Managing Crisis

What is a Crisis?

Most of us have some idea of what to do if an accident happens at home. It may be instinctive. Or it may be that we have read a first-aid manual. But what if someone with mental illness whom you know is having a relapse, expressing aggression or is contemplating suicide? Would you know what to do?

When confronted with emergency situations like these, your appropriate response is crucial. The more you know about how to manage such situations and the faster you take an appropriate course of action, the better the chances for the person to make a full recovery.


The seriously suicidal person is usually experiencing feelings of worthlessness and hopelessness. Some may also become suicidal when they are very mentally disturbed, hearing voices or having paranoid thoughts. The voices they hear may tell them that they are bad, useless, and should kill themselves.

If you suspect someone is suicidal, it is best to ask the person openly if he is thinking about harming himself. Be there for the person and let him know that you care. Encourage him to talk about what is troubling him and give him your empathetic, listening ear.  However, do not promise confidentiality. A life is at stake and you may need to inform a third party, e.g., family member/police/mental health professional, in order to keep the person safe.

If a suicide attempt seems imminent, seek help immediately by calling the police or crisis helpline, or take the person to an emergency room. While waiting for help to arrive, stay with the person and continue to engage him. Do not, under any circumstances, leave the person alone.


People with mental illness (PMI) are not normally as violent as they are often thought to be. In fact, only a minority of PMI display signs of aggression.

However, violence may sometimes occur, especially if the person is experiencing symptoms such as paranoid thoughts or hallucinations. He may believe people are plotting against him or trying to harm him directly. When a person is suspicious and frightened because of these distorted perceptions, he needs to be approached with caution.

Maintain a safe distance from the person and speak slowly in a mild tone. Ask non-judgmental questions and respond to the feelings of the person. However, put your safety first. If you feel unsafe or threatened in any way, get away from him and go somewhere safe. Call the police so as to ensure the safety of all.

In some situations, the person may need to be taken to the hospital for further treatment. If so, it is advisable for family members to accompany him to the hospital in order to provide information to the doctor about the symptoms and behaviours observed.


Times of crisis are difficult for everyone involved. While helping the primary person in need, caregivers often neglect their self-care. Even during periods of crisis, caregivers need to practice good self-care, so as to have the physical and/or mental strength to deal with all the stresses.

Give yourself permission to rest and to do things that you enjoy on a regular basis. Take care of your own needs and treat your body well, for instance, focus on healthy eating, getting at least some exercise, and getting quality sleep. When caregivers practise good self-care, caregiver burnout can be minimised.

  • Accept help
    Prepare a list of ways that oth­ers can help you in providing care. For instance, one person might be happy to take the person you care for on a walk a couple of times a week, or someone else might offer to pick up groceries for you.
  • Don’t give in to guilt
    Feeling guilty is normal, but understand that no one is a “perfect” caregiver. You are doing the best you can at any given time. And you do not have to feel guilty about asking for help.
  • Be informed
    Many organisations offer classes on caregiving, and hospitals may have classes specifically about the disease your loved one is facing. Get the knowledge and skills you need to be an effective caregiver.
  • Join a support group
    A support group can be a great source for encouragement and advice from others in similar situations. It can also be a good place to make new friends.
  • Stay connected
    Make an effort to stay in touch with family and friends. Set aside time each week for socialising, even if it is just having a cup of coffee with a friend. Whenever possible, make plans that get you out of the house.
  • Commit to staying healthy
    Find time to be physically active on a regular basis, and do not neglect your need for a good night’s sleep. It is also crucial to adopt a healthy diet.