Mental Health Crisis Response Protocol

A protocol for responding when you or someone you know is in mental health crisis — severe depression, suicidal ideation, psychotic symptoms, severe anxiety/panic, or psychological breakdown. For yourself: (1) If you're having thoughts of suicide: Call 988 (Suicide & Crisis Lifeline) or text HOME to 741741 (Crisis Text Line) immediately. You don't have to be 'bad enough' — these services exist for exactly this moment. (2) Remove access to means if possible (firearms, medications). (3) Don't be alone — call someone, go somewhere with people. (4) Ground yourself: Name 5 things you see, 4 you can touch, 3 you hear, 2 you smell, 1 you taste. This activates the sensory cortex and reduces emotional flooding. For someone else: (1) Ask directly: 'Are you thinking about killing yourself?' Research shows asking does NOT increase risk — it reduces it by breaking isolation. (2) Listen without judgment or rushing to fix. (3) Don't leave them alone if they're at immediate risk. (4) Help connect to professional support: drive them to the ER, call 988 together, help them contact their therapist. (5) Follow up the next day and the next week. The highest-risk period is often right after the acute crisis seems to pass.

When to use it

When someone expresses hopelessness, talks about being a burden, gives away possessions, or withdraws suddenly. When you notice drastic behavioral changes in someone you care about. When you yourself feel overwhelming despair, hopelessness, or impulses to self-harm. When in doubt — it's always better to ask and be wrong than to stay silent.

How it can help

Provides specific actions for the most frightening interpersonal situations most people will face. The direct question about suicide ('Are you thinking about killing yourself?') is the most evidence-based intervention available to non-professionals, yet most people are terrified to ask it. The 5-4-3-2-1 grounding technique works immediately for acute distress. The follow-up reminder addresses the critical finding that many suicides occur shortly after a crisis when others assume the person has 'recovered.'