What to Do if You Notice Symptoms
If you think you notice symptoms, schedule an appointment with a licensed psychiatrist or psychologist as soon as you can, or if that is not possible, then with your pediatrician or primary care physician. Make sure that you provide your healthcare professional with as much detailed information as you can:
- Past mental health evaluations and other medical records
- Descriptions of symptoms, when they began, and whether they have changed over time
- Any medications or other medical treatments that your child is receiving
- Anything else that is requested or that you think might be valuable information
If a doctor, psychologist or counselor does not provide a diagnosis or referral to another professional, you should ask why and consider their reasoning. If you disagree, trust your instincts and seek a second opinion. It is often better to be cautious than to ignore a potentially serious problem.
If your child reports seeing or hearing things that are not there, without the influence of drugs or alcohol, then you should seek medical treatment immediately. This may be an episode of psychosis. Such episodes might also include: spontaneous violent behavior, denial of reality, nonsensical and paranoid claims, removal of clothing, reckless and dangerous behavior, or claims of invincibility and other special powers.
Calling 911 and Talking with Police
If a situation escalates into a crisis, you may have to call the police. Thankfully, there are a few things you can do to keep the situation as calm as possible.
On the Phone
Share all the information you can with your 911 operator. Tell the dispatcher that your loved one is having a mental health crisis and explain her mental health history and/or diagnosis. If the police who arrive aren't aware that a mental health crisis is occurring, they cannot handle the situation appropriately. Many communities have crisis intervention team (CIT) programs that train police officers to handle and respond safely to psychiatric crisis calls. Not every police officer is trained in a CIT program, but you should ask for a CIT officer if possible.
During a Crisis
Police are trained to maintain control and ensure safety. If you are worried about a police officer overreacting, the best way to ensure a safe outcome is to stay calm. When an officer arrives at your home, say "this is a mental health crisis." Mention you can share any helpful information, then step out of the way. Yelling or getting too close to the officer is likely to make him feel out of control. You want the officer as calm as possible.
Be aware that your loved one may be placed in handcuffs and transported in the back of a police car. This can be extremely upsetting to witness, so be prepared.
What Can the Police Do?
- Transport a person who wants to go to the hospital. A well-trained CIT officer can often talk to a person who is upset, calm him down and convince him to go to the hospital voluntarily.
- Take a person to a hospital for an involuntary evaluation. In certain circumstances, police can force a person in crisis to go to the hospital involuntarily for a mental health evaluation. The laws vary from state to state.
- Check on the welfare of your family member if you are worried about her or can't reach her. Call the non-emergency number for the police department in your community and explain why you are concerned. Ask them to conduct a welfare check.
It can be frightening and intimidating when a loved one reveals or shows signs of suicidal thoughts. However, not taking thoughts of suicide seriously can have a devastating outcome. If you think your friend or family member will hurt herself or someone else, call 911 immediately. There are a few ways to approach this situation.
- Remove means such as guns, knives or stockpiled pills
- Calmly ask simple and direct questions, such as “Can I help you call your psychiatrist?” rather than, “Would you rather I call your psychiatrist, your therapist or your case manager?”
- Talk openly and honestly about suicide. Don’t be afraid to ask questions such as “Are you having thoughts of suicide?” or “Do you have a plan for how you would kill yourself?”
- If there are multiple people, have one person speak at a time
- Ask what you can do to help
- Don’t argue, threaten or raise your voice
- Don’t debate whether suicide is right or wrong
- If your loved one asks for something, provide it, as long as the request is safe and reasonable
- If you are nervous, try not to fidget or pace
- If your loved one is having hallucinations or delusions, be gentle and sympathetic, but do not get in an argument about whether the delusions or hallucinations are real
If you are concerned about suicide and don’t know what to do, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255). They have trained counselors available 24/7 to speak with either you or your loved one.
Even if your loved one isn't in a moment of crisis, you need to provide support. Let her know that she can talk with you about what she is going through. Make sure that you are actively and openly listening to the things she says. Instead of arguing with any negative statements that she makes, try providing positive reinforcement. Active listening techniques such as reflecting feelings and summarizing thoughts can help your loved one feel heard and validated. Furthermore, reassuring your loved one that you are concerned for her well-being will encourage her to lean on you for support.
No one wants to worry about the possibility of a crisis, but they do happen. That doesn't mean you have to feel powerless. Many healthcare providers require patients to create a crisis plan, and may suggest that it be shared with friends and family. Ask your loved one if he has developed a plan.
A Wellness Recovery Action Plan can also be very helpful for your loved one to plan his overall care, and how to avoid a crisis. If he will not work with you on a plan, you can make one on your own. Be sure to include the following information:
- Phone numbers for your loved one’s therapist, psychiatrist and other healthcare providers
- Family members and friends who would be helpful, and local crisis line number
- Phone numbers of family members or friends who would be helpful in a crisis
- Local crisis line number (you can usually find this by contacting your NAMI Affiliate, or by doing an internet search for “mental health crisis services” and the name of your county)
- Addresses of walk-in crisis centers or emergency rooms
- The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
- Your address and phone number(s)
- Your loved one’s diagnosis and medications
- Previous psychosis or suicide attempts
- History of drug use
- Things that have helped in the past
- Mobile Crisis Unit phone number in the area (if there is one)
- Determine if police officers in the community have Crisis Intervention Training (CIT)
Go over the plan with your loved one, and if he is comfortable doing so, with his doctor. Keep copies in several places. Store a copy in a drawer in your kitchen, your glove compartment, on your smartphone, your bedside table, or in your wallet. Also, keep a copy in a room in your home that has a lock and a phone.
Learn All that You Can
In addition to seeking help from healthcare professionals, you should educate yourself as much as possible about your child’s mental health condition. NAMI Basics is an educational class that teaches parents and other family caregivers how to cope with their child’s condition and manage their recovery. You can also find information about specific mental health conditions and treatment options on the NAMI national website (https://www.nami.org).