Mental health professionals are encouraging people to recognize warning signs earlier, including feelings of being overwhelmed, not feeling like themselves, and changes in sleeping patterns, behavior, and mood.
Data from the U.S. Centers for Disease Control and Prevention reveals America faces significant mental health challenges. Young people, particularly girls, are increasingly reporting poor mental health conditions. Although the national suicide rate decreased slightly in 2024, it dropped from historically high levels.
Mental health emergencies can develop suddenly or gradually escalate over time. They may stem from unexpected loss, traumatic experiences, personal or social disruption, underlying medical conditions, or multiple contributing factors.
Regardless of the trigger, professionals emphasize starting conversations early and establishing connections to broader support networks.
EDITOR’S NOTE: This story discusses suicide. Anyone needing assistance can contact the national suicide and crisis lifeline by calling or texting 988.
Mental health specialists explain that crisis definitions differ among individuals, but certain warning indicators suggest someone may be struggling, often beginning subtly.
“My crisis might not be your crisis, but what we do know is that — however people define crisis — there is a change in how they’re feeling, a change in how they’re behaving,” stated Dr. Theresa Miskimen Rivera, president of the American Psychiatric Association.
Emergencies may begin with depression or anxiety feelings without clear causes, Miskimen Rivera explained.
Additional warning signs include:
— Losing interest in previously enjoyed activities
— Withdrawing from social interactions
— Experiencing sleep disturbances
— Neglecting personal hygiene
— Increasing alcohol or drug consumption
— Displaying severe mood fluctuations
— Expressing feelings of being burdensome
— Feeling hopeless, expressing death wishes or suicidal thoughts, lacking purpose
When these changes appear, professionals recommend initiating conversations.
Crisis intervention specialists suggest researching and preparing before approaching someone experiencing difficulties.
Resources and guidance are available through organizations like the National Alliance on Mental Illness, The Trevor Project, the American Psychological Association, and 988, the national mental health crisis hotline. People can contact 988 through calls, texts, or chat for conversation guidance.
“We get more than 10 million calls, chats and texts a year, and a lot those are actually people just looking for resources for someone in their life that’s struggling,” said Tia Dole, who oversees the lifeline.
Alex Boyd, director of crisis intervention at The Trevor Project, which operates a suicide prevention hotline for LGBTQ+ youth, suggests structuring initial conversations into four components:
— Begin with open-ended questions acknowledging behavioral changes. Example: “I noticed you haven’t been showing up to (the space we share) recently. I want to check in. What’s going on?”
— Communicate care and concern
— Inquire about their crisis experience: “What’s been going on for you that has led you to (name the change in behavior)? What’s changed for you? What are you concerned about?”
— Recognize difficult circumstances and ask directly about suicide or self-harm thoughts. Consider additional support resources, remembering your role is supportive, not therapeutic. Ask: “What would feel helpful right now?”
Professionals dispel the misconception that asking about suicide contemplation plants the idea in someone’s mind.
Though potentially uncomfortable, directly asking about self-harm or suicide plans and intentions remains crucial.
When someone has a plan, Boyd suggests responding: “What would lead you to actually take that step? Because that sounds scary. I don’t want that to happen. What would lead you to feel more escalated to act on the plan?”
If immediate danger exists, seek professional assistance immediately. Ideally, collaborate with the person in crisis to maintain their autonomy and build confidence in seeking help, Boyd advised.
Contacting 988 or similar helplines connects callers to crisis intervention teams and specialized resources.
Emergency services through 911 or hospital emergency rooms remain options, though not all emergency personnel receive mental health intervention training.
Mental health crises involve complexity, requiring understanding of cultural stigmas and potential conversation barriers.
Some individuals may withdraw when hearing diagnostic terms like “depression” and “anxiety,” Dole noted. Others might remain silent initially but return for discussions days or weeks later.
Dole recommends “parallel activities” to reduce conversation pressure. Creating mental health discussion opportunities during walks or car rides allows people to open up without forced eye contact or formality.
Validating and normalizing experiences without minimizing them is essential, experts emphasized. Avoid dismissing concerns as temporary phases. Sharing personal experiences can help, but avoid making conversations self-centered.
Loved ones may require ongoing support navigating extended care and mental health system complexities. Options may be restricted by insurance coverage, location, or personal identity. Finding suitable therapists may require multiple attempts.
“Getting help — the traditional, clinical help — is really hard,” Dole said. “It takes perseverance to find a clinician.”
She encouraged exploring non-medical resources, including faith communities, community centers, and educational institutions.
Most importantly, don’t allow a loved one’s struggles to change your perception of them.
“Being suicidal or having a mental health crisis does not diminish who they are as your loved one,” Dole said. “They’re still them.”
