Crisis Intervention

Life can shift in a moment. What seemed manageable one day can suddenly feel overwhelming the next. For someone experiencing the intense distress, confusion, or despair of a mental health crisis, it can feel like there’s no way forward. In these moments, support matters. As a short-term approach for people experiencing acute distress, crisis intervention connects people to safety, resources, and compassionate support during their most vulnerable moments.

What is a Mental Health Crisis?

A mental health crisis is any situation in which someone’s thoughts or behavior puts them at risk of harming themselves or others or prevents them from being able to care for themselves. Myriad situations can lead to a crisis, including everything from ongoing mental health issues, domestic violence, and substance misuse to more situational causes such as grief, job loss, and trauma ^[1]. 

While the situations mentioned earlier may all sound alarming, crises don’t always involve overt signs. Some people retreat into silence while others lash out in confusion or fear. Regardless of its outward appearance, a mental health crisis signals an urgent need for care and connection, whether that’s immediate intervention, ongoing support, or protection from harm. 

Suicide and Crisis Warning Signs 

A mental health crisis doesn’t always come with a clear warning, but sure signs may suggest that someone is at increased risk. Warning signs include dramatic mood changes, sudden depression and withdrawal, and even increased energy, pacing, or sudden happiness after a depressed mood. Additional warning signs include agitation, isolation, paranoia, psychosis, an inability to perform daily chores and maintain personal hygiene, and abusive behavior to oneself or others ^[1]. 

When it comes to suicide, warning signs also include verbal statements about wanting to die, feeling trapped, being a burden to others, or having no reason to live. Additionally, changes in behavior can signal increasing risk, particularly when someone begins giving away prized possessions, saying goodbye to friends and family, increasing substance use, withdrawing, sleeping too much or too little, and more ^[2]. 

If someone’s behavior raises concern, it’s always better to reach out immediately than to wait. Acting early, even if warning signs seem minimal, can help prevent a crisis or lessen its impact. Whether it’s for a loved one or oneself, getting mental health support is never an overreaction.

National Hotlines for Immediate Support

When someone faces a mental health crisis, knowing where to turn can make all the difference. There are a host of free and confidential national hotlines available 24/7, many of which offer phone, text, chat, and other messaging options. Additionally, some crisis intervention options assist in multiple languages and provide special assistance for those who are deaf or hard of hearing. 

National support resources for mental health and suicide crises include:

• 988 Suicide & Crisis Lifeline: Call or text 988 or chat at 988lifeline.org. This service offers support for anyone in emotional distress with services in English and Spanish, and for the deaf or hard of hearing. 
• Crisis Text Line: The Crisis Text Line offers 24/7 crisis support. Text HOME to 741741, or visit crisistextline.org to chat or connect via WhatsApp. 
• SAMHSA National Helpline: Offered by the Substance Abuse and Mental Health Services Administration (SAMHSA), this free and confidential helpline provides confidential treatment referrals and information for mental health or substance use concerns. Call 800-662-HELP (4357) for help in English and Spanish.
• 911: If the crisis is life-threatening, reach out to local emergency services via 911, or visit a local emergency department. 
• 211: Call 211 or visit 211.org to find local support for housing, food, mental health, and more.
• Global Emergency Resources: Visit mentalhealth.com/emergency for a complete list of international emergency resources.

These services can be a lifeline during moments of deep distress, offering calm, clarity, and connection when it’s needed most. Help is always just a call, text, or chat away.

Specialized Crisis Intervention Options

Mental health crises affect people from all backgrounds, but not all situations and needs are the same. A few examples of specialized crisis lines and resources include:

• Boys Town National Hotline: Call 800-448-3000 or visit BoysTown.org for mental health support for children, teens, and parents.
• National Domestic Violence Hotline: This hotline supports people experiencing domestic violence. Call 800-799-SAFE (7233), text START to 88788, or visit TheHotline.org. 
• StrongHearts Native Helpline: Offering culturally appropriate support for Native Americans and Alaska Natives experiencing domestic or sexual violence, this helpline can be reached via call or text at 844-7NATIVE (762-8483) or through StrongHeartsHelpline.org. 
• Trans Lifeline: Call 877-565-8860 or visit TransLifeline.org to reach a peer support service run by and for trans people that provides emotional and crisis support without nonconsensual active rescue. 
• The Trevor Project: Call 866-488-7386, text START to 678678, or visit TheTrevorProject.org to reach crisis intervention and suicide prevention services for LGBTQ+ youth under age 25.
• Veterans Crisis Line: Veterans, active-duty service members, and military families can access mental health and crisis care by calling 988 and pressing 1 or chatting at VeteransCrisisLine.net, where additional international hotline numbers are available.

The American Psychological Association offers additional hotline resources, including those for child abuse, substance misuse, farmers’ issues, and more. 

