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If you want to help a family member in a mental health crisis over the holidays – or at any time during the year – here’s the essential information you and everyone in your family need at the ready:

988 is the National Suicide and Crisis Lifeline

TO ACCESS IMMEDATE SUPPORT:

Dial 988 for mental health crisis support 24/7/365
Text 988 for support via text
 Text NAMI at 741741 for support via text
Visit 988lifeline.org to chat online

The holidays can be the most wonderful time of year, and that’s why millions of people around the country love them.

But not everyone loves the holiday season.

Why?

Because many of things that make it the most wonderful time of the year for some – being home, seeing family, revisiting old memories – can make it the most challenging time of the year, psychologically and emotionally, for others.

For a person with a mental health disorder, being home during the holidays can feel like a pressure-cooker. They come face-to-face with many of the issues that cause them distress and pain. If they haven’t received treatment, or they have but the emotions become to overwhelming, the situation may become completely overwhelming.

That’s when family issues that simmering below the surface can blow up – and that’s when a family member might escalate from having a hard day to having a full-blown mental health crisis.

If that happens, you may or may not know what to do. If you don’t, then this article offers a set of steps you can take to help your family member move from crisis to support to stability.

Compassion and Communication

Our first piece of advice is perhaps the most important:

If a family member is in a mental health crisis, avoid personalizing the situation. The crisis is not about you: it’s about them, their emotions, and what they need to achieve safety and stability.

Take that to heart, and it will help you navigate not only any acute crisis that happens during the holidays, but also the entire experience of living with a family member with a mental health disorder. With that said, we’re ready to offer our list of tips for supporting a family member in a mental health crisis over the holidays.

How to Help A Family Member During a Mental Health Crisis

1. Make a Plan Beforehand

If you have a family member with a mental health disorder, you know a crisis is possible – and if you didn’t, we’re telling you now: a crisis is possible. Mental health experts advise creating a WRAP: a Wellness Recovery Action Plan. Each WRAP is unique to each family and individual, and includes resources to access during a crisis. To create your resource list, start here:

  • Phone numbers of professionals who already support your loved one:
    • Therapist, psychiatrists, counselors, healthcare providers
    • Trusted friends
    • Other family members living elsewhere who may be helpful
  • Crisis line phone numbers (see above)
  • Addresses:
    • Walk-in crisis centers
    • Emergency rooms
  • A personal history sheet for your loved one that lists:
    • Their name, address, and phone number
    • Your name, address, and phone number
    • Any current mental health diagnoses
    • Any current medication
    • Crisis history: overdose, breakdown, suicide attempts
    • Alcohol or substance use history
    • Likely triggers
    • Things that help

When making your plan, it can also help to learn whether your local police officers have received Crisis Intervention Training (CIT).

2. Stay Calm and Communicate Clearly

One thing we can guarantee will not help is anger or frustration from you. If you’re in an emotionally reactive state, it may be best for you to step back and take a breath before engaging, or let another family member take the lead. If you’re balance and stable – after a few deep breaths – then here’s how you communicate with someone in crisis:

  • Stay calm
  • Listen first, listen with compassion. It’s absolutely essential they feel heard, understood, and supported. To ensure they know you’re there for them – really there for them – practice active listening:
    • Learn forward
    • Make eye contact
    • Ask simple, direct, open-ended questions, but don’t interrupt
    • Keep your voice even, peaceful, and calm
    • Reflect back what you hear, without adding advice or editorializing
    • When listening, don’t plan your response – that’s not listening, that’s planning your response
    • Pay close attention to their body language and non-verbal cues

The most important part of listening is creating an environment that encourages your loved one to talk. Let them talk as long as they want. Talking things out can be healing, and in some cases, can facilitate the end of a mental health crisis.

3. Seek Professional Crisis Support

If talking and listening doesn’t de-escalate the crisis, it’s time to seek professional support. Suggest to your family member you want to call or you want them to call a crisis line.

Don’t do anything about them without consent from them.

It’s possible talking to someone on a crisis line will de-escalate the situation completely, and end the crisis. However, if the crisis persists, you may need to consider taking them to a psychiatric hospital.

But don’t do anything about them without consent from them.
They need to feel empowered, feel agency, and feel like they have a say – even when they’re in crisis.

However, if they’re in imminent danger/risk of harm, you’re in imminent danger/risk of harm, or another family member/friend is in imminent danger, then the best option is to call 911. When physical safety is at risk, maintaining that safety supersedes their feelings of agency.

If someone in your family does call 911, here are important steps to take:

  • Ask for a responder trained in crisis intervention (CIT).
  • Be clear about the nature of the emergency, and share everything you know:
    • Diagnosis
    • Symptoms
    • Presence of alcohol/drugs
    • Any other factors that increase risk
    • Factors that may decrease risk
  • If you have any reason to believe your family member will seek to provoke an extreme reaction from a police officer, relay that information to the dispatcher clearly, and repeat it until you’re sure the dispatcher will relay the information to the responders.
  • Stay with your family member to help them feel safe
  • Stay with your family member to facilitate communication
  • Call local crisis centers and ask if they can send a professional crisis intervention specialist to your location to advocate for your loved one, and mediate the encounter if necessary

Those three tips can help you manage a mental health crisis in a family member or other loved one this holiday season. We’ll reiterate that when an individual is in crisis, your first job is to maintain your personal safety, your second job is to maintain the safety of your family, and your third job is to do your best to de-escalate the crisis.

Always remember safety comes first.

What Happens After a Mental Health Crisis?

Whether you’re able to de-escalate the crisis yourself, or you enlist the support of a mental health professional via hotline or a first responder by calling 911, the first thing to do is check yourself and check your family.

Are you okay?

Are they okay?

A mental health crisis can be traumatic for everyone involved. If children or adolescents are in the home, they may need professional counseling to help process powerful and confusing emotions. You may need professional counseling and support, too.

Once you check yourself and your family, it’s time to set expectations. If your loved one required emergency hospitalization, you can talk with the medical staff at the facility to find out when they’ll be released – and you can make your plan based on that. If the crisis passed without the need for emergency hospitalization, it’s time to have an open and honest conversation with your loved one, with three primary goals:

  1. How to avoid or prevent a crisis in the future
  2. How to manage any subsequent crises.
  3. Set expectations for the future

Achieving all three goals will require collaboration between you and your family member/loved one. They’ll guide the first two, and you’ll likely guide the third goal. If you expect them to engage in professional treatment, then make that clear. If they’re already in treatment, it’s reasonable to suggest a more immersive level of care.

Those are examples of possible expectations you may set. Any plans for treatment or changes to treatment, e.g. seeking support for the first time or moving up or down a level of care, must be the result of a collaboration between you, your family member/loved one, and a mental health treatment professional.

Finding Help: Resources

If you or someone you know needs professional treatment and support for a mental health disorder, please contact us here at Crownview Psychiatric Institute: we can help. In addition, you can find support through the following online resources: