Responding to those in mental health crisis
This is part of a helpful series of weekly articles and stories on Mental Wellbeing presented by Suzie Baird and Tricia Hendry to help the Church build our knowledge, understanding, and skills to strengthen our communities.
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As churches, we’re communities doing life together and loving one another through thick or thin. At any one time there will always be some of us facing a crisis of some kind. If we know someone facing a mental health crisis, how best can we support them? How can we show them empathy, compassion, and respect?
A mental health crisis happens when a person’s mental distress is so great that they’re unable to care for themselves or function in a healthy way, or they’re at risk of harming themselves. It can take many forms, such as frequent panic attacks, serious depression, paranoia, or attempting suicide.
We can’t always tell what a person is dealing with. Sometimes it’s clear they’re having difficulty managing their distress because there are indicators we notice, such as:
rapid mood swings, from high energy to low, ups to downs
increased agitation
erratic, impulsive, or reckless behaviour
aggression; verbal threats
struggling with daily tasks, like getting dressed, basic hygiene, basic housework, etc.
self-abusive behaviour, including substance use or self-harm
withdrawing and isolating from friends, family, whānau, and church family
sleeping a lot more, or difficulty sleeping at all
negative outlook; hopelessness; suicidal thinking
loses touch with reality (psychosis) – finds it hard to recognise family or friends, confused, strange thoughts and ideas, hears voices, sees things that aren’t there
paranoia – the feeling that they're being threatened in some way, such as people watching them or acting against them.
Please note: for some people, these symptoms may be part of their ongoing mental health journey and they may not be in crisis. They may be having a hard day. If you’re not sure, ask the person how they are doing.
How can I help?
The most important thing you can do for someone is show you are concerned for their wellbeing and let them know you want to support them through it. Their struggle may be so great that you feel a sense of crisis too but try to stay calm. I find sending up quick prayers helps, asking Jesus to be with me and the person I am with.
Here are some general strategies to use:
Listen to them well, without judgement. Use body language and eye contact to show you’re listening. Talking can take a lot of trust and courage. Let them share as much or as little as they want to.
Don’t minimise their experience. It can be frightening seeing, hearing, or believing things others don’t. Don’t reinforce or dismiss their experiences but do acknowledge how they’re feeling.
If they’re very confused, gently remind them who you are and that you’re there to support them.
The situation may be confronting and unsettling. Take some deep breaths. Fire off some prayers. Continue to keep calm and be patient.
Focus on their immediate needs in that moment. Ask them what would help. Consider offering simple things, like a snack or a meal, a drink of water or cup of tea, going for a walk together, or sitting outside for a bit. Ask what’s helped most in the past.
Check if there’s anyone they would like you to contact.
Reassure. Remind them they don’t always have to feel like this and that they’ll begin to recover with some extra help.
Avoid confrontation. However, if aggression escalates, look after your own (and others’) safety.
Know your limits. If you’re not an expert, don’t pretend to be and don’t ever diagnose. Encourage them to seek appropriate professional help. Offer help to get this assistance, such as giving them a phone number to call or taking them to an appointment.
Unless it’s an obvious emergency, enable the person to make choices and decisions for themselves. Confidentiality should only be broken when a person appears to be at risk of harm to themselves, or others, and immediate crisis help is needed.
If they have hurt themselves, get them the assistance they need.
Keep in touch with them. Think practical. Maybe consider sharing a meal or a coffee.
If they’re feeling suicidal, or you suspect they are:
Have an honest conversation about this. Encourage them to get help. If you think they’re at immediate risk of harm, first remove potential means to reduce risk. Then either you can call 111, go with them to a doctor or emergency department, or call your DHB’s mental health crisis team. Stay with them until help comes.
This link provides the contact details for DHB mental crisis services in your region – see page 7 and 8: https://www.mentalhealth.org.nz/assets/Helplines-and-local-mental-health-services/MHF-Helplines-A4-WEB-FINAL.pdf
An alternative is calling or texting 1737 to speak with a trained counsellor together, anytime of the day or night. You could also call any helpline and take this approach. The above link provides a list of these.
We’ll be talking about supporting those who are suicidal in later posts.
Providing support in a crisis can often take a toll on support people too
It’s important to take care of yourself as well. Find someone trusted to talk with, to debrief a bit. If you are in ministry, seek some professional supervision. Ask the person if there are others who could become part of a support team around them.
“This is my commandment, that you love one another as I have loved you.” John 15:12
By Tricia Hendry
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Suzie Baird is a mental health advocate. She has lived experience of mental distress that helps her to support others and educate those wanting to understand more. She attends Lyall Bay Community Church, an Anglican pioneer mission unit.
Tricia Hendry is a writer and educator specialising in issues relating the mental health and resilience. She has many years’ experience supporting others through mental health and trauma challenges. She attends All Saints, Hataitai.
