The Do’s and Don’ts of Supporting Someone in a Mental Health Crisis

No one — not even the most energetic among us — has an unlimited supply of emotional resources.

But I know how much we wish we did. When someone we love is struggling with their mental health, oftentimes our instinct is to throw ourselves into the fray… but without being thoughtful about what kind of support we offer, we risk burning out.

If you’re reading this, you probably know what I mean.

In my own history, I’ve been both the person in crisis and the supporter. And I know firsthand that when someone hits bottom, it’s hard not to get swept up in the intensity. We forget ourselves sometimes. We go all-in, just to find ourselves depleted and resentful.

I wrote this because, having seen both sides, I know just how difficult it can be.

It hurts to give someone every last ounce of compassion that you have, just to find them still immobilized by their despair, not seeming to get any better.

I also know what it’s like to have a friend bail on you in your darkest hour, confirming your fear that you are, in fact, “too much.”

But here’s the truth: You don’t have to sacrifice yourself to support someone else. And no, you’re not “too much” for needing support from the people you love. Both of these things are true.

We need to be thoughtful about how we step into our role as supporters, though, for those things to feel true for everyone.

If you’re wondering where to start, these do’s and don’ts can offer a blueprint for showing up more compassionately, both toward yourself and your loved one.

DO: Have a plan from the beginning

If you know someone is in crisis, the chances are high that they’ll need more than just your support, and they’ll need it for the long haul, including that of professionals.

Your loved one will need a strong network of care, as well as a plan if things should escalate. Thankfully, that’s something that can be organized upfront.

That’s a WRAP!

Many mental health professionals recommend that individuals have a Wellness Recovery Action Plan (WRAP). This can include:

phone numbers for a therapist, psychiatrist, and other relevant healthcare providers or healers

contact info of family members and friends that can offer support

phone numbers for local crisis numbers and mental health organizations

addresses for walk-in crisis centers and emergency rooms

a list of triggers and forms of self-care to try when your loved one is activated

a schedule of community resources, like online support groups, 12-step meetings, etc.

Your loved one should share this plan with their network of support.

If their network seems limited (or is limited to just you), work together to see what resources you can find, including these affordable therapy options and this “choose-your-own-adventure” guide.

DON’T: Make decisions without their consent

There’s a common assumption that people who are struggling with their mental health can’t be trusted to make their own decisions.

But most of the time, this simply isn’t true. Whenever possible, we should involve our loved one in any and all decisions that impact them.

This is especially true when we’re considering making decisions that could further traumatize them. Encounters with police officers — including wellness or welfare checks — can be terrifying, and in some cases, have turned deadly, particularly for Black people and people of color.

It’s best to familiarize yourself with local crisis teams and reach out to your loved one and others in their support system ahead of time to determine the safest course of action in an emergency.

If someone has called 911, take the following precautions as harm reduction:

Request an officer that’s trained in crisis intervention (CIT).

Give as much information as possible to the dispatcher, including their diagnosis, symptoms, and the nature of the emergency.

If you’re fearful that your loved one may purposefully provoke an officer into firing their weapon (also known as “suicide by cop”), repeat this information to the dispatcher multiple times to ensure that those on-site are aware and do not fire.

Send a nearby supporter to meet them at the location to calmly intervene and ensure the situation doesn’t escalate on either side.

Even if 911 has already been called, it’s still worth contacting local crisis resources. Check and see if they can send someone to mediate any police encounter that happens.

Please remember that there is no guarantee that your loved one will be kept safe if 911 is called. Tragedies are known to happen. Voluntary admission to inpatient care will always be the safer option.

In such emergencies, you are responsible for taking as many precautions as you can to ensure the best possible outcome.

DO: Set reasonable expectations upfront

Avoid overextending yourself or offering high levels of support indefinitely. You can do this by ensuring that your loved one understands your expectations of them at this time.

