Mental Health Crisis and Suicide Prevention
It's important to understand what a mental health crisis is, be aware of the warning signs, and know how to help. The first step in addressing any type of mental health crisis is identifying when someone is in crisis and providing support.
What Is a Mental Health Crisis?
A mental health crisis is a situation where someone's thought processes, emotional responses, and physical actions or behaviors put themselves or others in danger and/or leads to the inability to care for themselves. This can happen to anyone at any time. It's important to be able to recognize a mental health crisis and know how best to help.
Warning Signs of a Mental Health Crisis
Mental health crises are unique to the individual. There are many different factors that can contribute to experiencing a crisis, often related to significant stressors such as trauma, loss, and financial hardship. Some common warning signs for children/adolescents and adults are listed below. It is important to recognize them and know how to approach the person in crisis.
Mental Health Crisis Warning Signs in Teens and Children
Children and teens may not have the language skills yet to label or describe their experiences and therefore, their distress may be expressed through their behavior.
Look for signs such as:
- Refusing to eat or eating constantly.
- Frequent nightmares.
- Changes in school performance.
- Sudden or extreme mood changes.
- Feeling extremely sad.
- Difficulties understanding or relating to others.
- Recurrent agitation or aggression.
- Excessive worrying.
- Avoidance of sleep, school, or social outings.
- Self-injury or suicidal behaviors.
- Uncharacteristically unusual behavior.
- Recent break-up with boyfriend/girlfriend/significant other
- Any event that may cause public embarrassment or shame
- Bullying, be it online or face to face
- Failure to achieve important goal or milestone
- Significant changes to their family unit or relationships within the family
Suicide Warning Signs in Adults
Adults may show signs such as:
- Threatening to or talking about wanting to hurt or kill oneself.
- Looking for ways to kill oneself by seeking access to firearms, available pills, or other dangerous means.
- Talking, writing, or looking up on the internet about death, dying, or suicide when these actions are out of the ordinary for the person or if the person has previously thought about or talked about wanting to die or suicide.
- Feeling hopeless.
- Feeling rage or uncontrolled anger or seeking revenge.
- Acting reckless or engaging in risky activities — seemingly without thinking.
- Feeling trapped — like there's no way out.
- Increasing alcohol or drug use.
- Withdrawing from friends, family, and society.
- Feeling anxious, agitated, or unable to sleep or sleeping all the time.
- Experiencing dramatic mood changes.
- Seeing no reason for living or having no sense of purpose in life.
- Giving away possessions.
- Saying concerning statements such as: “I just can't take it anymore" ; “All of my problems will end soon" ; “No one can do anything to help me now."
What Is 988?
The 988 Suicide & Crisis Lifeline is a national program to help people who are having a mental health crisis or who know someone who is. The lifeline is available 24 hours a day, seven days a week, 365 days a year.
By calling 988, you can speak to someone who will assess your situation and connect you with local resources to get you the help you need. You also can find information and chat online at 988lifeline.org.
When you call 988, you are directed to the closest crisis center based on your area code. This gives you the best chance to get connected to help from trained volunteers and mental health professionals close to you.
What to Do if Someone Is Experiencing a Mental Health Crisis or Showing Suicide Warning Signs
#BeThe1To — an effort by the National Action Alliance for Suicide Prevention and the 988 Suicide & Crisis Lifeline — outlines five action steps you can take to help someone experiencing a mental health crisis, or having suicidal thoughts or actions.
Asking the question, “Are you thinking about suicide?" communicates that you're open to talking about the subject in a nonjudgmental way. Asking can open the door to dialogue about their emotional pain. Other questions can include, “How do you hurt?" and, “How can I help?"
Be sure to listen to their answers and take them seriously. Studies show that asking at-risk persons if they're thinking of suicide does not increase suicides or suicidal thoughts. In fact, studies show that talking about suicide may reduce suicidal thoughts or actions.
2. Be There.
This could mean being physically present, talking on the phone, or any other way you can support the at-risk person. Follow through on any forms of support you offer them. If you can't be there in person, help them develop ideas for others who might be able to help.
Increasing the person's connections to others and limiting their isolation (both in the short and long term) can protect against suicide.
3. Help Them Keep Safe.
Establish their immediate safety. Have they already done anything to try to kill themselves before talking with you? Have they made a plan or thought about how they would do it? Do they have access to firearms or other methods?
Knowing the answers to these questions can tell you a lot about the immediacy and severity of danger the person is in. The more steps and pieces of a plan that are in place, the higher their risk. Or, if they have immediate access to a firearm and are very serious about attempting suicide, then extra steps — such as calling 911 or driving them to an Emergency Department — might be necessary.
4. Help Them Connect.
Establish a safety net of ongoing support that the at-risk person can connect with when they find themselves in crisis. Helpful resources include:
- The 988 Suicide & Crisis Lifeline. Dial 988.
- The National Alliance on Mental Health (NAMI) Helpline. Call 800-950-6264, or text "Helpline" to 62640.
Community support, mental health professionals, and other programs also may be available in your area. Help the person develop a safety plan of who to call and what to do if they start to have severe thoughts of suicide.
5. Follow Up.
After your contact, follow up with them to see how they're doing and make sure they've connected with immediate support systems. Leave a message, send a text, or give them a call. At-risk individuals are less likely to follow through with suicidal actions when they have a constant connection with someone. It's important to maintain communication with the individual and show support.