What to do in a mental health crisis: Tips for families
Families with a loved one going through a mental health crisis can feel overwhelmed, frightened, and helpless. Calling law enforcement is something most of us have been programmed to do in an emergency, and it is sometimes the first solution that springs to mind when a family member, friend or neighbor begins acting in an aggressive or threatening way.
With a lack of community and workplace-based mental health support and resources, it can also appear to be the only option. But too often, an interaction with law enforcement — whose officers sometimes have not had the opportunity to learn best practices for responding to people living with mental illness — can be unhelpful and confrontational. In the case of 20-year-old Porter Burks, it was fatal, though Detroit police officers on the scene had crisis intervention training.
If you are dealing with someone who is experiencing a mental health emergency, here are some steps to take, according to several specialists interviewed Wednesday by the Free Press:
Assess the situation
If someone has a weapon and is threatening to use it, it may be too great a risk to your safety or to the safety of those around you to intervene. In these cases, you may decide that calling for law enforcement is the best course of action.
Because not all police officers have received crisis intervention training, it’s worth asking the dispatcher to send someone who has. Some counties are also partnering with Community Mental Health Service Programs to send trained social workers or other crisis response personnel to the scene alongside police officers, but it’s certainly not guaranteed. Mobile crisis units may ask whether the person is willing to receive help.
Either way, you can make it clear when calling for help that no crime has occurred, and that you are seeking help with a mental health crisis.
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If you can, have a calm conversation
Especially if someone is threatening self-harm, talking to them with compassion and kindness is important. Most likely, someone suffering from an acute mental health situation is also scared, confused and feeling powerless.
Do your best to find a calm environment in which to talk. Especially if there are onlookers, try to find an environment with less stimulation.
Reassure the person that they are safe, while remaining vigilant regarding your own safety.
Depending on your friend or family’s members chronic mental health issues, it might make sense to ask whether they are hearing any voices other than yours. If they are, ask casually what those voices are saying. They may be friendly voices, or they may be critical. But if they are commanding voices that are ordering the person to commit harmful acts, you should consider the person dangerous and seek help.
“Very often, your tone of voice and your nonverbal behavior is just as important as your verbal behavior because these are people who are very sensitive to being rejected, bullied, mocked, dismissed,” said Kenneth Wolf, CEO of Incident Management Team and a former trainer of Crisis Intervention Teams in Michigan and Florida. “You want to treat them with tremendous respect.”
Gather information, stay calm
Perhaps you’ve dealt with this person’s mental illness in the past, but if you’re not aware of previous mental health situations, ask some questions that will help you find assistance.
Ask whether there is anyone who has helped them in the past who you could mobilize to help in the moment, such as a therapist, a caregiver, or even a friend.
Ask whether they have taken their prescribed medication, and where to find it if they need it or need more. Find out who prescribed the medicine so that you can get in touch with their care team.
Ask what needs to happen for them to feel safe.
Ask who they have received care from in the past who might be helpful now.
Announce what you’re going to do before you do it, such as bringing the person over to a table, making a phone call or going inside to look for medication. If feasible, give them choices as to their actions.
Although dealing with mentally ill people in a crisis can feel frustrating, try to remain patient and calm.
Finally, if you haven’t spent much time with the person recently, try to gather information about how the person has been doing so you can convey their situation to a mental health professional. If you call a crisis hotline or mobile crisis unit, they’ll likely ask you questions about the person’s recent behavior, ability to take care of themselves, participation in social life and more.
Call 988 for help
Anyone in the United States can dial 988 to reach trained crisis counselors standing by to help.
Crisis counselors are trained volunteers who can provide support, but not medical advice. They are trained to help in a mental health, suicide or substance use crisis.
The calls are routed to local organizations based on your phone number’s area code, so if you live somewhere other than your phone number indicates, you might want to look up your county’s community mental health service. This list of suicide and crisis lines by county can help you find it.
For those who are hard of hearing, a chat service is available at 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 and then 800-273-8255.
You can also text any word to 74174 to be connected with a live, trained crisis counselor over a secure platform.
Other options for getting help include:
Directly contacting your local Community Mental Health Services Program, which has a 24-hour crisis hotline.
Reaching out to a psychiatric emergency service through a hospital, such as the University of Michigan’s.
Calling Common Ground Crisis Line, which also offers Behavioral Health Urgent Care
Other specialty helplines, such as the Trevor Project, which offers suicide prevention and crisis intervention for LGBTQ young people ages 13-24, or the Substance Abuse and Mental Health Services Administration’s 24-hour treatment referral and information service.
Know you did your best, and prepare for the next time
After a crisis has passed, the job of a caring family member or friend may be just beginning. If the situation you dealt with didn’t go well, try not to blame yourself.
"In those situations, it almost seems as though no matter what anybody else says or does, sometimes they still end up making those choices,” said Tara Melton, a crisis center worker in Macomb County. She said to do everything you can in the situation, and then remind yourself that you did your best.
Then, the most empowering thing may be to make a plan for the next mental health crisis that may arise.
The National Alliance on Mental Illness recommends helping a friend or family member struggling with mental health make a Wellness Recovery Action Plan.
Make a list of numbers to call in an emergency and keep them posted or in your phone. Those sources of help could include:
Community Mental Health crisis or emergency number.
Name and number of a mental health professional.
Friends, neighbors or other family members who could help — especially those who have helped before.
The nearest NAMI affiliate.
A psychiatric emergency service.
You should also keep a list of medication and dosage information nearby.
It might be worth a preemptive call to your local police department to find out whether officers there have received crisis intervention training.
NAMI also recommends going over the plan with your loved one, and with their consent, their doctor.
You may also want to create a Psychiatric Advance Directive — a legal document that allows a second party to act on your loved one's behalf in the case of acute illness and inability to make treatment decisions. This directive details the individual’s preferences for treatment should they become unable to make such decisions due to their mental health condition and is written during a time of mental health competence.
If you believe your loved one needs to be admitted somewhere for treatment, contact your local Community Mental Health Services Program or file a petition directly with probate court. You could also bring the person you’re concerned about to a physician, hospital, or the pre-admission screening unit of the local Community Mental Health Services Program for an assessment and to fill out an application for hospitalization form.
Families might not want to overstep or may be holding on to hope that things will improve. But helping a family member or friend get treatment is the best thing to do.
Jennifer Brookland covers child welfare for the Detroit Free Press in partnership with Report for America. Make a tax-deductible contribution to support her work at bit.ly/freepRFA. Reach her at jbrookland@freepress.com.
This article originally appeared on Detroit Free Press: What to do in mental health emergency: Tips for families needing help
