Mental health crises and timely help

Recognize danger and impaired functioning before assigning a diagnosis

A mental health crisis involves distress or behavioral change that makes it difficult to remain safe or manage life and calls for timely support. It can occur with or without an established psychiatric diagnosis. Talk about dying, unbearable pain, or being a burden, unusual farewells, giving away valued possessions, withdrawal, or increasing risky behavior deserves attention, especially when new or worsening. NIMH warning signs support observation, but a checklist cannot predict an individual's outcome or establish safety through one missing sign.

Self-harm and suicidal intent are not identical. Ask about both and address injuries; a stated wish to relieve distress does not remove concern. An injury, suspected overdose, or statement about acting immediately requires emergency medical help. Appearing calm or joking does not cancel the need for assessment. The practical task is to identify immediate danger and support needs rather than debate whether the person is overreacting.

Ask directly and listen without judgment

In a safe, relatively quiet setting, say that you have noticed their distress and ask directly whether they are thinking about suicide. If so, ask whether they have thought about how or when they might act, whether harmful items are accessible, and whether an injury or action has already occurred. This establishes urgency; it is not an interrogation or a request for technical details. NIMH guidance explains that asking directly does not increase suicidal thoughts or behavior.

Let them finish, then check your understanding: they may feel unable to cope, and you want to connect them with help now. Avoid blame, challenges, moral arguments, or promises that everything will definitely be fine. Do not promise permanent secrecy about a life-threatening plan. Explain that you respect privacy and need to involve people who can help keep them safe. 988 guidance for supporters emphasizes listening without judgment and seeking appropriate assistance.

Immediate danger requires protection and emergency help

Call local emergency services for ongoing harm, serious injury, suspected poisoning, or someone who says they may act immediately or cannot remain safe. Medical emergency numbers are 120 in mainland China, 911 in the US, and 999 in the UK; they are not interchangeable across regions. Give the exact location, observed behavior and statements, responsiveness, breathing, and known injuries without waiting for a complete history. Suspected overdose needs reporting even without symptoms; do not induce vomiting, give medicines, or suggest sleeping it off. NHS advice separates emotional support from emergency treatment.

Stay with a person at immediate risk when safe, involve trusted support, and reduce access to harmful items without struggling over them or endangering yourself. If weapons or threats make the scene unsafe, keep your distance, move to safety, and tell dispatchers. Support does not mean physical restraint. At a distance, establish their location, try to maintain contact, and involve local emergency responders or someone trusted who can attend immediately; do not simply leave a message and wait.

Psychiatric symptoms and physical illness can both change behavior

Psychosis can involve hallucinations, delusions, and disordered thought or speech. Hallucinations are perceptions without a corresponding external stimulus; delusions are false beliefs that remain strongly held despite contrary evidence. These symptoms require assessment but do not establish one particular diagnosis or imply inevitable violence. New symptoms need prompt clinical contact, especially when self-care or safety is compromised. If a care team already exists, contact staff familiar with the person. NHS psychosis guidance describes possible psychiatric, substance-related, medication, and physical causes requiring assessment.

Speak calmly in simple sentences, allow space, and avoid crowding or arguing. Acknowledge fear without agreeing with unverified beliefs, following NAMI advice while arranging care. Sudden confusion, impaired attention, or disorientation may instead signal an acute physical emergency. Infection, low blood glucose, and stroke can cause this. A psychiatric history must not explain away abrupt change; NHS sudden-confusion advice calls for immediate assessment.

Find local support and make sure the person receives help

A crisis helpline can listen, help someone manage distress, and connect them with services. Concerned friends can also seek advice. In mainland China, call 12356. The Fujian Health Commission's official briefing describes the national requirement for at least 18 hours of daily service; do not assume every local service operates around the clock. Check local published hours. Immediate danger calls for emergency services such as 120, without repeated waiting on a busy support line.

In the United States and its territories, call or text 988 or use the 988 website for chat, available around the clock. In the UK and Ireland, Samaritans provides 116 123 listening support around the clock. These lines provide emotional support; immediate danger still requires local emergency medical services. Elsewhere, consult local official resources. Help make contact, explain needs, arrange assessment, and confirm who takes over, respecting language and trusted-contact preferences while explaining necessary safety arrangements.

Plan specific actions before another crisis

Once the situation is stable, work with a clinician on a safety plan: personal warning signs, safe coping activities, people and places providing distraction, trusted people to ask directly for help, professional and emergency contacts, and concrete arrangements reducing access to harmful items. The VA Safety Planning Intervention provides this structure. Check working numbers, available contacts, overnight options, and easy access to the plan. A promise never to self-harm is not a substitute, and a written plan does not remove the need for emergency assessment or ongoing treatment.

Suppose a friend says they might hurt themselves tonight and demands secrecy. Ask about immediate danger, remain with them when safe, and connect emergency help; next week's appointment is insufficient. Afterward, arrange follow-up and review where the previous plan failed. Supporters can share responsibilities, rest, and seek support themselves. Ongoing connection matters, but no friend can independently control every outcome. Recurrence or additional treatment needs do not mean the person failed to try.

Bilingual terms

心理危机 · Mental health crisis

Distress or behavioral change threatening safety or everyday coping and requiring timely support.

自杀意念 · Suicidal ideation

Thoughts of ending your life; intent to act needs further assessment.

幻觉 · Hallucination

A perception without a corresponding external stimulus.

安全计划 · Safety plan

A prepared sequence of coping actions, contacts, and environmental safety arrangements.

安全交接 · Safe handover

Confirming that appropriate support takes over with relevant risk and care information.

Sources and further reading

• NIMH: Warning Signs of Suicide
• NIMH: Five Action Steps
• 988: Help Someone Else
• NHS: Help for suicidal thoughts
• NHS: Psychosis overview
• NAMI: Helping during a psychotic episode
• NHS: Sudden confusion
• Fujian Health Commission: 12356 official briefing
• 988: About the Lifeline
• Samaritans: Contact a Samaritan
• VA: Safety Planning Intervention
• GOV.UK: China emergency contacts
• NIMH: Help for Mental Illnesses
• NHS: Poisoning

Original course source-check record: 9 September 2026. Full Chinese and English sentence-by-sentence language review: 14 September 2026. AI editing and language review are not human clinical review. Linked institutions have not participated in or endorsed this course.