If you expect them to be in therapy, for example, you can ask if they intend to find a therapist and within what timeframe (assuming, of course, that they have access). If you’re expecting that you won’t be the only person they rely on for emotional support, ask who else is on their team and how you can support them in accessing additional support.

If you expect them to seek out a higher level of care if things don’t improve, work together to determine when that would be and what that would look like.

Setting expectations

“I’m happy to support you, but I want to make sure you also have professionals in your corner. When are you reestablishing care with a therapist?”

“I’m glad you asked for my help. Do you have a plan for what you’ll do if this gets worse? I want to make sure you have a backup plan in case you need extra support.”

“I love you so much and I want to support you. It would help put me at ease if you let me know who you’ll reach out to if I’m not available at a particular time, just so that I know you aren’t doing this alone.”

DON’T: Blame or shame

It can be tempting to criticize our loved ones when they aren’t making the choices that we ourselves would make.

For example, your loved one may be withholding information from their therapist, using alcohol or drugs to cope, or making impulsive decisions that appear to be making things worse.

However, blame and shame rarely motivate people to make changes to their behaviors.

What your loved one needs more than anything is unconditional love and positive regard. Rather than criticizing their choices, it’s best to extend support that they can then choose to accept if they feel able to.

For example, for a loved one who’s struggling with alcohol, you might say, “Hey, I’ve noticed you’re drinking a lot more than usual and it’s worrying me. Can I help you find some resources and support around that?”

Helping them make better choices for their own well-being will do a lot more good than shaming them for the ways they’re choosing to cope.

DO: Name your needs and boundaries clearly

You are allowed to have boundaries. In fact, you really should. Knowing what your limits are can help prevent taking on too much and experiencing burnout.

It’s hard to set boundaries you didn’t know you needed, though. And many of us don’t know what our limits are until they’re tested.

To help you determine what you might need and where your limits may be, try completing these sentences with your loved one in mind:

Knowing your limits

My preferred mode of communication is [text, phone, etc.] so please don’t [call, leave a voicemail, text].

I’m only available to talk [during the day, during specific hours, etc.], so you’ll need extra support outside that time. Who can you reach out to?

I can’t pick up the phone when [I’m at work, when I’m visiting family, etc.] but I’ll get back to you when I’m able to.

[Topics] are triggering for me, so please ask me before you share about them.

I can’t [talk daily, come over, etc.], but I’m happy to support you in [finding a therapist, video chatting tonight].

I care about you, but I can’t talk if you’re [yelling at me, not sober, hurting yourself], so please have a plan for who you’ll reach out to instead.

DON’T: Personalize their behavior

No one chooses to be in crisis, and a mental health crisis is not an accurate reflection of who someone is.

Defining someone by their struggles can have a deep impact on how they internalize what’s happening and their ability to recover.

A former friend of mine once described supporting me through a depressive episode as “being sucked into [my] world.” By defining “my world” as a dark and despairing one, I was left feeling as though depression was at the core of who I was, and that I was a burden on the people I love.

Our words have a tremendous impact on other people. If we want people to have faith in themselves and their ability to live a full life, we need to be mindful of how we frame their struggles.

A mental health crisis does not define who someone is, but rather, it’s a temporary period of time which they can endure with the support of those around them.

DO: Practice rigorous self-care

This is a common refrain, I know, but it bears repeating: An abundance of self-care is critical when we’re supporting someone in crisis.

It can be especially helpful when we schedule it in advance, so we know when to anticipate a break and can protect that time by setting our boundaries accordingly.

Self-care looks differently for everyone, but consider activities that leave you feeling rested, relaxed, recharged, and reset. It can be helpful to journal about this if you aren’t sure what those activities might be!

DON’T: Wait until your resentment builds up

Don’t wait until you’re resentful, burnt out, and fed up before practicing self-care and taking the time you need to recharge.

If you had a leaky pipe in your basement, you wouldn’t wait until your basement flooded to fix it, would you?