Deciding When and Whom to Call

Making that first call to a crisis intervention helpline can be scary. But research shows most people benefit from the experience. A recent study found that even though a hotline call is typically a person’s first connection to mental health services, which can be intimidating in itself, 99.5% of people who reached out felt the experience was helpful ^[3]. Statistics about hotline use further support this claim. Since launching in July 2022, the 988 Suicide & Crisis Lifeline has received more than 11 million calls, nearly 3 million texts, and 2.5 million chats ^[4]. 

Given these stats, the importance of crisis intervention is obvious. However, it’s not always easy to recognize when someone is in urgent need of help. Emotional distress can take many forms, and in the moment, it can be difficult to tell if a situation is life-threatening, urgent, or simply overwhelming. Deciding whether to call 911, contact a crisis line, or schedule a mental health appointment can feel confusing. Understanding the differences between these options can make it easier to get the right help when it matters most. 

When to Call 911

Call 911 or go to the nearest emergency room if someone is in immediate danger, such as if they’re unresponsive, experiencing a medical emergency, or threatening violence or harm. Emergency services are best equipped to handle life-threatening situations and can offer medical care, protection, or hospitalization if needed. If it’s unclear whether a situation is an emergency, it’s safer to call 911 and let trained professionals make that determination ^[1]. 

When to Call a Crisis Line

Crisis intervention hotlines such as the 988 Suicide & Crisis Lifeline are ideal when someone is in emotional distress but not in immediate physical danger. This could include thoughts of suicide without a plan, severe anxiety, panic, feelings of overwhelm, or the need to talk through a difficult situation. Crisis counselors can help provide a sense of calm and connect people to resources and ongoing care if needed ^[1]. 

Remember, crisis lines aren’t just for people at immediate risk of suicide. They’re also for anyone feeling anxious, scared, alone, or unsure of what to do next. While 911 is likely a better option if serious physical injuries, weapons, or elements of violence are involved, a crisis line is an excellent option for those who need immediate guidance and support.

When to Make a Mental Health Appointment

If someone isn’t in crisis but has been struggling with ongoing issues like depression, anxiety, substance misuse, or stress, scheduling an appointment with a mental health professional, such as a psychiatrist, counselor, therapist, etc., can be a valid option. If a person’s concerns are urgent but they’re not in immediate danger, a mental health professional may be able to assess the situation and provide guidance about next steps ^[1].

SAMHSA offers a valuable search tool at www.FindTreatment.gov that allows users to search for mental health and substance use disorder treatment options according to their locations. Plus, myriad filters, ranging from types of care and service settings to payment options, accreditations, and language services, help users tailor results to their needs. 

What to Expect During a Call

Many people hesitate to contact a crisis line simply because they don’t know what to expect. After all, reaching out for help can feel intimidating. But knowing what happens during a call, text, or chat can make it a little easier to take that first step.

When someone reaches out for help via phone, they typically first hear a brief recorded message with options for specialized or language support. After choosing their preferred options, they’re connected to the next available counselor or responder. Some are licensed professionals while others are trained volunteers, but they should be equipped to offer empathy, support, and guidance ^[5]. 

From there, the conversation depends on what each person needs. The counselor may ask questions to understand the situation better. However, the caller doesn’t have to share anything they’re not comfortable revealing, and they can end the conversation at any time. Most importantly, the focus is on helping the caller feel safe and heard ^[5]. 

For those in immediate danger, counselors may assist in connecting them with emergency services. Conversely, suppose the person is overwhelmed but not in a life-threatening situation. In that case, counselors can help them explore next steps, whether that’s talking to a loved one, connecting with a therapist, or accessing community resources. For many people, the call itself is enough to create a sense of calm, clarity, and hope ^[5].

Crisis Intervention Next Steps

While crisis lines are designed to help at the moment, they also serve as a bridge to resources that extend beyond immediate emotional support. In many cases, crisis counselors recommend follow-up services such as outpatient therapy, community mental health programs, support groups, or primary care providers. Some crisis line counselors can also assist in locating local options, including clinicians who accept specific insurance plans or offer sliding-scale fees. Plus, for those without an established care team, crisis services can guide how to begin. 

Regardless of the outcome of the call, follow-up is an important part of recovery. Emotional distress can fluctuate, and sustained mental health care helps build resilience, identify warning signs, and develop effective coping strategies. Whether the next step involves attending an appointment, confiding in a trusted support person, or simply taking time to rest, forward movement doesn’t have to be dramatic; it just has to continue.

From Immediate Help to Long-Term Healing

Crisis support is more than just a lifeline in the moment; it’s often the first step toward safety, clarity, and long-term care. Whether someone is overwhelmed, supporting another in distress, or uncertain about what to do next, these services offer calm, evidence-based direction in the face of instability.

Granted, reaching out may feel difficult, especially during moments of intense emotional strain. But crisis intervention services are designed to meet people where they are, with compassion, without judgment, and with a focus on progress. Even a single call, text, or chat can be the start of meaningful, lifelong change and improved well-being.