How to Help Someone in Crisis

By Laura Greenstein | Sep. 20, 2017

 

You’re getting ready to meet up with your friend Jill when she sends you a text: “I can’t hangout today. Sorry to bail last minute.”

“Is something wrong?” You respond.

“Just not feeling life today.”

“I’m coming over.”

 You get to Jill’s house, where you find Jill crying and hyperventilating. She tells you, “Life is too hard.”

Jill is having a mental health crisis. So, what do you do?

A mental health crisis can take many forms—self-harm, panic attacks, suicidal ideation, getting in trouble with the law, planning or considering hurting one’s self or others—but no matter what kind of crisis someone might be going through, you can help. Make sure to stay with your loved one while they’re at risk and do not hesitate to get them professional help.

Practice Clear Communication

When de-escalating someone from crisis, communication is key. It is essential they feel heard and understood, so make sure to give them your undivided attention. This is more than just listening, but also using body language, like eye contact, to show you’re listening. You can also use active listening techniques—such as reflecting feelings and summarizing thoughts—to help them feel validated.

“In sessions with suicidal clients, I often try to ‘hold their story,’ because I know that there are very few people in someone’s life who a person can talk to about suicide,” explains therapist Larry Shushansky. “Sometimes, just listening can be immensely helpful.”

Let your loved one talk about how they feel and ask them questions. Don’t be afraid to ask directly if they are thinking about suicide. Talk openly and lovingly about their thoughts. If they need time to respond, allow them to process. You can always repeat the question after a moment of silence, if necessary.

It’s essential to use an empathetic, non-judgmental tone. Don’t debate whether suicide is right or wrong or whether their feelings are good or bad. Minimizing their problems or giving advice may create distance between you and upset them further. Let them know that whatever they’re experiencing is not their fault and offer your help.

“What's going on? What’s wrong?”

Jill doesn’t answer.

You wait a moment and then ask, “Why are you crying?”

“I try so hard every single day. I try, despite my life being terrible. I’m tired of having to work so hard just to live. Things never get better for me; so, I just don’t see the point.”

“Yeah, that really sucks. I’m sorry. I’ve noticed how hard you’ve been working and I really do believe that your effort will pay off with time. You can’t give up now. How can I help you?”

“You can’t help me. No one can help me.”     

“You’re not going to push me away, Jill. I may not fully understand what you’re going through, but the way you feel isn’t your fault. I’m here for you. I’m not going anywhere.”

There isn’t one specific response that will de-escalate all crises—based on what’s happening, you can assess the situation and provide a supportive reaction. “Try not to figure out what the ‘right’ thing to say is—just be caring and concerned and let that show through in your conversation,” says Shushansky. The most important thing you can communicate in a crisis is that you are concerned for your loved one’s well-being, and that they can lean on you for support.

Reach Out For Help

If you feel that you are not able to de-escalate the person in crisis without additional support, call someone. You don’t need to do this alone. If your loved one has a mental health provider, that would be a good place to start. If they don’t, there are organizations who can help you through any crisis safely. Here are a few resources you can contact 24/7:

  • Call 911 if the crisis is a life-threatening emergency. Make sure to notify the operator that it is a psychiatric emergency and ask for an officer trained in crisis intervention or trained to assist people experiencing a psychiatric emergency.
  • National Suicide Prevention Lifeline – Call 800-273-TALK (8255) to speak with a trained crisis counselor.
  • Crisis Text Line – Text NAMI to 741-741 to connect with a trained crisis counselor to receive crisis support via text message.
  • National Domestic Violence Hotline – Call 800-799-SAFE (7233) to speak with trained experts who provide confidential support to anyone experiencing domestic violence or seeking resources and information.
  • National Sexual Assault Hotline – Call 800-656-HOPE (4673) to connect with a trained staff member from a sexual assault service provider in your area that offers access to a range of free services. Crisis chat support is also available at Online Hotline.

Jill’s phone buzzes. She looks down at her phone and her expression shifts. She starts crying again.

“What is it?”

“It doesn’t matter. There’s nothing you can do. Just leave me alone!”

You’re not sure what else to say, so you decide to call the National Suicide Prevention Lifeline. Jill sees what you’re doing and gets upset.

“I don’t need to talk to those people.”

“Jill, please. It’s just a conversation. I want you to feel better.”

She doesn’t respond.

You hit dial and get a crisis counselor on the phone. You put the phone on speaker. The counselor asks a few questions and you respond as Jill remains silent. After a little while, Jill reluctantly starts responding. As she receives counseling, you sit next to her as a source of support and comfort. When she gets off the phone, you give her a hug and tell her: “You are not alone. I’m here.”

It can be intimidating talking to someone who is going through a mental health crisis or seriously considering suicide. However, sometimes all a person needs in that situation is one person being there, helping them access the help they need. You can be that person.

 

Laura Greenstein is communications coordinator at NAMI.

Comments
Ollie
It really hard when you are giving your best efforts to help your adult children, but they are being pulled into so many directions. I am in the pits of dealing with a schizophrenic son and I have issues of my own. I become physically sick when I feel caught like a deer in headlights; no help no real understanding of his illness from other and there is children involved. I just feel like give up on him and let life happen. Every time he gets to this point he places the blame on other.
11/10/2017 4:16:04 AM

Shirley Moore
Start a Homicidal Crisis Intervention
Suicide often follows homicidal ideations are acts. People are 5150ed for being a danger to themselves or others but the others seems to be secondary or just considered criminal. It is just the flip side of the coin. .
10/20/2017 4:38:56 PM

Alisha
I was reading a blog post about belief that we are to blame for our suicidal feelings. The writer says that she doesn't believe we are to blame. She said it is the "force of nature" that is to blame. Like cancer cells are to blame for cancer, not the person. The following was a comment I/we left. It might help explain where we are and how it feels to me/us right now.

