In a Crisis

The mental and emotional suffering that comes with depression is no less painful or dangerous than physical pain.

Fighting depression is tough and many guys reach a point where they feel completely overwhelmed.

In times of crisis – whether that means you’re no longer able to care for yourself, are thinking of hurting yourself or ending your life, or hurting someone else – it’s critical to reach out and get support.

Just as we wouldn’t hesitate to go to the doctor or the hospital if we broke a bone or were in severe physical pain, we shouldn’t wait to reach out if we’re in danger of harming ourselves or others.

There is no shame in reaching out, but rather pride in taking action to preserve our health.

WHEN TO REACH OUT, AND HOW

If you are feeling overwhelmed, but safe and in control:

  • Call or message your current mental health specialist (if available/appropriate) or arrange an appointment with a therapist or doctor.
    • It’s a good idea to write some notes about how you are feeling right now, so you can bring them to your appointment.
  • Connect with a crisis line (info below)
  • See our Guide to Managing Suicidal Thoughts

If you feel like your life, or others, may be in danger:

If you get to the point where you don’t feel safe with yourself and your ability to restrain from acting on suicidal thoughts, it’s time to seek immediate support.

In these cases, the best option is to visit a hospital Emergency Room (ER). There you can explain what is going on in your life, the thoughts you are having, and get in-person support from a mental health professional.

  • To get to an emergency room to speak with a mental health professional for assessment (info below)
    • Call 9-1-1 or go to a hospital emergency room
    • Ask a nearby trusted friend to take you to a hospital emergency room
  • If there isn’t a hospital nearby, call a suicide crisis line to ask for services where you are, or call 9-1-1 and they can help to keep you safe.

This can also include no longer being able to take care of yourself (eg. feeling so depressed you are unable to get, prepare, or eat food).

Crisis Lines and Live Crisis Chat Support

Crisis lines offer non-judgemental and confidential support via phone or text. These lines have been created specifically to support people dealing with health issues, like depression. Crisis lines are operated by volunteers trained in mental health, active listening, crisis and suicide assessment and intervention.

Depending on location, healthlines are often available 24/7. This is the case in Canada, Australia, UK, US and many other countries (1-800, 1-877, and 1-888 numbers are toll free).

Canada

  • Talk Suicide Canada (1 833 456 4566): Provides immediate 24/7 help over the phone and also text message support during limited hours. Also features blogs, articles, and information regarding crisis support, and how to get help.

United States

  • 988 Suicide & Crisis Lifeline: Provides immediate 24/7 help over the phone, a directory for various other help-lines, and information on general lifelines and crisis support.

United Kingdom and Republic of Ireland

  • Samaritans (116 123): Provides immediate 24/7 help over the phone, and highlights information on how to get involved with a support group and how to deal with suicidal thoughts.
  • CALM (0800 58 58 58): The Campaign Against Living Miserably provides immediate 24/7 free and confidential help over the phone. They also organize campaigns that challenge male stereotypes and encourage getting support.

Australia

  • MensLine Australia (1300 78 99 78): Provides immediate 24/7 help over the phone, helpful men’s health guidelines and strategies, and free online counselling.
  • Beyond Blue Support Line (1300 22 4636): Provides immediate 24/7 help over the phone, online chat support 11 hours/day, and facilitates online chat forums hosted by community members.
  • Lifeline: Crisis Support and Suicide Prevention (13 11 14): Provides immediate 24/7 help over the phone, online chat support 12 hours/day, and hosts free online chats 5 hours/day.

Outside of Canada, US, UK, and Australia

  • Search online based on your country, state, province, or city and the words “crisis phoneline,” “distress phoneline,” “helpline,” “mental health line,” or “nurse line” to find a healthline near you.

TIPS TO KEEP IN MIND

Reaching out for support can seem intimidating, but it’s not that different from having a friend who’s a doctor we can call to find out what to do after spraining a knee.

Write down or save the number for your location

Write down the numbers for your area and keep them handy (add them to your phone or keep a note in your wallet). If you want or need to reach out, you’ll have the number on you and won’t need to look it up.

Let them know what’s bothering you or what you need help with

If you’re stressed, worried, or depressed and it’s affecting your life, let them know.

You can say something like:

  • “I can’t keep up with work (or school). I’m feeling really overwhelmed.”
  • “I don’t have any energy these days, I don’t know where to start with getting better?”
  • “I’ve been struggling with depression and don’t really know how to get better.  What services can I try?”

