If you or someone near you is in immediate danger, call 988 (the Suicide and Crisis Lifeline) by phone or text, or call 911. Those lines are available 24 hours a day, 7 days a week. Outside the U.S., call 13 11 14 in Australia, 116 123 in the UK (Samaritans), or 988 in Canada. What you do next depends on the severity of the crisis and what resources are around you.
Recognize What Counts as a Crisis
A mental health crisis is any moment when your emotions or thoughts feel so overwhelming that you can’t function safely. That includes thoughts of suicide or self-harm, but it’s broader than that. Hearing or seeing things that aren’t there, feeling completely disconnected from reality, being unable to eat or care for yourself, or experiencing rage so intense you’re afraid of what you might do all qualify. The common thread is that your usual coping strategies aren’t working and the situation feels urgent.
Not every crisis requires an emergency room. Some need a calming conversation with a trained counselor. Others need in-person professional support within hours. A few need immediate emergency care. Figuring out which category you’re in is the first step.
What to Do Right Now
Start by making your environment safer. If there are medications, sharp objects, firearms, or anything else that could cause harm, move them out of reach or move yourself to a different room. If you’re with someone in crisis, stay calm, speak slowly, and avoid arguing with them about what they’re experiencing. Physical safety comes first.
Once the immediate environment is safer, try a grounding technique to interrupt the spiral. The 5-4-3-2-1 method works well during acute panic or overwhelming distress. Begin with a few slow, deep breaths, then work through your senses: name five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. This pulls your attention back into the present moment and out of the loop of distressing thoughts. It won’t solve the crisis, but it can buy you the mental space to take a next step.
Who to Call Beyond 911
The 988 Suicide and Crisis Lifeline connects you to a trained counselor by phone call or text. When you dial in, you choose between the Veterans Crisis Line, Spanish-language services, or a local in-state counselor. If your local center can’t answer within a set window, the call rolls over to a national backup so you’re not left waiting indefinitely. Texting “HELLO” to 741741 reaches the Crisis Text Line if you’d rather not talk out loud.
Many communities also have mobile crisis teams. These are small groups of mental health professionals who come to your location, de-escalate the situation, and connect you with follow-up care. They exist specifically as an alternative to police response for mental health emergencies. You can ask your local 988 counselor whether a mobile crisis team is available in your area, or search for one through your county’s behavioral health department.
For young people in Australia, Kids Helpline (1800 55 1800) serves ages 5 to 25 around the clock, and Headspace (1800 650 890) offers free phone support for those 12 to 25 and their families.
What Happens If You Go to the Emergency Room
If the crisis involves active danger to yourself or others, an emergency room is the right call. Knowing what to expect can make the experience less frightening.
The first step is a medical assessment. Staff will check your vital signs, review your medical history, and do a physical exam. The goal is to rule out anything physical that could be causing or worsening your symptoms, like an infection, a blood sugar drop, substance withdrawal, or a neurological problem. Diagnostic testing (blood work, imaging) isn’t always required. It depends on your specific situation.
Mental health visits in the ER take significantly longer than other types of visits. One study found the average stay for a mental health visit was about 7.5 hours, compared to roughly 2 hours for other complaints. If any screening tests are ordered, that alone adds about 2 hours to your wait. Bring a phone charger, a water bottle, and anything that helps you stay grounded. The long wait is not a sign that you’re being ignored.
After medical evaluation, a psychiatric assessment determines what level of care you need. Some people are discharged the same day with a safety plan and outpatient referrals. Others may be held for observation for up to 72 hours if there are concerns about immediate safety.
Involuntary Holds
If someone is unable or unwilling to seek care voluntarily but poses a serious safety risk, most states allow an involuntary psychiatric hold. The general criteria are: a mental health condition with severe symptoms, an immediate threat of harm to yourself or others, inability to meet basic needs like food and shelter, and a likelihood of benefiting from inpatient treatment. The specifics vary by state and county, but the initial observation period is typically up to 72 hours, after which a provider makes an official decision about continued care. A court hearing is required before any longer-term commitment.
Alternatives to Hospitalization
Emergency rooms and inpatient wards aren’t the only options. Peer-run crisis respites offer a homelike environment staffed by people who have their own lived experience with mental health recovery. These centers focus on self-care, personal responsibility, and regaining a sense of control. Staff use everyday language rather than clinical terminology, and the atmosphere is designed to feel safe rather than institutional.
The outcomes are encouraging. A randomized controlled study found that people who used crisis respite care showed greater symptom improvement than those hospitalized, reported higher satisfaction, and cost more than $450 less per day. Respites are not appropriate for everyone, particularly if the crisis involves severe psychosis or active medical needs, but for many people they offer effective support without the trauma that can accompany an ER visit or psychiatric ward. Programs like Recovery Innovations’ “Living Room” model let you walk in as a guest and receive comfort and peer support from a team of specialists.
Build a Safety Plan Before the Next Crisis
A safety plan is a written, prioritized list of coping strategies and contacts you create in advance, so you don’t have to think clearly in the worst moment. It typically includes your personal warning signs, internal coping strategies you can use on your own (like the grounding technique above), people and places that provide distraction, specific people you can call for help, and professional or crisis contacts as a final layer.
This isn’t a feel-good exercise. A large study published in JAMA Psychiatry compared patients who received a safety plan plus follow-up against those who got standard care after an ER visit for suicidal behavior. Over six months, those with safety plans were 45% less likely to attempt suicide, roughly cutting the odds in half. They were also more than twice as likely to attend at least one outpatient mental health appointment afterward. You can create a safety plan with a therapist, or download a template from the 988 Lifeline website and fill it out on your own.
What to Do After a Crisis Passes
The days and weeks immediately following a crisis are a vulnerable window. The relief of surviving the worst moment can mask the fact that the underlying conditions haven’t changed yet. Getting to an outpatient appointment quickly matters. Research consistently shows that prompt follow-up care after a psychiatric hospitalization or ER visit reduces the likelihood of readmission and repeat crises.
If you were given referrals at discharge, call to schedule within 24 to 48 hours, even if you’re feeling better. Many clinics have cancellation lists that can get you seen sooner. If you weren’t given referrals, call 988 and ask for local outpatient resources, or contact your insurance company’s behavioral health line.
Keep your safety plan somewhere accessible. Update it as your situation changes: new phone numbers, new coping strategies that work, new warning signs you’ve noticed. A crisis plan that stays current is one of the most effective tools for preventing the next crisis from escalating the way this one did.