When someone you love is in crisis, your presence can be the single most stabilizing factor. This guide synthesizes research-informed clinical strategies and humane principles to help you respond safely, effectively, and sustainably. It uses evidence-based terminology—such as crisis intervention, risk assessment, de-escalation, and safety planning—so you can act confidently and compassionately.

What is a mental health crisis?

A mental health crisis is a situation in which a person’s thoughts, feelings, or behaviors pose an immediate risk to their safety or significantly impair their functioning. Crises can be acute (suicidal ideation, psychosis, panic attacks) or exacerbations of chronic conditions (major depressive episodes, mania, severe anxiety). Timely support focuses on stabilization, risk reduction, and connecting to appropriate care.

Immediate priorities: safety, assessment, and stabilization

In any acute situation, prioritize these three tasks:

• Ensure immediate safety. If there is imminent danger—active suicidal intent with plan and intent, active self-harm, or violence—call emergency services. Never assume you can manage extreme risk alone.
• Conduct a brief risk assessment. Ask direct questions about suicidal thoughts, plans, means, and timelines. Use neutral language: “Are you thinking about killing yourself?” and follow with questions about plan and access to means.
• Stabilize and de-escalate. Use calming presence, grounding techniques, and remove immediate means if safe and possible.

Communication skills that help (and why they work)

Communication matters more than words alone. These skills are supported by research in motivational interviewing, trauma-informed care, and crisis intervention:

• Active listening and validation. Reflect back what you hear: “It sounds like you’re feeling overwhelmed and hopeless.” Validation reduces limbic activation and promotes regulation.
• Open, nonjudgmental questions. Avoid minimizing or lecturing. Ask curiosity-driven questions: “What do you feel would help right now?”
• Concrete, time-limited offers. People in crisis often can’t plan long-term. Offer immediate, specific help: “I can stay with you for the next two hours,” or “I’ll call the crisis line with you now.”
• Boundaries and limits with compassion. Clear limits (e.g., no tolerance for threats) provide safety while preserving the relationship.

Psychological principles to guide your approach

Understanding underlying mechanisms will help you be both effective and resilient:

• Emotion regulation: Crises often reflect dysregulated affect. Grounding, paced breathing, and sensory strategies reduce physiological arousal.
• Attachment and safety: Presence from trusted others reduces perceived threat and can re-engage prefrontal control systems.
• Motivational stance: Avoid coercion; elicit the person’s own reasons for wanting to be safe, which improves engagement.
• Protective and risk factors: Foster protective factors (social support, problem-solving skills) and reduce risk factors (access to means, isolation).

For more on how emotions influence physical and mental wellbeing, see how emotions affect your health.

Practical step-by-step plan

1. Assess safety. Ask directly about suicidal thoughts/plans and access to means.
2. Stay present. Maintain a calm tone, eye contact as comfortable, and minimize distractions (silence phones).
3. Use grounding tools. Breathing, sensory prompts, and a safe-space visualization help reduce acute panic.
4. Create an immediate safety plan. Identify people, places, and specific steps to reduce risk for the next 24–72 hours.
5. Connect to professional support. Facilitate contact with crisis teams, therapists, or emergency services as indicated.
6. Follow up. Check in consistently after the crisis to maintain connection and support care continuity.

Table: Crisis response phases and recommended actions

Phase	Goal	Concrete actions	Timeframe
Immediate	Ensure safety and reduce acute risk	Risk assessment, remove means, stay with person, call emergency services if needed	0–24 hours
Stabilization	Lower arousal and create short-term plan	Grounding, safety plan, contact crisis team or outpatient provider	24–72 hours
Recovery	Connect to ongoing treatment and resilience supports	Therapy referral, medication consult, social supports, skill-building	Weeks–Months

Supporting recovery: referral, resources, and follow-up

After immediate stabilization, the next phase is linking the person to appropriate care. This often includes:

• Formal mental health services: outpatient psychotherapy, psychiatry, or intensive outpatient programs depending on severity.
• Peer and community supports: support groups, faith communities, or peer crisis lines that reduce isolation.
• Practical assistance: help with appointments, transportation, or medication access.

Encourage the person to engage with care but respect autonomy. Use collaborative language: “Let’s look at options together.” If they’ve experienced setbacks like job loss or relationship strain, integrating resilience strategies can help; see approaches to cope with failure for transferable skills such as reappraisal and behavioral activation.

