Help in a Crisis

“Having some experience preparing, I was able to remain calm and call 9-1-1 while helping to ensure my friend’s safety until First Responders arrived.”

Suicidal thoughts arise from profound pain, hopelessness, and/or emptiness (like life has lost all meaning). The despair that underlies suicidal thoughts can be all-encompassing.

Though depression carries a risk of suicide, research and experience has shown that with timely intervention, suicides are preventable.[1]

Learning how to support a man in suicidal crisis is similar to learning how to provide emergency first aid. Our goal isn’t to ‘fix’ or ‘cure’ him. Rather, it’s to keep him alive until we can connect him with further medical support.

Helping a man during a mental health crisis can be very stressful. Going over the steps below can help us remain calm and responsive should we ever find ourselves in a situation like this.

High vs. Imminent Risk

The differences among suicide risk levels relate to intent and action.

At high risk, suicide is a persistent thought or fantasy. It’s a way to imagine escaping the pains of depression. The person may have a plan, with a desire to, one day, follow through with the suicidal thoughts/plan. A man at high risk tends to have the following warning signs:

  • Clear and/or repetitive suicidal desire
  • Having a general suicide plan [method(s) in mind to end his life]
  • Voicing future intent (e.g., “If things don’t get better by next month, I’m gonna end it.”)
  • Access to lethal means

Imminent risk is when a person has a specific suicide plan (including a method or place to end his life) and has stated an actual intent to act on this plan now or very soon.

Imminent risk would involve the person telling you or clearly hinting that he has the intent to die now or very shortly and how he will follow through i.e., telling you he’s going to overdose on medication, poison himself, use a weapon he already has or is in the process of obtaining, or walk to or stand near the edge of a building or bridge.

Questions to Clarify Risk Level

It’s a good idea to be open and direct, so you can gather enough information to know what a person is really thinking about.

  • “Are you thinking about suicide or ways to end your life?”
    • “Do you have a plan to die by suicide?”
    • “Have you started to take any steps towards completing this plan?”
  • “Do you have a crisis safety plan? Or is there someone I can contact for you in case of an emergency like this?”
  • “Can we call a crisis line together and get you someone to talk to?”

It’s important to know that mentioning suicide, when framed in terms of suicide prevention and referring someone to resources, will not make things worse.

Depending on risk level, you can follow the steps below for imminent risk or see our Manage Suicide Risk page for how to provide less immediate support.

Steps to take when the risk is imminent

In circumstances where a guy’s life is at risk, it’s essential that we intervene to stop him (as long as we are not jeopardizing our own or another’s safety in doing so).

The order in which you take the steps below may vary based on the situation and his reactions or responses.

These steps can be modified based on whether or not you are physically present with someone or in contact via phone, text, messaging app, or social media platform.

Move or separate him from danger

Ask him to move away from or put down any potential means to die by suicide.

What you can say:

  • “I’m trying to remain calm and patient, but I am worried for you. Can you come away from that ledge/put down the gun so we can talk?”
  • “Jason, I need you to know I care about you. Please let me take the rope. I’ll put it away/hold onto it for now so we can try to help you get through this.”
  • (On the phone) “I’m not sure where you are right now, but we’re going to get through this together. Can you please put the weapon down and walk away from it. Have you backed away?”

Express concern, and try to remain calm

It’s okay to feel stressed or scared yourself, but we want to make sure our words and actions emphasize care and concern. Despite what he may be thinking, let him know that you and others really do care about him.

What you can say:

  • “It’s normal to lose hope and feel overwhelmed. Let’s work together to find a way to get through this.”
  • “You’re strong and capable of getting better, and I believe in you. There is help available and you deserve the chance to get better.”
  • “I care about you. Your family and friends care about you. You may not see it now, but we do. We need you.”
  • “Let’s try a breathing exercise together to help calm things down, can you look at me and breathe with me. Inhale (“…1, …2, …3”), exhale (“…1, …2, …3”). Let’s keep doing this for a few minutes to help us cool down.”

Remain positive and sincerely hopeful

As shared in some of our Recovery Stories, men can and do get better after thinking about suicide, and even after surviving a suicide attempt. Let the man you care about know that his recovery is possible too.

If you have doubts about his ability to recovery, please see our Recovery Stories. If the man you’re supporting doubts the prospect of his recovery, you can share these stories with him as well. Hearing the positive recovery experiences of other men can be a source of hope for him and let him know he’s not alone.

What you can say:

  • “I hear that you feel alone right now. It’s normal for guys to go through times where they lose hope and it’s okay to feel like that. But often people, even those that try to end their lives, do get better. There’s no reason you can’t recover as well.”
  • “I hear that you’re in a lot of pain and you want that pain to go away. It’s natural to want to find ways to stop feeling like this, but death isn’t the only way. Recovery is possible.”
  • “Think about how proud you’ll be at Francis’ graduation? You’ve done such an amazing job raising him. Yeah, there are ups and downs but you know he loves you. He needs his Dad, and I need my friend.”

Actively listen

Encourage him to share his thoughts and feelings with you. Rephrase what he says to show that you’re listening and want to understand. This means being compassionate, non-judgmental, and open to hearing what he has to say – skills outlined in our article on Supporting a Man Through Active Listening.