You can always try again

If you call and don’t find it useful, you can always say thanks and hang up, or try calling a different healthline.

Be honest, especially about suicidal thoughts

There’s no need to sugar-coat things. If you’re going through some pretty rough times – let them know.  The best support comes from you being honest.

Crisis lines exist to help people in times of suicidal crisis – it’s what they’re trained to do. Tell the person on the line what you are thinking and let them point you toward resources and services to get better. Suicidal thoughts are a symptom of depression and ignoring them won’t make they go away.

9-1-1 AND HOSPITAL EMERGENCY ROOM (ER)

An emergency is any situation in which our lives (or someone else’s) are at immediate risk.

This can include:

  • Thinking about ending our life or putting ourselves in grave danger.
  • Being unable to care for ourselves (not getting enough to eat and drink) and putting our health in serious jeopardy.
  • Taking a dangerous combination of medications and/or alcohol.
  • Thinking about hurting others.

In these kinds of cases, don’t hesitate to call 9-1-1 (or your local emergency telephone number, 112 in most European nations, or 000 in Australia) or go to the nearest hospital emergency room.

Some guys think calling 9-1-1 or going to a hospital is a signal that all is lost. But going to a hospital is the smartest thing to do if your depression is severe and overwhelming. Getting crisis support shouldn’t be construed as failure, but rather as getting the right support at the right time.

Through an ER, you will meet with an emergency room doctor and a psychiatric nurse and/or on-call psychiatrist for assessment.

TIPS FOR REACHING OUT

What you can say if calling 9-1-1

You can say something like:

  • “I am battling depression, and I can’t stop thinking about ending my life. I don’t feel safe. Can you send someone to take me to the hospital?”
  • They will ask about the situation and where you are so they can send help and won’t let you off the phone until help arrives.

What you can say, if asking a nearby trusted friend to take you to the hospital

You can say something like:

  • “You know how I’ve mentioned before that I’m really depressed? Right now, it’s gotten worse. Tonight, I can’t stop thinking about ending my life… I need a lift to the hospital to see if I need to be admitted, can you help me get there?”

WHAT TO EXPECT WHEN GOING TO THE EMERGENCY ROOM (ER)

Prepare yourself for some stress as going to the ER can be a frustrating process and it may take a long time to finally be seen. Sometimes though, being in an ER waiting area can help provide a sense of calm and control as you take action to safeguard your health.

Try not to let worries or fears of being ‘locked up’ prevent you from reaching out and sharing your suicidal thoughts with others. Today’s inpatient services are very different from how they are often negatively portrayed in popular media.

Like treating other illnesses or injuries, hospital care can be a crucial temporary step needed for some guys’ recovery – there is no shame in this. Many men have had to seek support at a hospital and were able to get better because they did.

Once you get to the emergency room, here’s what to expect:

Present at hospital triage

What you can say:

  • “I’m feeling very depressed and am fearful for my safety.”
  • “I’ve been having suicidal thoughts and I’m worried about acting on them.”

Follow standard hospital procedures

This includes filling out forms, a quick screening by a nurse, and waiting to see a doctor, which can be anywhere from one to several hours depending on how busy the hospital is. If you wait a long time, just be assured that you are in a safe place.

Meet with a nurse or doctor

You will meet with an emergency room doctor and a psychiatric nurse and/or on-call psychiatrist for assessment. Your admittance to hospital often depends on how much space the hospital has. Unless you have a clear plan to harm yourself or others and are at immediate risk to act on such plans, you may not be admitted. If you have a family doctor, they may try to contact them to ask for more information.  It’s really important to be honest and let them know how you are feeling and what you are thinking.

Admitted to inpatient services

If admitted, our steps from here can vary widely depending on where we live, whether or not our visit was voluntary (for example, after an attempted drug-overdose a person will be incapacitated and not capable of providing consent), and what space is available in hospital. Most hospitals that offer inpatient services have specific acute crisis wards, but in practice they will fit you in wherever possible.

Hospital stays can last anywhere from a couple of weeks to several months, depending on the speed of your recovery.  Learn more about emergency and inpatient services.

Referred to additional outpatient resources

If not deemed a threat to ourselves or others, we will not be admitted to hospital and instead will be referred to other outside resources. In this case, it’s important to follow up with the referred supports, and also with a family doctor.