How to care for yourself as a supporter

Helping someone in crisis is emotionally demanding. Caregivers risk burnout, compassion fatigue, and secondary traumatic stress. Practice the following:

• Set and communicate boundaries. Decide ahead what you can realistically do (time, tasks) and communicate it kindly but firmly.
• Use peer or professional supervision. Talk to a therapist or trained peer specialist to process your feelings and improve your approach.
• Maintain self-care rituals. Prioritize sleep, nutrition, movement, and activities that replenish you—these are not optional.
• Recognize limits. You can be supportive without being solely responsible for recovery.

Research shows that small daily practices compound; habits that increase wellbeing are helpful for both you and your loved one — explore evidence-based habits of happy people for practical routines.

Common mistakes and how to avoid them

• Minimizing feelings. Saying things like “It’s not that bad” invalidates and increases isolation. Instead, validate and acknowledge suffering.
• Overreacting or catastrophizing. Panic can escalate the situation. Maintain calm, use grounding, and seek help rather than amplifying alarm.
• Giving ultimatums. Threats of abandonment can worsen risk. Set boundaries with empathic language and collaborative problem solving.
• Playing the therapist. Providing emotional support is vital, but diagnosing or treating is a professional role—encourage or facilitate access to clinicians.
• Ignoring your own needs. Failing to seek support for yourself increases risk of burnout and reduces effectiveness.

Reflection prompts to guide your approach

Use these prompts to check your readiness and align actions with values:

• What are my immediate safety steps if this situation escalates?
• How can I remain present and calm without losing boundaries?
• What supports do I need to sustain this caregiving role?

When to involve emergency services or crisis teams

Engage emergency services if the person has imminent intent to harm themselves or others, is psychotic and unable to care for themselves, or is otherwise incapacitated. Many regions have specialized crisis intervention teams trained in mental health stabilization—use them when possible to reduce retraumatization that can accompany traditional law enforcement response.

Encouraging long-term resilience

Recovery is not linear. Encourage treatments and behaviors that strengthen protective factors: consistent therapy, medication adherence if indicated, social connection, skill-building (emotion regulation, distress tolerance), and lifestyle changes. Reinforce small victories and progress, not only the absence of symptoms.

Common scenarios and recommended scripts

• If they express suicidal thoughts: “Thank you for telling me. Are you thinking about killing yourself? Do you have a plan and the means to carry it out? I’m going to stay with you and help you keep safe.”
• If they are panicking: “Your breathing is speeding up; that must feel awful. Let’s try three slow breaths together and name five things you can see right now.”
• If they refuse help: “I respect your choices. I’m worried about your safety. Can we agree on a small step you can take right now—calling a friend, waiting with me for an hour, or reaching out to a crisis line?”

FAQ

Q: How can I tell if a situation is a crisis or just a bad day?

A: A crisis typically involves severe functional impairment, intense emotional dysregulation, imminent risk to safety, or a marked departure from the person’s baseline. If you’re unsure, err on the side of caution: ask direct questions about suicidal thoughts and capacity, and seek professional assessment if concerns persist.

Q: What if the person refuses to get help?

A: Respect autonomy but continue to express concern and offer options. Use motivational interviewing techniques: ask permission to discuss concerns, reflect, and elicit their own reasons for safety. If there is imminent risk, contact emergency services—sometimes involuntary intervention is necessary for safety.

Q: How do I avoid burning out while supporting someone long-term?

A: Set clear boundaries, maintain your own support network, schedule regular breaks, and seek professional supervision or therapy. Delegating tasks (transport, appointment scheduling) and using community resources reduces burden. Remember: sustainable caregiving requires protecting your own wellbeing.

Closing: act with courage and compassion

Supporting a loved one in crisis is both a heavy responsibility and a profound opportunity to help restore safety and hope. Use research-informed practices—direct risk assessment, validation, grounding, safety planning, and linkage to care—while protecting your own wellbeing. Small, consistent acts of presence are often the most therapeutic. If you need practical strategies to strengthen emotional skills over time, consider reviewing resources on resilience and adaptive habits that support recovery.

You don’t have to do this alone. Reach out to professionals, crisis teams, or peer supports to share responsibility and ensure the best outcome for your loved one and for yourself.