When a mental health crisis happens to someone you know, it can catch you by surprise. You may not realize that the person was having mental health issues. Maybe they have a positive attitude, appear happy, or seem put together.

But how someone acts or looks on the outside may not represent how they feel on the inside. Mental health crises can happen to anyone. And there are risk factors besides a mental health disorder that can factor into a mental health crisis.

Understanding the risk factors for a mental health crisis and recognizing the warning signs are important so that you can help to improve the outcome.

What is a Mental Health Crisis?

The National Alliance on Mental Illness (NAMI) defines a mental health crisis as:

Any situation in which a person's behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community.

A mental health crisis can differ from person to person. Symptoms of a mental health crisis can vary based on the mental health disorder someone is struggling with.

Signs of a mental health crisis may include:

• Self-harm, such as someone cutting themselves.
• Severe panic or anxiety attacks.
• Suicidal behavior or action.
• Threats of violence or harm to others.

Risk Factors for a Mental Health Crisis

Many factors can contribute to someone's risk of experiencing a mental health crisis. Risk factors for a mental health crisis might include:

• Access to a firearm.
• Alcohol or substance use.
• Community risk factors like discrimination, community violence, or lack of access to health care.
• Gender.
• Genetics and family history.
• History of depression or mental illness. Mood disorders are the third most common cause of hospitalization in the U.S. for people aged 18 to 44. This category includes major depression, bipolar disorder, and dysthymic disorder.
• History of physical or sexual trauma or abuse.
• Impulsive or aggressive tendencies.
• Job, financial, or relationship problems or loss.
• Medications. Some medications may increase a person's risk of suicidal thoughts, anxiety, or panic attacks. These include certain antidepressants, anti-anxiety drugs, opioid painkillers, and corticosteroids. Talk about any medications you take with your doctor to reduce the risk of mental health side effects.
• Recent tragedy, loss, or abuse.
• Relationship risk factors like bullying, social isolation, or violent or high-conflict relationships.
• Severe or chronic health conditions.
• Stress.
• Suicidal thoughts, suicidal actions, or self-harm.
• Previous suicide attempt.

Suicide Warning Signs

A leading cause of death in the United States, suicide has long-lasting effects on families, friends, and communities. It's possible to prevent suicide if you know the common warning signs.

Warning signs of suicide include:

• 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."

How to Help Someone at Risk of a Mental Health Crisis

You can support someone at risk of a mental health crisis by encouraging them to get professional help. Getting mental health treatment may prevent the condition from worsening, which may help prevent a crisis.

Even with treatment, mental health crises can occur. Someone going through a mental health crisis may find it hard to communicate their thoughts, feelings, and needs. Be patient and follow these tips to try to de-escalate the situation:

• Ask them how you can help.
• Avoid constant eye contact.
• Avoid overreacting or making comments that might seem judgmental.
• Don't try to argue or reason with them.
• Don't try to take control — offer them options instead.
• Don't touch them without asking their permission.
• Give them space and keep stimulation levels low.
• Listen to them.
• Move slowly and announce actions before you do them.
• Speak calmly and softly, expressing your concern and support.

Someone in a mental health crisis may not understand what you are saying or that you are trying to help them. Get professional help by calling or texting one of the numbers below if the crisis continues despite your best effort.

When to Get Emergency Help

If you or someone you know is having thoughts of self-harm or suicide, get help right away. The following resources offer trained mental health counselors. They will listen, provide support, and connect you with additional resources, if necessary:

resolve Crisis Services (for those in Allegheny County): 1-888-796-8226.

988 Suicide & Crisis Lifeline: Call or text 988, or chat online at 988lifeline.org. Dialing 988 connects callers to the National Suicide Prevention Lifeline.

Crisis Text Line: Text HOME to 741741.

National Suicide Prevention Lifeline: 1-800-273-8255. Speaking to a Lifeline counselor can make a real difference in how you feel and get you, or someone you love, through a crisis.

Disaster Distress Hotline: 1-800-985-5990.

Trevor Lifeline (for LGBTQ+ youth): Call 1-866-488-7386, text 678-678, or chat online at thetrevorproject.org

Veterans Crisis Line: Dial 988, then select option 1. Or text 838255 or chat online at veteranscrisisline.net.

Call 911 if it's an emergency and you need immediate help.