Similarly, we should be taking care of ourselves and showing up for ourselves consistently to ensure that we can show up for others.

DO: Kindly step back when you need to

Life happens. And sometimes, we’ve reached our limit in what we can offer others.

You aren’t a bad person for needing to step back and take care of your own mental health — but doing so thoughtfully can ensure that you aren’t doing unintentional harm when you step away.

Have some TACT!

Before stepping back from supporting someone in crisis, remember TACT:

Timing. Consider the timing of your actions. Do they have other support around them, and if so, can they commit to reaching out to them? Will your withdrawal result in a worsening crisis, and if so, is there someone within their support system you can alert in case there is an emergency? When is their next support group or therapy appointment? Confirm that they have the support they need in your absence.

Accountability. Take accountability. This can be challenging for people, because sometimes we feel exhausted and resentful by this stage. But it’s critical not to blame the person who’s in crisis, the same way you wouldn’t blame someone who was sick with cancer for the stress that results from their struggles. Accountability means being apologetic if boundaries weren’t clearly communicated, not blaming the other person for things outside their control, and owning where you may have overextended yourself.

Check-in. Setting a date and time to check in next can be helpful reassurance so that your loved one knows you aren’t abandoning them. It can be hard to feel like you’re losing crucial support at a time when you need that support most. Touching base is a great way to affirm for your loved one that they still matter to you, and that the space you’re taking is temporary.

Transparency. It’s crucial to communicate your expectations and boundaries for the time that you’re apart, especially because they’re changing. If you need them to stop texting as frequently, say so. If you aren’t able to follow through on a commitment you made (like driving them to a particular appointment), let them know (see also: timing). Don’t assume that they can read your mind!

DON’T: Ghost, ignore, or avoid them

You might read this and think, “Wait, ghost them? Who does that?”

It’s not unheard of that someone might choose to avoid or discard a person who’s struggling because they’re too overwhelmed to continue engaging with them. Sometimes when people have reached their breaking point, they make really unfortunate decisions.

My hope, of course, is that everything I’ve shared above helps you avoid reaching this point at all. But should you arrive there, I need to emphasize how important it is to not simply drop someone who’s in crisis.

For one, this can do incredible harm. Treating a loved one as disposable can be damaging, and the abrupt loss of someone they care about can be triggering in an already vulnerable state.

A major life event, including the ending of a meaningful relationship, can be very detrimental to someone’s mental health.

I say this not to prevent you from ending a relationship that’s hurting you, but rather, to remind you to be thoughtful about how you proceed.

The acronym above (TACT) is just as applicable to ending a relationship as it is to taking a break.

Consider the timing, be accountable and transparent, and if possible, check in later on to have a conversation to process what happened, with the hopes of you both gaining some closure.

You both deserve care and support. If ending that relationship is the only path forward, please be sure to do so with respect, dignity, and thoughtfulness wherever possible.

Being supportive of someone in crisis is never easy

You can expect a whole spectrum of (very valid) emotions: everything from grief to anger, hopefulness, and despair.

But as someone who’s been there, I can confidently say that I’ve never regretted showing up for someone who needed me. And as the one who was in crisis, I’ve never, ever forgotten the kindness that people have shown me in my darkest hour.

I hope that having read this, you have a clearer idea of how to proceed in a responsible, empowered way — one that allows you to securely fasten your own oxygen mask before reaching for anybody else’s.

You deserve to stay well as you support others. And when we’re intentional about how we show up, we can be.

Sam Dylan Finch is a writer, positive psychology practitioner, and media strategist in Portland, Oregon. He’s the lead editor of mental health and chronic conditions at Healthline, and co-founder of Queer Resilience Collective, a wellness coaching cooperative for LGBTQ+ people. You can say hello on Instagram, Twitter, Facebook, or learn more at SamDylanFinch.com.

Posted : 2024-05-28 13:59

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