What to Do in Crisis: Immediate Support and Safe Next Steps

When you're in crisis—acute trauma response, suicidal thoughts, dangerous behavior, severe dissociation—you need immediate support. Here's a practical guide to what to do.

Defining Crisis

Crisis means:

- You're having thoughts of harming yourself or others - You're experiencing acute trauma symptoms (flashbacks, panic, severe dissociation) that are disabling - You're unable to keep yourself safe - You're in danger - You need immediate professional support

In Immediate Danger

If you or someone else is in immediate physical danger:

Call 911 (or your country's emergency number)

- Police will respond - EMS will assist if needed - You'll be taken to an emergency room

This is appropriate when: - There's a weapon involved - Someone is actively being harmed - There's imminent physical danger - You're experiencing a mental health emergency that feels dangerous

Crisis Text Line

If you're in crisis but not in immediate danger, you can text HOME to 741741 (in the US).

- Trained counselors respond - It's free and available 24/7 - They help you process what's happening and find resources - You can text without voice if that's easier

National Suicide Prevention Lifeline

If you're having suicidal thoughts:

- Call 988 (in the US, available 24/7) - Call 1-800-273-8255 - Text HOME to 741741

- Trained counselors listen without judgment - They don't call police unless you're in immediate danger - They help you find resources and safety planning

International Resources

Different countries have different crisis lines:

- Befrienders International: http://www.befrienders.org - International Association for Suicide Prevention: https://www.iasp.info/resources/Crisis_Centres/ - You can search "[your country] crisis line" or "suicide hotline [your country]"

What Crisis Support Does

When you contact crisis support:

- Someone trained listens to what you're experiencing - They help you feel less alone - They help assess immediate danger - They help you find resources - They help you make a safety plan - They connect you to longer-term support

Going to the Emergency Room

If you go to an emergency room:

- Tell them you're experiencing a mental health crisis - Be honest about your symptoms, thoughts, and feelings - They'll evaluate whether you need to be admitted - You might be admitted to a psychiatric unit for observation and stabilization - This is okay. It's temporary and focused on safety

In the ER: - You have rights. You can ask questions. - Bring someone you trust if possible - Be honest about medications and substances - Tell them about any medical conditions

Finding Longer-Term Crisis Support

After the immediate crisis:

Get a therapist - Crisis is often a sign you need professional support.

Consider medication - Talk to a psychiatrist. Medication can be stabilizing.

Build a support network - People who know about your crisis and can support you.

Develop a safety plan - See below.

Address underlying issues - What led to crisis? What needs to change?

Create a Safety Plan

A safety plan outlines what to do if you're in crisis again:

Warning signs - What tells you a crisis is coming? (increasing anxiety, isolation, intrusive thoughts)

Internal coping strategies - What can you do on your own? (breathing, grounding, journaling, calling a friend)

People and social settings to help distract you - Friends you can call, activities you can do

People you can ask for help - Therapist, doctor, trusted friend, family member

Professional contacts - Therapist, psychiatrist, crisis line numbers, emergency room

Ways to make your environment safer - Remove access to means of harm

What to do after crisis - Who to tell, what support to seek

Having This Conversation

It's worth having a crisis conversation with people close to you:

"If I ever seem to be in crisis, here's what I need..." "Here are signs something's wrong..." "Here's how to help..." "Here's who to call..."

Knowing that people care and are ready to help is powerful.

For Loved Ones

If someone you love is in crisis:

- Don't leave them alone - Call for professional help - Listen without judgment - Don't minimize their experience - Offer practical support - Get them to professional help - Take suicidal statements seriously - Reach out to crisis lines yourself for guidance

After Crisis

The time after crisis is important:

- Connect with your mental health team - Be gentle with yourself (crisis is exhausting) - Understand what triggered it (useful information) - Strengthen your support - Address underlying issues - Follow through with treatment

Remember

Crisis doesn't last forever. It feels eternal in the moment, but acute crisis episodes are typically hours or days, not permanent.

You can get through this. Help is available. You don't have to do this alone.

Reach out. Get help. It matters.