Recognizing when a mental health situation becomes an emergency can help you save a life—whether your own or someone else's. Understanding the warning signs and knowing how to respond is crucial.
What Is a Mental Health Emergency?
A mental health emergency exists when someone's thoughts, feelings, or behaviors put them or others at immediate risk of harm. These situations require urgent professional intervention.
Emergency Warning Signs
Suicide Warning Signs
Seek immediate help if someone:
- Talks about wanting to die or kill themselves
- Looks for ways to end their life (searching online, obtaining weapons)
- Talks about feeling hopeless or having no reason to live
- Talks about being a burden to others
- Increases use of alcohol or drugs
- Acts anxious, agitated, or reckless
- Sleeps too little or too much
- Withdraws from friends and family
- Shows extreme mood swings
- Gives away prized possessions
- Says goodbye as if they won't see people again
Signs of Psychosis
Emergency if accompanied by risk of harm:
- Hearing voices telling them to hurt themselves or others
- Beliefs that people are trying to harm them (paranoid delusions)
- Severe confusion about reality
- Bizarre behavior that endangers safety
- Complete inability to care for basic needs
- Command hallucinations (voices giving orders)
Severe Panic or Anxiety
May need emergency care if:
- Panic symptoms don't subside after 30+ minutes
- Chest pain or difficulty breathing persists
- Person is unable to be calmed
- First-ever severe panic attack (to rule out medical causes)
- Panic leads to dangerous behavior
Manic Episode Signs
Emergency if:
- Person hasn't slept for days
- Engaging in dangerous activities
- Making decisions that could cause serious harm
- Aggressive or violent behavior
- Psychotic symptoms present
- Unable to care for themselves
Severe Depression Signs
Emergency if:
- Not eating or drinking for extended periods
- Unable to get out of bed for days
- Neglecting necessary medical care
- Signs of suicide risk (see above)
- Catatonic state (unresponsive)
Substance-Related Emergencies
- Overdose symptoms
- Severe withdrawal (seizures, DTs)
- Dangerous behavior while intoxicated
- Mixing substances with psychiatric medications dangerously
How to Respond
If You're Having an Emergency
- Call 988 (Suicide & Crisis Lifeline) or text HOME to 741741
- Call 911 or have someone take you to the ER
- Tell someone you trust what's happening
- Remove yourself from dangerous items
- Don't be alone
If Someone Else Is Having an Emergency
- Stay calm—your presence matters
- Take any threat seriously
- Don't leave them alone if suicide is a concern
- Listen without judgment
- Call 988 together or on their behalf
- Call 911 if there's immediate danger
- Take them to the ER if needed
- Remove access to weapons or dangerous items if possible
What NOT to Do
- Don't argue or try to "talk them out of it"
- Don't promise to keep suicidal thoughts secret
- Don't leave them alone if you're concerned
- Don't be judgmental or dismissive
- Don't assume it will just pass
- Don't wait to see if things get worse
After the Crisis
- Follow up with mental health professionals
- Review and update safety plans
- Attend all follow-up appointments
- Consider what led to the crisis
- Adjust treatment plans as needed
- Take care of yourself if you helped someone
Prevention
Reduce emergency risk by:
- Staying engaged with treatment
- Taking medications as prescribed
- Having a crisis plan in place
- Knowing your warning signs
- Building a support network
- Removing access to lethal means
- Attending regular follow-up appointments
Crisis Planning at Next Step Psychiatry
At Next Step Psychiatry, we work with every patient to identify warning signs and create personalized crisis plans. If you're concerned about yourself or a loved one, please reach out to us or use the emergency resources provided above.