How Family Can Provide Support During A Loved One’s Mental Health Crisis

With rising rates of mental health conditions among Americans today, mental health crisis situations may be more common than ever before. Note that there are a number of resources available to help people who may be experiencing a mental health crisis. Often, though, a person may need assistance in connecting with those resources. In these cases, family members can act as a bridge to additional care that the person may need. Read on to find out more about mental health crises and how family members can help if someone they love experiences one.

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What is a mental health crisis?

There’s no set medical or psychological definition of when exactly a mental health symptom(s) may officially become a crisis situation. The National Institute of Mental Illness (NAMI) advises that the crisis threshold may be reached when an individual is in “a situation that the person or their loved ones are unable to resolve without the help of trained professionals.” Such a crisis could involve a person experiencing a psychotic episode, having immediate and pressing medical needs, or making threats or attempts to harm themselves or other people.

Some acute mental health crises require medical attention as soon as possible. If a person is displaying any of the following behaviors, contact emergency services:

• Going extended periods without sleeping
• Refusing to eat for extended periods
• Experiencing delusions or hallucinations
• Experiencing extreme withdrawal symptoms from a substance they are physically dependent on*

*If the substance the person is addicted to is alcohol or benzodiazepines, they need to go to a hospital immediately. Withdrawal from these substances without medical supervision can lead to seizures, brain damage, and sometimes death.

Possible warning signs of a mental health crisis

Most mental health crises do not emerge without some warning signs, or indications that a person may be experiencing severe mental health challenges and that a crisis may be imminent. Some signs you may notice over days or weeks that an individual might be at risk for experiencing a mental health crisis include:

• Rapid weight gain or loss
• Isolating oneself from friends and loved ones
• Neglecting personal hygiene
• Dramatic changes in sleeping habits or appetite
• Writing a will, giving away prized possessions, or otherwise getting their affairs in order
• Increased substance use
• Loss of interest in activities that once brought purpose or joy
• Declining performance at work or school
• Experiencing extreme feelings of anxiety, anger, guilt, shame, hopelessness, rage, or sadness
• Engaging in risky or self-destructive behavior

Some symptoms that could indicate that a person may be at risk of a mental health crisis in the coming moments or hours include:

• Displaying violent behavior, like punching things or provoking physical altercations with other people
• Irrational thoughts
• Compulsive pacing
• Confusion
• Mood swings
• Having extremely high levels of energy (which could be a sign of a potential manic episode) or no energy at all
• Behaving in an agitated way
• Talking very rapidly or nonstop (which can be a sign of mania or psychosis)

If you notice these or other recent, unusual changes in your loved one’s behavior, you might encourage them to seek support as soon as possible before things escalate. 

Tips for providing support during a family member’s mental health crisis

Mental health crises can be stressful situations for the individual themselves as well as their loved ones. Family members, romantic partners, close friends, roommates, or others who frequently spend time with an individual are often those who may need to step in and address any crisis situations that may occur, so it can help to be prepared.

If a crisis situation presents itself, it’s typically best to follow the advice of a qualified mental health professional as outlined in the crisis plan. In general, however, the following tips can be helpful. You might also explore the National Alliance on Mental Illness’s guide to navigating a mental health crisis for additional advice.

1. Remain calm

As frightening as a mental health crisis may be, remember that the person experiencing the crisis is likely feeling overwhelming fear as well, and you don’t want to heighten those emotions for them. To this end, you might speak in a soft, slow, calm tone and use open, relaxed body language. Keep your distance, don’t block exits, and avoid making any sudden movements or gestures that could be interpreted as threatening.

2. Refrain from judgment

Try to avoid expressing anything negative about the situation. It can be helpful to attempt to view the person’s experience from a place of neutrality and not project any of your own assessments, opinions, or fears onto them. For example, you may want to avoid:

• Telling the person what they should or should not do
• Talking to them in a patronizing way
• Arguing, criticizing, or trying to talk the person out of what they are feeling or experiencing—especially if they’re having hallucinations or delusions, which can be very vivid and real to them

3. Focus on determining next steps

To do this, you might ask your loved one questions like:

• “How can I help you feel safe and in control right now?”
• “Is there a therapist or doctor you feel comfortable with that I can call for you?”
• “Has this situation happened before?” If yes: “What helped then? If no: “Do you have any ideas about what might help now?”
• If the person is willing to engage with medical professionals: 

• • “Is there a certain hospital or clinic you would prefer to go to?”
  • “Is there anything you’d like to bring along or that I can get for you before we go?”
  • “Is there anyone else you’d like me to call?”
  • “Do you want me to drop you off at the hospital/clinic or stay there with you?”

According to NAMI, complying with their safe and reasonable requests could help give your loved one a greater sense of control over the situation, which can be helpful. 

If the person’s safety or the safety of those around them is at risk and they’re unwilling to seek professional help, you may need to reach out to medical providers for them. Working on a crisis plan with their mental health care provider ahead of time may help you understand when it may be appropriate to make this call.

Support for the loved ones of someone with a mental illness

Seeing someone you care about experience a mental health crisis can take a toll on your own well-being, and it may be helpful to process your emotions about the situation with a mental health professional. A therapist can provide a supportive environment in which to talk through your feelings without judgment. They may also provide family coping strategies to help you solve problems and navigate complex situations related to the mental health of one or more members. 

If you’re unable to attend in-person therapy for support—whether because of a busy schedule, a lack of providers in your area, or cost—you might consider online therapy instead. When you pursue online therapy through a platform like BetterHelp, you can get matched with a licensed provider and then attend sessions from the comfort of your own home. 

Studies indicate that online therapy may be just as effective as traditional in-person therapy in many cases, and it’s often more affordable as well. For example, findings from one group of researchers suggest that completing a course of online cognitive behavioral therapy (CBT) helped to reduce a number of mental health symptoms in participants, including those associated with depression, anxiety, and severe stress—all of which may be more common in people whose loved ones have experienced crisis situations.