is suffering from a suicide crisis, don’t wait to intervene. Take action. If you are considering thoughts of self-harm or suicide, help is always available.

The contemplation of suicide is a dire situation and knowing the warning signs of suicide could be life-saving. The possible suicide warning signs include:

• Talking as if they’re saying goodbye or going away forever
• Giving away personal possessions
• Taking steps to tie up loose ends, like organizing personal papers or paying off debts
• Making or changing a will
• Preoccupation with death
• Stockpiling pills or obtaining a weapon
• Sudden cheerfulness or calm after a period of withdrawal or isolation
• Dramatic changes in personality, mood and/or behavior
• Increased drug or alcohol use
• Saying things like “Nothing matters anymore,” “You’ll be better off without me,” or “Life isn’t worth living”
• Failed romantic relationship
• Withdrawal from friends, family, and normal activities
• Sense of utter hopelessness and helplessness
• History of suicide attempts or other self-harming behaviors
• History of family/friend suicide or attempts

If you or someone you know is having suicidal thoughts, don’t wait to get help. Call your doctor immediately, go to an emergency or reach out to The National Suicide Prevention Lifeline which offers a suicide crisis hotline at 1-800-273-TALK (8255), a live suicide crisis chat and a Crisis Text Line which you can reach by texting HOME to 741741 from anywhere in America.

Evaluating the Crisis Situation

When you or someone you know is facing a mental health crisis, the first step is to evaluate the crisis situation and ask yourself some questions like what is the nature of the crisis? Is it something that requires immediate treatment?

If there are any thoughts about self-harm or injury to others, it is very important to get immediate help. If you are feeling like you are leading down a spiral of negative feelings and emotions, talk with a mental health professional or people around you about getting help. You do not need to keep these feelings to yourself and there are people who can help. You can go to a hospital emergency room or call 9-1-1 and trained healthcare professionals will conduct a thorough mental health crisis assessment. This crisis evaluation will help determine the best treatment for you.

When facing a mental health crisis, it is important to know that you are not alone. Although it may feel as if you are completely isolated, there are people who want to help you get better and they will be there to help you through your difficult time.

What to Do in Case of Crisis?

The most important thing to know when dealing with a mental health crisis is there is always help available and you do not have to try to handle the situation alone.

Trained professionals are always available to help with a mental health crisis intervention. Depending on the situation, a trained professional can guide you through crisis de-escalation techniques, such as breathing exercises or calming strategies and getting appropriate follow-up treatment. Mental health first aid can be administered for immediate support until a solution or professional intervention is available.

Preparing for a Mental Health Crisis

If you or someone you know lives with a mental health condition, it is important to plan ahead and to know that help is available when struggling with a mental health crisis. The National Alliance on Mental Illness suggests that having a plan for dealing with a possible mental health crisis and sharing it with your friends, family or caregivers can help avoid a crisis.

Here are some things you can keep in mind when determining how to prepare for a mental health crisis:

• Know where to go for help. This could be a hospital emergency room, a psychiatric treatment facility, reaching out to a loved one or reaching out to resources such as the National Suicide Prevention Lifeline which is available 24/7 at 1-800-273-TALK (8255).
• Save the contact information for emergency services in your phone
• Identify family members and friends who can help and be available in a time of crisis
• Have the contact information for your doctor, psychiatrist, therapist or other healthcare providers available
• Compile a complete list of medications and diagnoses
• Share de-escalation techniques that have worked for you with your family, friends, and caregivers

Having a plan that involves others who care about you is the best way to prepare for and possibly prevent a mental health crisis.

Crisis Prevention Plan

It may be helpful to use a formal mental health crisis plan template to develop your crisis prevention plan and action plan in the event of a mental health crisis. There are many examples available online or you can ask your healthcare provider to give you a recommended template to use when developing your individual mental health crisis plan.

You may also want to involve your family, friends and any caregivers in developing a plan. This will help them better understand how to help and be prepared if the situation arises.

Getting Immediate Help

If you or someone you know is experiencing a mental health crisis, it is important to know that help is always available.

Options for immediate mental health crisis help include:

• Crisis Hotlines or 24-Hour crisis lines: these are often the first point of contact for a person in crisis. These confidential, telephone services provide assessment, triage, preliminary counseling and information about follow-up treatment and care. The National Suicide Prevention Lifeline offers a mental health crisis hotline at 1-800-273-TALK (8255) and a Crisis Text Line which you can reach by texting HOME to 741741 from anywhere in America.
• Mobile Crisis Teams: Teams of trained professionals that often work closely with the police, crisis hotlines and hospital emergency personnel are available to intervene wherever and whenever a crisis is occurring. A mobile crisis team, also known as a crisis intervention team or crisis response team, responds to the mental health crisis emergency and provides access to coordinated care for the individual experiencing the crisis.
• Walk-in Crisis Services:  A mental health crisis center will offer immediate attention to resolve the crisis in a less intensive setting than a hospital. This includes clinics or psychiatric urgent care centers that specialize in crisis services.
• Crisis Stabilization Units and Hospitalization: These are options for emergency mental health services when a person would benefit from more intensive treatment and evaluation. Hospitals and Crisis Stabilization Unit (CSUs) have the appropriate resources available to ensure that every aspect of an individual’s psychiatric and medical care is being addressed. Although these options are viewed as more intensive options, they can be very helpful in ensuring comprehensive treatment for the individual.

Additional Resources

If you or someone you know wants more information or additional mental health crisis resources, The Recovery Village regularly publishes new and updated information about mental health including how crisis counseling can help someone experiencing a mental health crisis and when involuntary commitment may be the best option in a dangerous situation.

You can also gather more information on mental health by speaking with a mental health professional or therapist or by talking with your primary care doctor. Additional resources include that provide for more information on handling mental health emergencies.

• The National Alliance on Mental Illness
• American Psychological Association

Do you or does someone you love struggle with substance use disorder and a mental health condition? The Recovery Village can help with comprehensive, compassionate treatment for co-occurring mental health conditions and addiction. To speak with a caring representative, call The Recovery Village today.

Editor – Renee Deveney

As a contributor for Advanced Recovery Systems, Renee Deveney is passionate about helping people struggling with substance use disorder. With a family history of addiction, Renee is committed to opening up a proactive dialogue about substance use and mental health. Read more

Medically Reviewed By – Kathleen Oroho Linskey, PharmD

Kathleen is a licensed pharmacist in New Jersey. She earned her Doctorate of Pharmacy from Rutgers University. Read more