What to Do When Someone You Love is Experiencing a Mental Health Crisis

Like 17 million other Americans last week, I found myself glued to the TV viewing the long-awaited Oprah interview of Prince Harry and Megan Markle. The interview undoubtedly had more than one shocker. The one I found the rawest was Megan expressing she had suicidal thoughts while pregnant with her first son, Archie, and living under the palace rule. Here is a woman isolated, silenced, and scared and many people in her position might have experienced suicidal thoughts as well. I, unfortunately, wasn’t surprised that this would be the devastating outcome of years of bullying by the press and unfathomable racists words and actions towards Megan.

Suicide and suicidal thoughts leave no one invulnerable or immune. It also leaves family and friends feeling unsure of what to do when someone they love is experiencing a mental health crisis or dealing with a mental illness.

For several years, I taught Mental Health First Aid courses. Mental Health First Aid is a wonderful 8-hour class that teaches people how to intervene when someone they know is experiencing symptoms of a mental illness or in a mental health crisis. The idea is that just like First Aid for physical health, everyone should be trained in Mental Health First Aid. I highly recommend taking a class, where you will learn in-depth about mental health disorders and how to assist in a mental health crisis. You can find a course near you here.

Below is what Mental Health First Aid teaches when someone is experiencing a mental health crisis. The acronym used is ALGEE (catchy, right?).

A – Assess for suicide or risk of harm

The most important thing is ensuring your loved one can remain safe and does not have a plan or intent to harm or kill themselves. Ask them directly, “are you having thoughts of suicide” or “are you thinking of killing yourself?” You will not put thoughts in their head about killing themselves by asking this question.

If they say yes, ask further questions such as “do you have a plan” and “do you know when you will do this?” If someone is at imminent risk of suicide, meaning they have a plan and intend to act on it or are already attempting, call 911 right away. If your loved one is experiencing suicidal thoughts, you can call the National Suicide Hotline at 1-800-273-8255.

If assessed that your friend or family member is not an imminent risk for suicide, let the person know you are willing to help. Most of the time the person will say they do not have a plan or wouldn’t carry out a plan. If the person isn’t at imminent risk, it is still a very serious situation, however, you know they are probably not in immediate danger. Continue with the steps below.

L – Listen non-judgmentally

Now is not the time to insert your opinion or any knowledge you may have. Listen to your loved one and hear them out. This will allow them to feel respected, heard, and understood. Be attentive when you are listening to your loved one and show how much you care.

G – Give reassurance and information

Reassure your loved one that they aren’t crazy and you are there for them. Your loved one is probably scared and confused. Your reassurance will provide them comfort. Give the person hope for the future. Trivializing the person’s experience or dismissing the person’s feelings is not helpful. Validate their experience and offer support. Simply listen and reassure. You aren’t there to “cure” your loved one, but rather offer them support and information they need. Avoid trying to solve the problem. Your loved one might not be thinking logically right now.

E – Encourage appropriate help

Encourage your loved one to seek professional help in the form of therapy from a mental health professional for talk therapy or counseling, and/or a psychiatrist or Primary Care Physician for medication. If they are willing, help them find a provider and schedule an appointment. You can find more information on how to find a mental health provider HERE. Your loved one might not be willing to schedule something right now but leave the door open to talk later. They may very well change their mind.

E – Encourage Self-Help and other support strategies

Encourage your loved one to get connected to other friends, family, or support groups. NAMI is a wonderful resource to get connected to support groups. Encourage other self-help strategies such as exercise, checking in with a friend or self-help books. These things won’t cure your loved one, but may help ease some of the distress they are feeling in the immediate and help them feel less alone.

If your loved one isn’t willing to get help at this time, let them know you are here for them and that your door is always open. Just because they do not want help right now, doesn’t mean they won’t reach out in the future.

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If you or someone you know is experiencing suicidal thoughts, please call the national suicide hotline at 1-800-273-8255. 

For information on Mental Health First Aid and to find a course near you, visit http://www.mentalhealthfirstaid.org/.

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