When you or a loved one has schizophrenia or another serious mental health condition, it’s common for the symptoms to vary over time. They could get better with treatment and then worse again. It’s a good idea to think ahead about how you’ll get help in the event of a mental health crisis.
What does it mean to have a mental health crisis? If you think your loved one is in danger of hurting themself or someone else, it’s a crisis. If your loved one can’t care for themselves or function normally, they need to get help to avoid a worsening mental health crisis. Because schizophrenia symptoms include delusions, hallucinations, and disordered thinking, your loved one with schizophrenia may not realize they need help. They may not be aware they’re having trouble as a result of a mental health disorder. You need to be ready to get help for them, if needed.
You might think the best thing to do in a crisis is call 911. That’s what you do when there’s an emergency, isn’t it? Not necessarily. Usually calling 911 for an emergency means that the police will come, perhaps along with emergency medical services (EMS). While you should call 911 if you think you’re in immediate danger or it’s a life-threatening emergency, police don’t always know how best to help with a mental health crisis. That’s not what they’re primarily trained to do. Your loved one with schizophrenia who is having a mental health crisis might also feel threatened if police arrive, which could make matters worse.
Fortunately, many communities do have other crisis response resources to help you avoid or intervene in a mental health crisis. The key is to have a plan and know where to find those resources before you’re in the midst of a crisis. And, if at some point you do need to call 911, there are some things to know to help your loved one’s encounter with the police go well.
Finding Help When There’s a Mental Health Crisis
The mental health crisis services available to you will depend on where you live. It’s a good idea to look into what’s available in your community ahead of time. Here are some key elements to look for:
- 24-hour crisis hotline. This is a number you can call first as soon as you realize or even suspect your loved one is in crisis. They’ll ask questions to assess what’s going on and help you decide where to go for more help.
- Walk-in crisis services. These are walk-in clinics or urgent care centers that specialize in immediate psychiatric care. They can help you assess and manage the crisis without going to a hospital. They also may help you decide when it’s time to get care at the hospital or in another long-term care setting.
- Mobile crisis teams. This is a specially trained team of professionals that can come to you when a crisis is under way. Mobile crisis teams may work closely with the police, crisis hotlines, and hospitals. Mobile teams can help to assess the situation firsthand and connect you with other clinical or community-based services as needed.
Getting Treatment for a Mental Health Crisis
If you’ve decided on your own or with the help of a hotline, urgent care, or crisis team that your loved one needs immediate and continuing care, there will be more choices to make depending on what’s needed. Here are some of the options:
Residential Services. Crisis residential services can help get your loved one stabilized. They can help you resolve problems and connect with other sources of ongoing support. Services may include:
- Physical and psychiatric assessment
- Daily living skills training
- Social activities
- Treatment planning
Crisis residential services may be an alternative to the hospital. If your loved one has already been admitted to the hospital, these services may help after they leave the hospital.
Hospitalization. Your loved one may need to spend some time in the hospital for intensive treatment. Private psychiatric hospitals, general hospitals with a psychiatric floor, or state psychiatric hospitals are all equipped for intensive mental health treatment. They can observe your loved one, review their diagnosis, adjust medications, and help to stabilize them.
If your loved one agrees that they need inpatient treatment, they may be admitted on a voluntary basis. Some hospitals only care for patients who are there voluntarily. If your loved one with schizophrenia refuses to go to the hospital and is a danger to themselves or others, involuntary hospitalization may be an option. Before your loved one leaves the hospital, a social worker or case manager can help with a plan for their return home, including any ongoing support that they’ll need.
Emergency room. Sometimes a visit to an emergency room might be your only option. The ER is a good choice if you need immediate help for a crisis and don’t have anywhere else to go. Consider the ER if your loved one with schizophrenia has:
- Tried to kill themselves
- Hurt or threatened you or another person
- Heard voices or is confused and/or paranoid
Providers in the ER can help to assess your loved one’s mental health condition. They may offer treatment to stabilize your loved one and help you decide what to do next.
When You Need to Call 911 or Talk to Police
If you decide that you need to call 911 for help, make sure to let the operator know that your emergency is related to a mental health crisis. Ask them to send emergency responders who have Crisis Intervention Team (CIT) training. Police or other first responders are likely to handle the situation better if they know what to expect.
CIT-trained officers will know better how to avoid making the situation worse. They will be less likely to arrest or restrain your loved one with schizophrenia. They also can help connect you to other mental health crisis services.
If you find yourself in a situation where you need to talk to the police, stay as calm as you can. Remind them that "this is a mental health crisis." Offer to share any helpful information and then let them do their jobs. The goal is for everyone to manage the immediate crisis as calmly as possible before deciding what’s next.
Planning for a Mental Health Crisis
No one wants to think a mental health crisis will happen. But it’s best to have a crisis plan in place in case it does. A plan may help you and your loved one avoid a full blown crisis.
Ask if they have a plan in place first or will work with you to make one. If they won’t, go ahead and make a plan on your own. Make sure it includes a list of essential contacts and places where you can find help, if needed. With a solid plan in place, the hope is that you can get your loved one the help they need before you find yourself reaching for the phone to call 911.