A mental health crisis is an intensely distressing experience that can affect anyone, regardless of background or previous mental health history. It represents a state of acute emotional or psychological distress that rapidly overwhelms a person’s ability to cope. Recognizing this situation and understanding how to navigate it is the first step toward safety and recovery.
Defining a Mental Health Crisis
A mental health crisis is a behavioral or psychiatric emergency where an individual experiences such overwhelming distress that their ability to function safely or manage daily life is severely impaired. This is a situation that requires immediate intervention to prevent harm to the individual or others. The crisis state is characterized by the failure of customary coping mechanisms, meaning the person’s usual strategies for handling stress no longer work effectively.
The distress is acute, leading to disorganization, confusion, and a reduced capacity for rational thought and decision-making. This inability to function can manifest externally as an inability to perform basic tasks like maintaining personal hygiene or eating, or internally through a profound sense of hopelessness. The goal of initial intervention is short-term stabilization and de-escalation, focusing purely on safety rather than long-term treatment. Stabilizing the situation helps the person to regain a baseline level of functioning.
Recognizing the Warning Signs
Identifying a mental health crisis often involves observing sudden or extreme changes in a person’s typical behavior, emotions, or physical state. Behavioral indicators can include sudden withdrawal from social interactions, an inability to get out of bed for days, or rapid changes in energy levels. A person might engage in high-risk behaviors without regard for consequences, such as reckless driving or increased substance abuse.
Emotional and cognitive warning signs can signal a loss of touch with reality or an imminent risk of harm. These signs include expressing feelings of hopelessness, talking about suicide, or giving away prized possessions. A person may experience severe paranoia, characterized by intense and irrational mistrust or suspicion, or feel that others are plotting to harm them. Such signs indicate a serious escalation and require immediate attention, particularly if they involve delusions or hallucinations.
Immediate Action and Crisis Stabilization
The most urgent priority during a mental health crisis is ensuring the safety of the individual and those around them. If the individual is actively threatening self-harm, engaging in a suicide attempt, or in danger of harming others, calling 911 is necessary. In these life-threatening situations, a rapid response from law enforcement or medical services is required for physical safety.
For a mental health or substance use crisis that is not immediately life-threatening, the 988 Suicide & Crisis Lifeline is the best resource, available 24 hours a day via call, text, or chat. This three-digit number connects callers to trained crisis counselors who can provide immediate support, de-escalation strategies, and connection to local resources. Counselors at 988 are trained to resolve crises over the phone and only dispatch emergency services when there is an imminent and unmanageable threat to life. If a person is experiencing signs of psychosis, such as severe hallucinations, uncontrolled mania, or if self-harm has resulted in a serious injury, visiting an emergency room is warranted.
If you are with the person, maintain a calm demeanor and use active listening to reduce escalation. Speak in a quiet, non-judgmental tone, and respect their personal space, avoiding physical contact unless you have permission. Do not argue or attempt to use logic to reason them out of their distress, as their higher-level cognitive function is temporarily impaired. Remove any immediate means of self-harm, such as firearms, sharp objects, or excessive medications, to secure the environment.
Pathways to Recovery and Ongoing Support
Once the immediate crisis is stabilized, the focus shifts to follow-up care and building a foundation for sustained wellness. This post-crisis phase involves establishing connections with mental health professionals, such as a therapist and a psychiatrist, who can manage long-term recovery. A structured safety plan is an important step to prevent future crises by identifying personal warning signs, such as increased isolation or specific thought patterns.
This safety plan outlines internal coping strategies the person can use on their own, such as mindfulness or physical activity, before contacting others. It includes a list of supportive friends and family members who can distract the person from distress, as well as a list of professional and emergency contacts. Therapeutic modalities like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are highly effective in this recovery period.
Cognitive Behavioral Therapy (CBT)
CBT helps restructure the negative thought patterns that contribute to emotional distress, providing structured problem-solving skills for daily life.
Dialectical Behavior Therapy (DBT)
DBT focuses on teaching concrete skills for emotional regulation, distress tolerance, and improved interpersonal relationships, which often break down during a crisis.