Crisis Intervention: Getting Help in Mental Health Emergencies

A crisis can arrive suddenly—a call in the middle of the night, a text that raises alarm, a moment when someone you love seems to be unraveling before your eyes. Or maybe the crisis is your own: thoughts that terrify you, pain that feels unbearable, a sense that you simply cannot go on.

In mental health emergencies, knowing what to do—and doing it quickly—can make the difference between life and death. Crisis intervention exists to provide immediate support during these critical moments, to ensure safety, and to connect people with the help they need.

Understanding Mental Health Crises

What Is a Mental Health Crisis?

A mental health crisis is a situation in which someone’s behavior puts them at risk of harming themselves or others, or prevents them from being able to function or care for themselves.

Key Characteristics:
– Immediate risk to safety
– Inability to cope with current situation
– Potential for self-harm or suicide
– Potential for harming others
– Severe impairment in functioning
– Requires immediate intervention

Types of Crises

Suicidal Crisis:
– Active suicidal thoughts
– Suicide plan or intent
– Suicide attempt in progress or recent
– Gathering means for suicide

Psychiatric Emergency:
– Acute psychosis
– Severe mania with dangerous behavior
– Severe depression with inability to function
– Dissociative crisis
– Panic attack that won’t subside

Self-Harm Crisis:
– Active self-injury
– Urges to self-harm that feel uncontrollable
– Escalating self-harm behavior

Violence Crisis:
– Threatening violence toward others
– Homicidal thoughts or plans
– Violent behavior

Acute Intoxication/Withdrawal:
– Drug overdose
– Severe alcohol or drug withdrawal
– Dangerous intoxication

Warning Signs of Crisis

Behavioral Signs:
– Talking about wanting to die or end their life
– Looking for ways to kill oneself
– Talking about feeling trapped or in unbearable pain
– Talking about being a burden to others
– Increasing use of alcohol or drugs
– Acting anxious, agitated, or reckless
– Withdrawing from activities
– Giving away possessions
– Saying goodbye to people
– Putting affairs in order

Emotional Signs:
– Hopelessness
– Rage or seeking revenge
– Feeling trapped
– Unbearable psychological pain
– No sense of purpose
– Dramatic mood changes

Situational Factors:
– Recent major loss (relationship, job, death)
– Traumatic event
– Humiliating experience
– Anniversary of a loss
– Discharge from psychiatric facility
– Recent suicide of family member or friend

When to Seek Emergency Help

Call 911 or Go to Emergency Room If:

• Someone has attempted suicide
• Someone is actively harming themselves
• Someone has a plan to kill themselves and access to means
• Someone is threatening to hurt others
• Someone is experiencing severe psychosis
• Someone has overdosed
• Someone cannot be kept safe at home
• There is immediate danger

Call a Crisis Line If:

• You’re having suicidal thoughts but not immediate danger
• You need someone to talk to right now
• You’re not sure if it’s an emergency
• You need help deciding what to do
• You need support while waiting for other help

Key Crisis Resources

988 Suicide and Crisis Lifeline:
– Call or text 988
– Available 24/7
– Free and confidential
– Trained crisis counselors
– Connects to local resources

Crisis Text Line:
– Text HOME to 741741
– Available 24/7
– Text-based support
– For any crisis

Emergency Services:
– Call 911
– For immediate danger
– Can dispatch mobile crisis teams in some areas

Local Crisis Centers:
– Many communities have local crisis lines
– May offer walk-in crisis services
– Can coordinate with local resources

What Happens During Crisis Intervention

Crisis Line Support

When you call a crisis line:

What to Expect:
– A trained counselor answers
– They ask your name (you can be anonymous)
– They ask what’s happening
– They assess safety
– They listen and provide support
– They help create a safety plan
– They connect you to resources

What Counselors Do:
– Listen without judgment
– Help calm intense emotions
– Assess level of risk
– Develop immediate safety plan
– Connect to appropriate resources
– Follow up if needed

