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 What to Do In a Crisis

When someone you know is experiencing a mental health crisis or showing signs of suicidal behavior, remember three things: Take it seriously, ask questions, and get help.

Take it Seriously

Thoughts of death or suicide are a serious symptom of depression, so take any suicidal talk or behavior seriously. Stay calm and be willing to listen without judgment or criticism. Allow and encourage the expression of feelings. Let the person know that suicidal thoughts are temporary and depression is a treatable condition.

Remind the person that no matter how awful the problems seem, they can be worked out and you are willing to help. Don't try to argue a person out of suicide, and don’t be sworn to secrecy. Offer hope that alternatives are available.

Ask Questions

You might open a dialogue by saying, “I notice you don’t seem like yourself lately. What’s been going on?” Listen more than you talk. Ask simple questions. Say, “I’m here. I care. How can I help you?”

Asking about suicide—and encouraging the person to get help—does not increase the risk of suicide. Ask questions about how the person is feeling and how you can help. Be direct. Ask whether the person is considering suicide. Ask if they have a particular plan or method in mind. Talking openly about it is the first step toward help. It may be a relief to the person to know that it’s all right to talk about it.

Get Help

If you think a person is suicidal or you discover plans for self-harm, treat it as an emergency. Crisis intervention specialists can help people cope with stress and trauma and offer short-term intervention and stabilization of the crisis situation. 

If you fear the person is in danger of harming himself or others, seek help immediately.

Take the person to the nearest hospital emergency room, where medical staff can keep the person safe and help you deal with the crisis.

Following an behavioral health assessment, the ER will determine care options. Often the patient is held for 48 to 72 hours for further observation and evaluation.

Hospital admissions through the ER may be voluntary or involuntary. If the patient is a potential danger to himself or others, a hospitalization will be arranged.

  • What happens when I arrive at the emergency room?
    When you arrive, you’ll complete the intake paperwork and meet with a staff member who will ask some questions about your thoughts, feelings, and current situation. Some of the questions may be a bit uncomfortable, but it’s important to answer honestly so that you can get the help you truly need.

  • I’m scared that I will have to stay at the hospital overnight. Will I be admitted?
    The hospital staff will review your current situation and make recommendations for next steps. In some cases, they may release you from the emergency room and recommend that you follow up with a mental health professional in an outpatient setting, such as a therapist or psychiatrist.

    If you are actively suicidal or if the hospital staff believes you are a danger to yourself or someone else, they will recommend that you stay in the hospital for a few hours or days. The goal is to keep you safe and ensure you receive the appropriate treatment for your mental state.

    In the state of Texas, you may be placed in an extended observation unit (EOU) for up to 48 hours. Individuals in an EOU may be at moderate to high risk of harming themselves or others. During this time, the staff will determine whether the individual is now stable and can be released or if they require psychiatric hospitalization.

    Source: https://www.txcourts.gov/media/1445767/texas-mental-health-resource-guide-01242020.pdf (January 2020)

  • I don’t have insurance. Will they still help me if I go to the emergency room?
    If you have a medical or mental health emergency and you don’t have insurance, go to the nearest emergency room. Doctors and medical professionals are required by federal law to treat you as a patient. The Emergency Medical Treatment And Labor Act or EMTALA ensures that “any individual with an emergency medical condition, regardless of the individual’s insurance coverage, is not denied essential lifesaving services.”

    Source: https://www.govinfo.gov/content/pkg/FR-2012-02-02/pdf/2012-2287.pdf (2012)

If you can’t take the person to the emergency room, dial 911, call your local mobile crisis team, or contact a crisis line. See GET HELP NOW for more information.

Don’t leave a suicidal person alone until help is available. To reduce the chance that they will hurt themselves or others, eliminate access to firearms, pills, sharp objects, ropes or other items they could use to harm themselves.

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