“Life sucks, now what?” In recent years, increased mental health awareness and connectivity through social media and communication platforms have resulted in a greater tendency for people to share their inner lives and experiences, particularly distress. Yet, it could be challenging to discern when, or, how to respond to a friend or loved one in distress. In this article, we hope to help you learn how to identify a mental health crisis and how to be a better mental health supporter.

What is a mental health crisis? A mental health crisis can refer to any situation in which a) distress (e.g., feelings of sadness, hopelessness, anxiety, or despair) is severe and/or chronic, b) when an individual’s behaviour puts someone at risk of hurting themselves or others, and/or c) hinders their ability to care for themselves or function effectively. Mental health crises can take many forms and can be caused by a variety of factors, such as loss, trauma, chronic stress, substance abuse, or an underlying mental health condition. Here are some common signs of a mental health crisis and how you can recognise them:

Intense and persistent feelings of sadness, hopelessness, anxiety, or despair.
Rapid mood swings or extreme shifts in emotions, like being unable to sit still, pacing, sudden outbursts of aggression and/or emotional withdrawal
Changes in behaviour, such as withdrawing from social activities and/or increased isolation.
Changes in sleep patterns, such as insomnia or oversleeping.
Difficulties coping with day-to-day tasks or responsibilities like bathing, brushing teeth, and changing clothes.
Increased substance uses or abuse including smoking or drinking excessively to cope with thoughts or emotions.
Difficulty thinking clearly, focusing, or making decisions.
Thoughts of self-harm, suicide, or preoccupation with death which are at times, accompanied by talks of saying goodbye or going away forever.
Physical symptoms include headaches, fatigue, or gastrointestinal problems.
Hear, see, smell and/or taste things that may not be present.

Everyone experiences mental health crises differently, and not all of these signs will be present in every case. When in doubt, reach out to check-in. If you notice some of the signs above in people you know, you might find yourself at a loss as to how to support them. Broadly, there are three ways you can support others going through a mental health crisis. By providing emotional support, practical help and/or by connecting them to a wider support network.

To start off, know that it is common for you not to know what to do or say. Sometimes the best thing you can do is simply be present to listen. Active listening is akin to giving the person you are supporting permission to talk about their feelings without judgement or interruption. Though this sounds simple, it is often the most important yet challenging thing to do. Here are three ways you can provide emotional support for others.

Listen actively. Show the person you are supporting that you are present and there for them through your verbal and non-verbal language (e.g., nodding, putting away devices). When listening, remember key points of what was shared, how they felt during those times, and clarify when you feel confused. Check-in on your understanding of the situation by asking questions or summarising what you have heard.
Hold the silence. Sharing about feelings and thoughts could be the most intimidating act of vulnerability. It is often difficult to find the right words or express thoughts of fear or insecurity. If the person you are supporting is struggling to do so, reassure them by letting them know you are there when they are ready. Be patient, and be willing to sit in silence. Here are some things that you can say/do:

Would you like some company in silence while you process things for a bit?
Provide reassurance by letting them know you will be there when they are ready to talk. I’m here with you if you want to sit in silence, that’s okay. If not, I will be here to listen when you are ready to talk.
Allow them to express their feelings (e.g., rant, cry, ramble) without jumping in to provide solutions.

Respond empathetically: Try to perceive things through their perspective to understand what they may be going through, then validate their feelings. Validation is the act of understanding where the other person is coming from without judgement (especially, or even if, you disagree).

Practical support

Someone going through a mental health crisis may find completing daily tasks challenging. Providing practical support can help to decrease barriers to help-seeking and encourage a sense of normalcy.

Respect their decision and needs. Ask what kind of support is needed and seek permission to provide support. Listen out for the task they are struggling with and ask how they would like to be supported. Remember to respect their opinion.
Accompany them for their appointments. When the person you are supporting is feeling unsure about seeking help from a mental health professional or doctor, moral support can go a long way in making the intimidating experience more bearable.
Learn more about the problem they are experiencing. Mental health distress is often disconcerting and can make someone feel very alone or stuck in a problem they have difficulties understanding. You could help by learning more about the problem they are experiencing.
Help with specific day-to-day tasks. Specific day-to-day tasks could include help with reminders for important events, arranging a ride somewhere, running an errand, or taking over a household chore.
Help to organise thoughts and perspectives. Help them note down key points of conflict, sources of distress, and/or questions that they might want to ask their doctor or therapist. This helps to provide perspective and clarity of their thoughts.
Maintain social contact. Keeping routines and social engagement as normal as possible could help the person you are supporting feel safe and accepted. Let them know that you are there for them by checking in regularly, either in person or via phone or text. Have conversations about other parts of your lives and not just about distress. Also, involve them in social events as positive interactions are good mood boosters.

Connecting them to a wider support network

Encourage them to seek professional help. While you are providing emotional support, encourage them to seek professional help if their distress persists or worsens. Offer to help them find a therapist, counsellor, or support group. Connecting them to a mental health professional can provide the person you are supporting with guidance and support in developing a plan to manage the distress in a sustainable manner. If their symptoms are severe and they are in danger of harming themselves or others, they may need to be hospitalized for their own safety. This can provide a structured and supportive environment for the person you are supporting to receive treatment.
Collaboratively compile resources that may help. Work with the person you are supporting to compile a list of people, places or things that can help them feel safe when life gets tough. This can include involving other trusted friends, family members, or crisis hotlines. Crisis hotlines can provide immediate support and connection with local resources.
Take care of yourself. Remember that supporting a friend through psychological distress can be a long and emotionally challenging process. It's important to take care of your own mental health and well-being first, before supporting others.

If this list sounds daunting, do not be discouraged. The most important support is your willingness to be present. With the right support and treatment, many people are able to recover and regain their emotional and mental well-being. A good mental health supporter can support others and is not afraid to ask for support for themselves.

How to be a mental health supporter

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