How to spot and help someone in a mental health crisis
[April 14, 2026]
By DEVI SHASTRI
Experts wish more people spotted the signs earlier: feeling overwhelmed,
not feeling “like yourself,” shifts in sleep, behavior and mood.
The United States has a mental health problem, data from the U.S.
Centers for Disease Control and Prevention show. More young people,
especially girls, are reporting poor mental health. And while the
national suicide rate fell slightly in 2024, it did so from one of its
highest levels ever reported.
Mental health crises can happen abruptly or build to a tipping point
over time. They can be fueled by a sudden loss or traumatic event,
personal or societal upheaval, underlying health conditions, or any
combination of factors.
Whatever the cause, experts say the best thing to do is to spark a
conversation as early as possible and connect to a broader support
system.
___
EDITOR’S NOTE: This story includes discussion of
suicide. If you or someone you know needs help, the national suicide and
crisis lifeline in the U.S. is available by calling or texting 988.
___
Recognize the signs of a crisis
Mental health professionals say what constitutes a crisis varies from
person to person. But there are some key signals that could indicate
someone is struggling, and they can be subtle at first.
“My crisis might not be your crisis, but what we do know is that —
however people define crisis — there is a change in how they’re feeling,
a change in how they’re behaving,” said Dr. Theresa Miskimen Rivera,
president of the American Psychiatric Association.
Crises can start as someone feeling depression or anxiety but not quite
being able to pinpoint the cause, Miskimen Rivera said.
Other signs can include:
— Not enjoying or engaging in things they used to like.
— Engaging less socially.
— Sleep irregularities.
— Decreased hygiene.
— Increasing use of alcohol or drugs.
— Extreme mood swings.
— Talking about being a burden on others.
— Feeling hopeless, wanting to die or kill themselves, having no reason
to live.
If you see these changes, it's time for a conversation, experts say.
Prepare for the conversation
Crisis intervention experts recommend taking a moment to do some
research and prepare before jumping into a conversation with someone in
crisis.
Tips and resources can be found on the websites of organizations
including the National Alliance on Mental Illness, The Trevor Project,
the American Psychological Association and 988, the U.S. mental health
crisis hotline. You can also call, text or chat with 988 to get guidance
on how to start a conversation.
“We get more than 10 million calls, chats and texts a year, and a lot
those are actually people just looking for resources for someone in
their life that’s struggling,” said Tia Dole, who oversees the lifeline.
How to have the conversation
Alex Boyd, director of crisis intervention at The Trevor Project, which
runs a suicide prevention hotline for LGBTQ+ youth, breaks the initial
conversation into four parts:
— Start with an open-ended question that acknowledges the shift in
behavior. For example: “I noticed you haven't been showing up to (the
space we share) recently. I want to check in. What's going on?”
— Express your care and concern for the person.
— Ask what the crisis looks like for them. “What's been going on for you
that has led you to (name the change in behavior)? What's changed for
you? What are you concerned about?”
[to top of second column]
|
 — Acknowledge it is a tough time and
ask directly: Are you having thoughts of suicide or self-harm? At
this point, you should also think about other support and resources
for the person. Your job is to support them, not treat them. Ask
them: What would feel helpful right now?
Speak openly about suicide
It's a common myth that asking someone about whether they are
contemplating suicide can put the thought in their mind, experts
said.
It may seem awkward or scary, but it's very important to ask people
directly if they have plans to harm or kill themselves and if they
intend to act on them.
If they have a plan, Boyd recommends saying something like: “What
would lead you to actually take that step? Because that sounds
scary. I don’t want that to happen. What would lead you to feel more
escalated to act on the plan?”
If someone is in immediate danger of harming themselves or others,
seek professional help immediately. Ideally, you can do this in
collaboration with the person in crisis, with the goal of giving
them agency and build their confidence to ask for help, Boyd said.
Calling 988 or another helpline can connect you to available crisis
intervention teams or other specialized resources.
Phoning 911 or going to an emergency room are options, experts say,
though not all emergency medical service personnel or dispatchers
are trained in mental health intervention.
Starting the conversation is only the beginning
Mental health crises are complex, experts say, and it is critical to
understand cultural stigmas and other barriers that might be at play
in starting a conversation.
For some, jumping right in with diagnostic words like “depression”
and “anxiety” can cause the person to shut down, Dole said. Others
might not say anything the first time you try to have a
conversation, but come back days or weeks later to talk.
Dole recommends using “parallel activities” to take the pressure off
the conversation. Creating space for a conversation about mental
health while taking a walk or during a car ride can allow someone to
open up without forcing eye contact or formality, she said.
It’s important to validate and normalize the person’s experience
without minimizing it, experts said. Don’t write anything off as
“just a phase.” Sharing your own experience can be helpful to a
degree, but make sure not to make the conversation all about
yourself.
True healing can take years
Your loved one may also need support as they navigate years of care
and the complexities of the mental health care system. Their options
may be limited based on whether they have insurance, where they live
or their personal identity. They may have to try several therapists
before they find the best fit.
“Getting help — the traditional, clinical help — is really hard,”
Dole said. “It takes perseverance to find a clinician.”
She encouraged people to also consider leaning on other, nonmedical
resources, including faith-based organizations, community centers
and schools.
Above all, don't let the news that a loved one is struggling taint
your view of them.
“Being suicidal or having a mental health crisis does not diminish
who they are as your loved one,” Dole said. “They're still them.”
___
The Associated Press Health and Science Department receives support
from the Howard Hughes Medical Institute’s Department of Science
Education and the Robert Wood Johnson Foundation. The AP is solely
responsible for all content.
All contents © copyright 2026 Associated Press. All rights reserved |