What you can say:

  • “I hear that you’re feeling overwhelmed and like there’s no way out. That must be really tough. Can you tell me more about what’s behind that feeling?”
  • “I’m here to listen and support you in any way I can. Tell me about what’s going on.”

Call 9-1-1 or take him to a hospital emergency room

The next step is to get him somewhere safe, which in this case means the nearest hospital, or if there are no hospitals nearby, by calling 9-1-1 (999 in the UK, 112 in most European nations, or 000 in Australia, or your local emergency telephone number).

Let him know you are taking action to get him help to ensure his safety. Being honest and transparent about this can help him feel more supported and less alone during these crucial moments.

  • If you feel safe and he is cooperating, taking him yourself to the nearest hospital may be best, as involving the police can sometimes make a situation more stressful or traumatizing, depending on a person’s prior experience.
  • If he’s not willing and you can’t convince him (or he ends your phone call or chat), call 9-1-1 right away.

It’s important to acknowledge that we may need to take actions against a person’s wishes, such as calling 9-1-1. It’s always better to err on the side of caution when someone’s life is at stake. Calling 9-1-1 for a mental health emergency related to suicide is a responsible and necessary action.

If he needs some encouragement

  • If he expresses fears about going to a hospital, it’s important to validate his feelings and concerns, and reassure him that seeking help is a positive step toward getting better. Sometimes depression requires treatments that can only be provided in a hospital.
  • Going to the hospital doesn’t necessarily mean that he will be committed. Let him know that the hospital staff will conduct a thorough evaluation and work with him to develop a treatment plan that is tailored to his needs.

What happens when you call 9-1-1

Here’s what to expect if you ever have to call 9-1-1 for a man in a mental health crisis.

  1. Receiving your call: The 9-1-1 operator will ask questions to determine the severity of the situation and the level of risk. They will ask you for the person’s name, age, phone number, what he looks like, and location, as well as any information you have regarding the situation, such as if the person has made any attempts to harm themselves or if they have access to any weapons or harmful substances.
    • Even if you are not with the man in-person, providing the operator with his name and mobile phone number will likely be enough to locate him.
  2. Dispatching services: If deemed appropriate, they will dispatch emergency responders, which may include police officers, paramedics, or both. They may also provide you with instructions on how to keep the person safe until help arrives.
    • If emergency responders are not deemed necessary, ask the operator what you can do to help. Try to connect him with a local crisis line or see our Manage Suicide Risk page for more options.
  3. Arrival of first responders: When the emergency responders arrive, they will conduct a thorough assessment of the situation and provide any necessary medical attention. They may ask him questions about his mental health and assess his level of risk for suicide. They may also transport him to a nearby emergency room or a mental health facility for further evaluation and treatment.
    • Depending on the situation, the police may respond to the call, in addition to the medical emergency responders. In some cases, they may ask you to come with them to provide additional information or support. You can also offer to stay with the person to provide support, if possible/appropriate.
    • If the person is not deemed to be an immediate risk to themselves or others, the police may refer them to community mental health resources or provide them with information on how to seek help for their mental health concerns. In this case, try to connect him with a local crisis line or see our Manage Suicide Risk page for more options

At the emergency room (ER)

It’s important to note that going to the hospital does not necessarily guarantee the man you are helping will be admitted/hospitalized.

ER staff will conduct a thorough assessment of his mental health and determine the best course of action based on their findings. This may involve hospitalization for observation, medication management, or referral to mental health professionals or other services for ongoing care.

If he’s not admitted to the hospital, it’s still important to encourage him to seek professional help for his mental health. See our Manage Suicide Risk page for other ways you can help.

What does hospital admission for mental health look like?

  • Hospital stays for suicidal thinking can range from a few hours to several days, weeks, or more. The goal of hospitalization is to provide a safe and supportive environment for the person to stabilize and get the appropriate treatment. This may include medication management, individual and group therapy, and other support services.
  • The length of the hospital stay will depend on several factors, such as a man’s level of risk, his response to treatment, his overall progress in his recovery, and his surrounding life circumstances.
  • After being discharged from the hospital, it’s important for the man to continue to receive ongoing care and support, such as outpatient therapy, medication management, and support from community resources.
  • More on Inpatient Services.

Debrief for your own mental health afterwards

Supporting someone who is experiencing suicidal thinking can be emotionally draining. Make sure you set time aside to take care of yourself and seek support from friends, family, or a mental health professional if needed.

Follow up with the man you helped

Depending on your relationship with him, try to check back in with him to show your continued support and care.

Be prepared for a range of responses. Some men may be thankful for your intervention to safeguard their safety, while others may express resentment for calling 9-1-1 or taking them to a hospital. Once he reaches a better headspace, it is likely that any resentment and anger will fade and, in turn, he will come to recognize and appreciate your willingness to intervene and get him help.

While helping in a crisis can be a tricky situation to navigate, by following the tips above, you can feel assured that you took the best steps to intervene and ensure his safety and recovery.


References:

  1. World Health Organization. (2014). Preventing suicide: A global imperative. World Health Organization.

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