How to support someone in a mental health crisis

When someone you care about is struggling with their mental health, it’s normal to want to help and support them as much as you can.

Knowing ways you can support them and when and how to seek help in a crisis, can make a big difference.

Sometimes it’s easy to read how people you care about are feeling. Other times it’s harder to know what’s going on for them.

Mental health, just like physical health, changes every day. Some days you feel great, others you don’t. Low moods or bad days come and go, but they usually don’t persist.

When someone is living with a mental health condition, those low moods last longer than usual. Some signs of depression or anxiety, 2 of the most common mental health conditions in Australia, can be easy to miss.

They might include:¹

• Withdrawing from social events or time with friends and family.
• Difficulty sleeping.
• Weight changes.
• Getting easily annoyed or angry by things that didn’t used to bother them.
• Trouble concentrating or focusing.
• Lack of motivation at work or school.
• Negative self-talk such as ‘I’m useless, I can’t do anything right, you’d be better off without me.’
• Inability to enjoy activities they used to love.
• Excessively worrying about things that may not happen or often being scared or nervous.

If you have noticed a change in someone you know and are concerned they might be facing mental health challenges, there are ways to help.

Set aside a time when there’s no one else around and you won’t be interrupted.

Instead of telling them what you think is happening for them, explain what you’ve noticed.

You might say: ‘I’ve noticed you haven’t been sleeping well, and you’ve stopped going to basketball practice. Is everything ok?’

Talking about mental health struggles can be hard, says Dr Zena Burgess, CEO of the Australian Psychological Society, and people may be reluctant.

“There may be cultural or other barriers for the person that prevents them from opening up. Mental ill health is still highly stigmatised in many communities.”

Don’t be surprised if the first time you broach the subject they dismiss your concerns.

“Let them know that you are there for them and will support them with getting help. Offer to check in regularly via text, phone, or in person, depending on their preference. If someone is reluctant to seek help, don’t pressure them,” says Dr Burgess.

If they want to talk about their mental health, resist the urge to find common ground or try and minimise or fix the issue.

Instead of saying something like, ‘I know how you feel, I hate my boss too, it’ll be ok, you just need to get over it,’ simply listen, says Dr Burgess. “Listen to their experiences, acknowledge their feelings and offer your support.”

Sometimes, just having someone listen to you is a huge comfort.

But if more support is needed, let them know you want to help. The best place to start is with a GP, who can listen, assess the issue and provide guidance on the best next steps to treatment or therapy.

Tell them how a GP could help and offer to go with them to the appointment.

If they’re not ready to seek help with their GP, suggest other services that might be useful, such as Lifeline, Beyond Blue or your state-based mental health helpline.*

These services are free, confidential and 24 hours. They can call, chat or email to get more support and information about looking after their mental wellbeing.

There may be some signs that someone you care about is in a mental health crisis.

“Signs that may indicate someone is thinking about suicide include talking about wanting to die or being a burden to those around them, feelings of emptiness or having no reason to live,” says Dr Burgess.

“They may withdraw from friends, give away items that were once important to them or take dangerous risks. If you observe these signs, it’s important to encourage them to seek urgent professional support.”

While asking someone if they are in crisis can be difficult, it’s essential they get the correct support says Dr Burgess.

“Anyone who has previously attempted suicide, or has a family member who has suicided, is at higher risk of suicide. For any person who has referenced suicidal thoughts, either directly or indirectly, it’s helpful to ask them if they have a plan to suicide.

“While this can feel like a difficult conversation, it can also help people feel that the degree of their suffering is being recognised and acknowledged.”

“In that situation, you don't need to have all the answers straight away, but it can be very helpful to say, ‘I hear you. and if you'll allow me, together we will work this out.’ Then support the person (if they consent) by making a GP booking or contacting local services who can advise on next steps.”

There are state-specific crisis lines for urgent assessment of mental health, or you can call triple zero (000). The Suicide Call Back Service is a national service offering counselling for people with thoughts of suicide, or those affected by suicide. You can contact them on 1300 659 467.

*Mental health services in each state.

Australian Capital Territory 1800 629 354

New South Wales 1800 011 511

Northern Territory 1800 682 288

Queensland 1300 642 255

South Australia 13 14 65

Tasmania 1800 332 388

Victoria 1300 651 251

Western Australia 1800 676 822 (PEEL) or 1300 555 788 (Metro)

Lifeline has a 24 hour, free crisis line run by trained counsellors. Call 13 11 14.

Beyond Blue offer free, confidential telephone and online counselling support. Go to the website or call 1300 22 4636.

Suicide Call Back Service is a free, national helpline for people in crisis and their loved ones. Call 1300 659 467.

Kids Helpline offers free, confidential counselling young people aged 5–25. Call 1800 55 1800.