What should you do when a mental health crisis strikes?

If you’re experiencing a mental health crisis,
I think the first thing to do is figure out what you need. Right? So, if you’re having
trouble with your own safety, you’re really thinking about killing yourself, you need
to get help. And you need to see a professional, or you need to go to an emergency room. Not
everything can be done on a self-help basis. That said, self-help and self-management have
become crucial aspects of helping people do well. So the idea over time is to learn as
much as you can by joining groups like the National Alliance on Mental Illness, to educate
yourself, to participate in your own care in an active way. And it’s not something
like, the doctor is giving you a medicine, it’s all forgotten. You learn about your
condition, you learn about the stresses, you learn about what it takes to help you live
the best way with it. Once you understand that, the crisis that you’re dealing with
is probably known to you, and you should have a framework for how to address future problems.
So the key thing about thinking about a crisis is how to get ahead of it, how to learn from
prior vulnerabilities, and how to enroll people in your life to help you anticipate it in
a way that you can accept their gentle feedback. When a person doesn’t want help, it generates
a tremendous challenge in all the people who care about them. How do you help a person
who isn’t particularly motivated? Or how do you deal with a person who feels ashamed
of their symptoms? Because when you ask a person, do they need help, the vulnerability
that they may feel, the shame that they may feel about knowing that they’re struggling,
is one of the things that you’re gonna be battling with. So the first thing I encourage
them is to be gentle with themselves. This is not an easy thing you’re trying to take
on. Then I encourage people to think of overlapping Venn diagrams. You might see: a psychotic
illness, a problem hearing voices, difficulty with functioning, and having trouble getting
out of bed. They might see: getting out of bed is a problem, and I wish I had more to
do. So I encourage people to ignore battling about their diagnosis or their symptoms, and
focus on the things that the other person wants to do. I wish I could get out of bed,
and I wish I could do more. By work, by starting with things you can agree upon, and building
upon them, that’s typically a good way to get started. You will probably need professional
help, though. And professionals deal with this hard topic all the time. In the Wellness Recovery Action Plan, and
with any good caregiver, the purpose of the work is to identify patterns for you that
you can anticipate future vulnerabilities. Some patterns repeat themselves. So, if you
have depression that occurs in the winter, or if you have bipolar episodes in the context
of relationship distress, these become predictable phenomena. The idea of creating an anticipation
of your risk for crisis is actually part of the answer to dealing with a crisis. So the
idea would be to understand, if it’s seasonality, relationship changes, medication changes,
that are risks for you, and then to identify a series of things that you can do to minimize
your risk. Is it aerobic exercise? Is it having a social role? Is it participating in helping
other people as a peer and giving yourself a sense of meaning? These are the things that
we find over and over help people contend with reducing their vulnerability. So the
earlier a person gets help, the better their chances become. People can recover and live
great lives. One place to get help is the NAMI helpline.
The NAMI helpline is staffed by people who are living with mental illnesses successfully
and by their family members. The number is 1-800-950-NAMI.


  1. Isolate yourself from family and have no motivation,showing signs of depression…. people will just use it to hurt you more not help…. humans

  2. From my experience, and what I have heard from others, people at the emergency room don't like suicidal patients. They can be dicks.

  3. I think the fact that the phone number for a help line was at the end made this the most practically useful Big Think video to date.

  4. What is a mental health crisis? When everyone acts like their mental illness that they don't actually have but were diagnosed with by a lazy doctor is life-ending and more important than everyone else's problems in the world?

    This is actually the only good video I've seen on mental illness, though. He doesn't sit there and say "It's not your fault you have depression, but you can't do anything but take these here pills so chow down!" He actually targets the necessary action of people needing to recognize how their illness works and try hard to work around it. It's their job to learn about it and learn how to live their life the best they can while having it, and that sitting on their ass chomping pills all day long won't actually cure anything. He ends the video saying it's perfectly possible to get over these illnesses and live fantastic lives, then offers a helpline for those who need the extra help. Finally a guy that knows what he's talking about.

