Abrupt changes in thinking, behaviour, hallucinations, and severe confusion can be frightening for the person experiencing it, and also for the people around them. When someone’s thinking and perceptions cause them to want to hurt themselves or others, it becomes an emergency and they need help quickly.
What to do
As with any other emergency, first try to check breathing, stop any bleeding, and check for other physical injuries.
Then reassuring, calming and comforting a person having a mental health emergency can save lives.
If the person is dangerous to others, it is often easier to move other people away than to move him. You may need help to make him and the area around him safe. And look out for your own safety as well.
If the person says s/he wants to hurt or kill himself, the first thing s/he needs is someone to listen calmly. Ask gentle questions, to show you care and to be sure you understand. Your questioning can help to interrupt his thoughts and distract him from his purpose. Some indicative questions are as follows.
Ask if s/he plans to hurt himself or someone else, or if s/he has already done so.
Ask how s/he plans to do it, and if s/he has the means to do it. The more specific the plan, the more serious the problem.
Ask the person to make an agreement that s/he will not hurt himself or others. Take away the means s/he would use to hurt himself or others.
Making an agreement like this can keep someone OK long enough to get more lasting help.
Do not leave the person alone. Stay with the person, or have family members or friends stay with him/her.
Make sure s/he stays sober and does not drink alcohol or use drugs. Alcohol or drugs can further cloud his/her judgement and make self-harm more likely.
It may be helpful to seek the help of spiritual or community leaders who s/he respects.
Following up to see that s/he continues to get help, and to show that you care about him/her, is important.