Emergency Room Crisis Care

If you go to the ER for a mental health crisis:

What to Expect:
– Triage to assess urgency
– Medical evaluation
– Psychiatric evaluation
– Safety monitoring
– Treatment decisions (admission vs. discharge with plan)
– Connection to follow-up care

Possible Outcomes:
– Discharge with safety plan and outpatient follow-up
– Observation in psychiatric emergency unit
– Admission to inpatient psychiatric unit
– Transfer to another facility if needed

Mobile Crisis Teams

Many communities now have mobile crisis teams:

What They Are:
– Mental health professionals who respond to crises
– Alternative to police response
– Come to your location
– Provide assessment and intervention

What They Do:
– Assess the situation
– Provide crisis counseling
– De-escalate crises
– Connect to services
– Avoid unnecessary hospitalization when safe

Psychiatric Hospitalization

When inpatient care is needed:

Reasons for Admission:
– Active suicide risk that can’t be managed outpatient
– Severe psychosis
– Inability to care for self
– Need for medication stabilization
– Safety concerns

What Happens:
– Comprehensive psychiatric assessment
– Medication management
– Therapeutic groups and activities
– Safety monitoring
– Discharge planning
– Connection to outpatient care

Length of Stay:
– Varies based on severity
– Average is 5-10 days
– Goal is stabilization and safe discharge

Creating a Safety Plan

What Is a Safety Plan?

A safety plan is a written, prioritized list of coping strategies and sources of support to use during a crisis.

Components

1. Warning Signs:
– Identify your personal signs that crisis is developing
– Thoughts, feelings, behaviors that precede crisis
– Early recognition allows early intervention

2. Internal Coping Strategies:
– Things you can do to distract yourself
– Activities that help you calm down
– Self-soothing techniques
– No other people needed

3. Social Contacts for Distraction:
– People you can reach out to for company
– Places you can go to be around others
– Not for crisis support, just distraction

4. People to Ask for Help:
– Trusted friends or family
– People who know your situation
– Who to call when you need support

5. Professionals and Agencies:
– Therapist contact information
– Crisis line numbers
– Hospital information
– Psychiatrist contact

6. Making Environment Safe:
– Reducing access to lethal means
– Removing or securing dangerous items
– Creating physical safety

7. Reasons for Living:
– What matters most to you
– Who would be affected
– Future hopes and plans
– What keeps you going

Using Your Safety Plan

• Keep it accessible (phone, wallet, posted at home)
• Review it regularly when not in crisis
• Work through steps in order
• Each step is meant to help before moving to next
• If early steps don’t help, move to next level
• If nothing helps, call 911 or go to ER

Supporting Someone in Crisis

How to Help

Stay Calm:
– Your calmness helps them
– Take deep breaths
– Speak slowly and softly
– Don’t panic even if scared

Listen:
– Let them talk
– Don’t judge or argue
– Validate their pain
– Express concern

Ask Directly:
– “Are you thinking about suicide?”
– “Are you thinking about hurting yourself?”
– Asking doesn’t plant the idea
– It gives permission to talk

Take It Seriously:
– Don’t dismiss their feelings
– Don’t say “you don’t really mean that”
– Treat all threats seriously
– Better to overreact than underreact

Don’t Leave Them Alone:
– Stay with them if there’s immediate danger
– Remove access to means if possible
– Get help—call crisis line together

Get Help:
– You don’t have to handle this alone
– Call crisis line for guidance
– Call 911 if immediate danger
– Connect them to professionals

What Not to Do

• Don’t promise to keep it secret
• Don’t debate whether suicide is right or wrong
• Don’t act shocked
• Don’t lecture
• Don’t try to be the only support
• Don’t leave them alone if in immediate danger
• Don’t minimize their feelings

After the Immediate Crisis

Follow Up:
– Check in regularly
– Continue to express care
– Accompany to appointments if helpful
– Help implement safety plan