  5. I have worked in mental health for the last 30 years and I also have a mental illness. Telling people to get help is easier said than done. Of course the big hurdle when it comes to someone in crisis is for them to see the problem and to realize that the problem has a solution. If one can get past that hurdle the next problem is finding help. In the area of country I live in it can take up to 3 months (if you have insurance) to get an outpatient appointment. If one can not wait for an outpatient appointment most emergency rooms are not equipped with mental health professionals. So outcomes are not what the person in crisis is expecting.

    We have a mental health crisis in this country. There is a lack of resources and hospitals look at the mentally ill as possible revenue sources and not as patients that need treatment. Until Americans start demanding from our elected officials that they take mental illness as a real medical problem people will continue to suffer and die.

  6. Good luck with that help if you have no insurance, and one wont feel much better after you get that extortionate bill from an emergency room either.

  7. I hate it when someone says, "They're fine. They're just lazy and have no ambition." Yeah… that's a sign they aren't fine.

  8. Someone who is suicidal isn't expecting to live long, and treatment is hard work. Telling a suicidal person to take part in treatment is like telling someone on death row to research and invest in stocks.

  9. You should straighten your jacket and do what you know you have to do you just don't like it. That's what I do. It's not going to be the answer you want. But it's the answer you need.

  10. Mental Illness is a serious issue, and those who are affected need a strong support group and (generally) professional care. Psychiatry and Psychology should work in tandem, with the Psychologist (i.e. 'Counselor') being the source of primary care. Where the medical system is truly fucked up is that the Md (Psychiatrist) does not have the proper education to adequately address the full spectrum of care often required. Is the Psychiatrist necessary? Yes!! Absolutely! Should they be the source or primary care for the Mentally Ill? Unless someone is an imminent danger to themselves or others, the answer is typically 'No'.

    As with most medical conditions, there are both behavioral and biological conditions that must be addressed. Medical doctors are skilled at addressing the biological, but are often ineffectual (if not completely inept) at addressing the behavioral. There are biological conditions that affect Mental Health, and those can often be successfully treated with the appropriate medications. But there are no magic pills. The patient still must develop a behavioral framework that is beneficial to their own mental health.

  11. Well, I was a bit upset a few days ago when I lost some shiny bottle-caps that I quite liked, but, I found 'em and ever since it's been damn good times. I'm feeling very very happy and I never felt healthier. I have a good life. Thank you!

  12. Suicidal thoughts overcome any will for one to seek help.
    reaching out to a stranger would be the last thing to ponder with such a mindset.

  13. Many people with mental illness do not and cannot realize they need help. Cognizance is the issue. You say irrational people need to be rational and think things out. They need outside help.

  14. No shame here from me personally. I've had mental health issues over the years. Hospitalized myself for the first time(and hopefully last for this) back in March. Some of mental health issues are perhaps genetic (I'm adopted) and other definitely situational/ environmental. Helping yourself is #1. So many positive ways to manage stressors. If you don't want to help yourself or have other's help you, you're really in a especially dark place. Some people don't want and can't get out of the dark though.

  15. I feel ashamed for how I used to perceive mentally ill people. But then I got sick myself, I kinda deserved it.

  16. I'm just glad to see that he never said, "In my book…"  I much prefer Big Think speakers who simply impart knowledge without trying to sell more.

  17. If you are to about to suicide don't waste it. Kamikaze yourself on some politicians or the bad rich people corrupting more than Satan if Satan existed. Rich people are like "we will give most of our money back before we die". Why don't they spend them on ways to prevent what's happening today from governments and corporations? Why not free insurance for everybody? No taxes? or Global peace but not in Germany Nazi way, or USA New World Nazi way or Great Nazi of China?

  18. Im a suicidal survivor. Raped repeatedly age 5-14 3 days a week and your rapists points a gun at your working mother weekly.

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