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.  

Seeing someone you care about experiencing a mental health-related crisis can be distressing. Being prepared for a crisis by learning about resources and support services allows you to act fast and make good decisions.  You may find the information contained in the section of NAMI’s website on  Getting Treatment During a Crisis to be particularly helpful.  You may also find our NAMI Guide,  Navigating a Mental Health Crisis to be extremely informative.  Additionally, the  My Mental Health Crisis Plan App lets individuals clearly state treatment preferences, decide who can make decisions on their behalf, and share a crisis plan with doctors and other members of their care team.

Practical tips for what to do and how to react in a crisis:

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.”

What Is a Crisis?

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.
Experiencing hallucinations or delusions
Isolating themselves from friends and family

How To Take Action

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.

Immediate Danger

If you feel that your loved one’s life is in danger, this is an emergency — you must take immediate action to keep everyone safe.

Please assist your loved one with calling or texting the 988 Suicide & Crisis Lifeline at  988 for help 24/7. Your loved one will be connected to a trained crisis worker who will talk with them about their feelings and work with them to develop a plan for staying safe. The National Suicide Prevention Lifeline can also provide information on local resources, including treatment.

To reach the 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
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
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.

Other options to consider include:

Mobile Crisis Unit (MCU) Also called Mobile Crisis Rapid Response Team, this is a mental health emergency service offered by many (but not all) counties across the nation to provide on-scene evaluation, treatment and crisis intervention in the community. An MCU will work collaboratively with the individual to assess their needs and identify the least restrictive treatment options; MCUs are also authorized to facilitate involuntary hospitalization and treatment when necessary. For information about the availability of mobile crisis services in your area or when it’s appropriate to call, contact 211.
Crisis Intervention Team (CIT). CIT officers are emergency-response police officers who are specially trained to de-escalate a mental health crisis. Should your loved one need emergency assistance during a mental health crisis call the non-emergency phone number for your local police department and ask if they have a Crisis Intervention Team (CIT). Explain that your loved one is experiencing a psychiatric emergency and that you need assistance.
Seek help at the nearest emergency room. 
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. The first available officers will respond and will likely not have de-escalation training. Meet emergency responders outside the home and brief them on the situation before they interact with your loved one.

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.

Urgent Psychiatric Treatment

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.

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