Take Care of Yourself:
– Supporting someone in crisis is stressful
– Get your own support
– You can’t pour from an empty cup
– Set sustainable boundaries

Specific Crisis Situations

Suicide Crisis

If Someone Is Suicidal:
– Stay with them
– Remove access to means (guns, pills, etc.)
– Call 988 or 911
– Take them to ER if needed
– Don’t promise not to tell anyone

If Someone Has Attempted:
– Call 911 immediately
– Stay with them
– Follow 911 instructions
– Do CPR if trained and needed
– Don’t leave until help arrives

Self-Harm Crisis

If Someone Is Self-Harming:
– Stay calm
– Remove objects being used if safe
– Provide first aid for wounds
– Don’t shame or lecture
– Connect to crisis support
– ER if wounds need medical attention

Psychotic Crisis

If Someone Is Experiencing Psychosis:
– Stay calm and speak simply
– Don’t argue about delusions
– Keep environment calm and safe
– Remove potential weapons
– Call crisis line or 911 for guidance
– Mobile crisis team may be appropriate

Overdose

If Someone Has Overdosed:
– Call 911 immediately
– If opioid overdose and naloxone available, administer it
– If unconscious, place in recovery position
– Stay with them until help arrives
– Tell paramedics what they took if known

Reducing Access to Lethal Means

Why It Matters

Research Shows:
– Reducing access to means saves lives
– Most suicide attempts are impulsive
– If a method isn’t available, most don’t substitute
– Barriers create time for crisis to pass

Practical Steps

Firearms:
– Store guns outside the home during crisis
– Use gun locks and safes
– Store ammunition separately
– Consider giving guns to trusted person temporarily

Medications:
– Lock up prescription medications
– Dispose of unneeded medications properly
– Limit quantities on hand
– Have someone else control access

Other Means:
– Remove or secure other dangerous items
– Lock up knives if concern
– Barriers on bridges and parking structures (community level)
– Creating distance between person and means

After a Crisis

Recovery Phase

Immediate Aftermath:
– Follow up care is essential
– Attend all appointments
– Take medications as prescribed
– Implement safety plan
– Stay connected to support

Processing What Happened:
– It’s okay to have feelings about the crisis
– Therapy helps process the experience
– Learn from what triggered it
– Strengthen coping and safety plans

Building Stability:
– Address underlying issues
– Maintain treatment
– Build support network
– Develop ongoing coping strategies
– Create routines and structure

Preventing Future Crises

Ongoing Treatment:
– Stay engaged with mental health care
– Medication compliance if prescribed
– Regular therapy
– Support groups

Early Intervention:
– Know your warning signs
– Act early when warning signs appear
– Reach out before crisis develops
– Use safety plan proactively

Lifestyle Factors:
– Sleep, nutrition, exercise
– Reduce substance use
– Stress management
– Social connection

Support System:
– Maintain relationships
– Let others know how to help
– Accept support when offered
– Don’t isolate

Resources

National Resources

988 Suicide and Crisis Lifeline
– Call or text 988
– Available 24/7

Crisis Text Line
– Text HOME to 741741

Veterans Crisis Line
– Call 988, press 1
– Text 838255

Trevor Project (LGBTQ+ Youth)
– 1-866-488-7386
– Text START to 678-678

Trans Lifeline
– 877-565-8860

Local Resources

• Emergency rooms
• Community mental health centers
• Mobile crisis teams (availability varies)
• Local crisis lines

Moving Forward

Mental health crises are frightening—whether you’re experiencing one or watching someone you love go through one. But crises are not hopeless situations. With proper intervention, people survive crises, recover, and go on to live meaningful lives.

If you or someone you know is in crisis, reach out for help. That’s what these resources exist for. You don’t have to face this alone.

This article is for educational purposes only. If you are in crisis, please reach out immediately to 988 (Suicide and Crisis Lifeline), call 911, or go to your nearest emergency room. Arise Counseling Services offers compassionate, professional support for individuals and families throughout Pennsylvania.