What can I do if my loved one has a mental health crisis?

Please note that NAMI does not operate a crisis hotline. If you or your loved one are in immediate danger, please call or text the 988 Suicide & Crisis Lifeline at 988. NAMI volunteers are not medical or mental health professionals, and we cannot offer medical or mental health advice. The material outlined below is informational and we hope that it provides guidance that results in help.   

• Stay calm. Respond calmly and gently; avoid arguing with or confronting a loved one about their beliefs or behaviors.    
• Be an ally. A loved one’s thoughts and experiences feel distressing to them. Help them manage their anxiety and confusion by offering empathy for their feelings. For example: “I’m glad you could talk to me about this.”  

Recognizing when someone you care about is experiencing a mental health crisis can be difficult. You may not be sure what constitutes a crisis situation versus a “bad day”. You may feel scared — perhaps you feel unsure of what to do next. Remember to trust your instincts. Even in this complicated situation, the certainties are that you care about your friend, and you will do whatever is needed to help them.   

A mental health crisis is when someone is at risk of harming themselves or others, or if their emotions and behavior seem extreme and out of control.   

Warning signs of mental health crisis may include:   

• Expressing suicidal thoughts, either through explicit statements such as “I want to die” or more vague statements such as “I don’t want to be here anymore”  
• Making threats to harm others or themselves  
• Engaging in self-injurious behavior, such as cutting or burning  
• Expressing severe agitation and aggression, including physical aggression, destruction of property, hostility, etc.  
• Having firmly held beliefs that aren’t rooted in realty (delusions) 
• Seeing or hearing things that other people don’t see or hear (hallucinations) 
• Isolating themselves from friends and family  

Once you suspect that someone you care about is in crisis, you will have some decisions to make. How you proceed depends on whether they are in immediate danger and the resources available in your community.   

Practical Tips for Getting Help in a Mental Health Crisis  

Use the following resources to get help if your loved one is experiencing a mental health crisis: 

• Call or text the 24/7 988 Suicide & Crisis Lifeline at 988 or chat here at 988Lifeline.org to speak to a trained mental health crisis worker. If a local mental health crisis team is available in your community, a mobile crisis team may be able to do an onsite evaluation and provide information about local crisis services.  
  • To reach the 988 Suicide & Crisis Lifeline for Veterans, select "1" 
  • To reach Nacional de Prevención del Suicidio (Spanish) select "2" 
  • Lifeline Options for Deaf + Hard of Hearing for TTY Users: use your preferred relay service or dial 711 then 988. You may also text 988, or chat function is available here at 988Lifeline.org. 
• If you can safely transport your loved one, another option is to visit your local emergency department for an emergency psychiatric evaluation. Be specific with emergency room staff about the crisis your loved one is experiencing and what kind of help you think they may need. 
• Local emergency mental health/walk-in psychiatric service resources and services vary by County/local jurisdiction. These services often can be found through the County or local jurisdiction’s Department of Health and Human Services. Search your local County’s website for the term “crisis”, or search for “Emergency Mental Health Services” in your area.  Services may include:   
  • Crisis Stabilization Units (CSUs): These are small, inpatient facilities of less than 16 beds for individuals experiencing a psychiatric crisis whose needs cannot be met safely in residential service settings. They offer structure, support and counseling support. Crisis Stabilization Units can be an alternative to hospitalization or a step-down setting upon leaving a hospital. CSUs try to stabilize the person and get them back into the community quickly. Conduct an internet search for “Emergency Mental Health Services [and the name of your county/State]”. 
  • Walk-in emergency psychiatric services: These are often associated with community/county mental health services. A clinician will assess the risk and help secure appropriate services. This may include medication, detoxification, or even hospitalization. SAMHSA Treatment Locator offers a treatment locator for finding low cost/sliding scale mental health care across the country; search on their website or by calling (800) 662-4357. to treatment facilities in the country, including assertive community treatment, community-based mental health care and residential treatment.   
• Other crisis resources include: 
  • The Crisis Text Line provides a free, confidential texting service that is available 24/7 in the United States. They can be reached by texting HOME to 741741.  
  • LGBTQ Youth & Young Adults:  
    • The Trevor Lifeline provides 24/7 crisis intervention and suicide prevention services for LGBTQ youth & young adults ages 13–24 and can be reached at (866)-488-7386 or text “START” to 678-678.  
    • Boys Town National Hotline also operates a 24-hour American Association of Suicidology accredited crisis line for teens and families at (800) 448-3000 

Immediate Danger

If the above options are not available in your community, or if your loved one or another person is in immediate physical danger, call 911. Be specific that you are calling about a mental health emergency. 911 will produce the fastest response, but it will be a police response.  

Your local police department may have law enforcement officers that are specially trained in crisis intervention ("CIT" officers); if possible, explain that your loved one is experiencing a psychiatric crisis and request that CIT officers respond to your call. Other officers may not have crisis intervention or de-escalation training, so it’s important to specifically describe the behavior you are seeing from your child that illustrates the need for urgent psychiatric support. Example:

• DON’T say – “My daughter is a danger to herself.”  
• DO say – “My daughter has not slept in 3 days, and she is hearing voices telling her to kill herself.”   

Meet emergency responders outside the home. Brief them on the situation before they interact with your child. Make it clear that you are seeking psychiatric hospitalization for your child, NOT arrest.

More Important Information on Supporting Your Loved One in a Mental Health Crisis

The Treatment Advocacy Center's "Get Help" section of its website also has helpful information on how to respond in a crisis.   

Consult the Risk of Suicide page on NAMI’s website that discusses how to help when someone shows signs of suicidal thoughts.  Also, see the American Foundation for Suicide Prevention for helpful guidance on how to help When Someone is at Risk.  

Visit the Friends and Family section of Speaking of Suicide.com for extensive information on resources and how to talk with and help someone who is having suicidal thoughts.  

Hours of operation: Monday-Friday, 10 a.m. – 10 p.m. EST 

Call: 800-950-NAMI (6264) 

Text: 62640  

Email: helpline@nami.org

Website: www.nami.org/help