If you’re witnessing somebody who’s in crisis, the first thing to do is be calm. You don’t want to match their level of intensity. That tends to not go very well. Remain calm and talk to this person as a human being. They’re scared. They’re upset, and they need somebody, typically in that instance, to just listen to them. If someone feels they themselves are experiencing a crisis, they can try to reach out for help. Typically, we say take a minute, breathe, and reach out to somebody – whether it’s their doctor, a friend or a support person. This pause and check in can help alert people you need help and diffuse the situation. If you’re a friend or somebody close to that individual and they’ve reached out to you, the important thing to do is listen and stay calm. Find out what’s going on with them. Where are they? What are some of their concerns? If they’re talking about harming themselves, if they’re talking about harming other people, that’s when we really need to do something now. Ask – have they reached out to their resources? Individuals can also activate an emergency response by calling 911 and asking for an ambulance or police assistance. Oftentimes, police departments have crisis-intervention trained officers who are used to responding to those situations. A lot of times people want to know how to help, and there might be times when it’s great to help, but there are also times when it is very important to get the professionals who are trained to help involved.
How do we know when a situation has reached the level of a crisis?
The first sign is someone might verbalize that things are not going well, such as, “I’m not handling this right now. I’m out of control. Things are just too much for me.” They might be agitated, yelling, threatening, hallucinating and doing certain things other people might think are odd and/or atypical. It could be much less obvious as well. They might not be sleeping anymore. They might become more isolated, be cutting themselves off from other people. Usually people realize something is different, something is off, but when it gets to the point of crisis, it’s an explosion of emotions. Things for this person have gotten really bad and we know we need to act now. Mental health crises are avoidable in a number of different ways. There are a lot of warning signs. For example, a person might stop taking their medication. They might be sleeping less or not sleeping at all. Their appetite might change and they eat more or less or not at all. Patterns are starting to change, and if a person can recognize that in themselves, that’s great, but especially if their support people – their family, their friends, the people they trust and rely on – if they can notice those things, we can really alter the trajectory of what might become a crisis.
How can I tell if someone has a mental health problem?
Common mental health problems such as depression and anxiety affect one in four people. But it’s still something that lots of people find hard to talk about, which can mean that many people keep their feelings about having a mental health problem a secret, even from close family and friends. You can’t always tell if someone has a mental illness – people might look as though they’re fine and doing well, when actually they’re silently struggling. If someone has bipolar disorder, they may show significant mood swings, or appear more withdrawn if they are dealing with self-harm or negative thoughts, but everything is dependent on the individual and there is no one way to know whether someone is unwell.
How can I speak to and help someone with a mental health problem like depression or anxiety?
Here are some suggestions for how you can help people living with anxiety and depression:
Encourage them to seek help
Perhaps the most important thing you can do is encourage them to seek appropriate treatment. You can reassure them by letting them know that help is out there, and that you will be there to support them.
Don’t be afraid to bring it up
It takes a lot for someone to say, ‘I need help’, but it doesn’t hurt to raise the subject yourself. Try to be open about depression and difficult emotions, so they know that it’s OK to talk about what they’re experiencing. Sometimes, you don’t have to explicitly talk about mental health to find out how they are doing – it can be as simple as texting them to let them know you’re thinking of them, or suggesting that you go out for dinner or a walk.
Don’t blame them
Try not to blame them for feeling anxious or depressed, or tell them to ‘pull themselves together’. They are probably already blaming themselves, and criticism is likely to make them feel even worse.
Be patient
Someone with depression may get more irritable, and be more liable to misunderstand others, or feel misunderstood, than usual. They may need reassurance in some situations.
Look after yourself
Your mental health is important, too, and looking after someone else could put a strain on your wellbeing. If you are able to stay well, you are more likely to be able to provide good support for longer. This could include trying to stay healthy and physically active, confiding in someone – other than the person you are worried for – taking a break from time to time and being realistic about what you can and can’t do yourself. Mind has lots of advice on helping someone else.
What do I do if it is an emergency?
Suicides are not inevitable; they can be prevented with the right support in place. It’s essential that services are able to respond when people reach out; from early treatment to help people manage their mental health problems as soon as possible, to crisis care services that can step in when someone becomes acutely unwell.