My force of nature came through 15+ years of sadistic abuse by my biological parents. My mother told me I didn’t deserve to live repeatedly for YEARS. She was my first abuser, physically, emotionally and sexually. I believe that I’ve always been bad.

Ptsd, depression and suicide thoughts, urges and attempts have been part of my life since I was very young. I learned from my mother that to protect HER, I had to be crazy.

My father had his own way of abusing my body and soul. There was no safe haven for me, until I found a way to escape, into my mind, in the form of dissociation. I became we as everything that was done to me shattered me into so many pieces, it feels as if we will never become whole again.

Since September 11, 2017, everything that is me/we/us, has shut down. We have become withdrawn, removing myself from social media and friends.

We have become caught in Suicide’s grip again and there is little to no hope that we will survive it this time.

We have a therapist, a really good, compassionate therapist. She doesn’t freak when I talk about dying by suicide. She gives empathy.

However since September 11th, I have even been trying to withdraw from her, going so far as to cry out to her that we no longer WANT to connect to her, my kids, my friends or ANYONE!! We have no peace. We have no faith. We have no hope.

In another article I read, it talks about giving suicide thoughts and intent 3 days. I’m giving it 3 weeks.

I don’t feel like we are going to make it out of this alive.
10/12/2017 9:21:48 PM

Christine Cadreau
Regarding Pat the 60 yr old male's comments. I agree with him 100%
I guess it's because we are the co-dependents trying to help. The actual person in crisis has to make the "I wanna get better" move. We've been there with our adult daughter and our diagnosis of her being bi-polar. We cannot make them better. The system is so broken too. It's such a typical scenario he portrays.
10/3/2017 5:37:24 AM

Shelli
...necessary and wonderful article. I have just completed my re-certifications for Mental Health First Aid, for adults, and also one for youth. Thank you for providing another reference point.
9/29/2017 4:29:01 PM

ana keller
I just went through a similar crisis last night with my son. After talking with him and praying, he calmed down.I gave him the NAMI crisis number and ask that he call when he needs help. I wish that I had called while I was with him in his time of need. It was overwhelming for me. I have 2 sons in their 30's that suffer from mental the bipolar illness and live with us at home.
9/29/2017 10:18:35 AM

Alex
Your dialogue is very helpful. I tried to commit suicide 3 times already. No one spoke to me that way. My "friends " have abandoned me and my daughter has as well. My parents tell me that I have to be strong as if I could.
9/29/2017 10:11:34 AM

Pat
I'm a 60 year old male, married for 20 years to a 58 yo bi-polar female, and by my own diagnosis, because she doesn't accept it, BPD. I used to call hotlines in the early days, but it never helped at all. A couple of really bad times, 911. All that happened was they "hauled" her away, in handcuffs. She'd calm down, they'd find out how long her insurance would pay, and magically that's how long she needed to stay at the "hospital". Professionals are no better. A GP will refer you to the most popular (gives the most papers/talks), and they will start at the top of the medication list... "take this, if you're not better in x weeks, we'll increase the dose or change. Wash, rinse, repeat. They have the best excuse of all doctors... "I tried everything, they're [crazy]". I've lost all confidence in the mental health care system, even if it keeps being covered in any way by insurance. All any of them want is your money. Take this pill and call me in a couple weeks. The scene in "Something About Mary" when the mental health professional is actually out of the room eating while the guy talks about his problems, then sneaks back in just before the session is over, says it all to me. Sorry for the negativity. I've lived it for 20 years, and am becoming depressed myself. Mostly because of my actual experiences of not ever being able to get real help, for my wife, or me as a caregiver, or now as a victim of the condition myself. It all sounds so easy in the beginning, "call the prevention hotline", or 911. No help, or squad car ride has been my experience over 20-30 years.
9/28/2017 10:53:20 AM

Rita Haque
Thank you for this article. We received some mental health nFirst Aid training that touched on this. However the dialogue really helps.
9/28/2017 8:09:25 AM

Mitchell FEE
Could someone from administration related to these types of articles please contact me, as I have ideas to share.
9/28/2017 7:44:40 AM

Lydia
The examples are extremely helpful. Especially for someone who has been on both sides of the conversation.
It is also innovative that NAMI has a text service! This is helpful for those with anxiety disorders who still want to reach out!
9/28/2017 1:37:35 AM

Amanda
Thank you for this truly helpful article! We are sharing it in our October newsletter. Thank you for all you do!
9/27/2017 11:18:07 PM

Bertha Alicia Silva
Gracias,
9/22/2017 11:30:09 PM

Bertha Alicia Silva
Gracias me siento ayudada por lo que he leido, ahora entiendo que lo mas importante es estar al lado de mi amado hijo.
9/22/2017 11:12:50 PM

Noreen Raza
Thanks...this is a really good article with great examples.
9/20/2017 5:12:31 PM

Jack Shifflett
Thank you, Laura, for this helpful post. We at NAMI Missoula work with local "QPR" instructors ("Question, Persuade, Refer") to bring suicide prevention techniques into the community; your post is a great and concise guide about how to deal with someone in crisis.
9/20/2017 2:23:20 PM

Subscribe
 Security code