Hesperian Health Guides

Hesperian Health Guides

Mental Health Emergency

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HealthWiki > New Where There Is No Doctor > First Aid > Mental Health Emergency


Abrupt changes in thinking, behavior, hallucinations, and severe confusion can be frightening for the person experiencing it, and also for the people around them. The chapter Mental Health (in development) has more information about mental illness, differences in thinking, and state of mind.

When someone’s thinking and perceptions cause them to want to hurt themselves or others, it becomes an emergency and they need help quickly. As with any other emergency, first try to check breathing, stop any bleeding, and check for other physical injuries. Then reassuring, calming and comforting a person having a mental health emergency can save lives.

If someone says he wants to hurt himself or others, believe him.


If the person is dangerous to others, it is often easier to move other people away than to move him. You may need help to make him and the area around him safe. And look out for your own safety as well.

2 men speaking; one sits with his head in his hands.
You sound upset.
I've had enough.

If he says he wants to hurt or kill himself, the first thing he needs is someone to listen calmly. Ask gentle questions, to show you care and to be sure you understand. Your questioning can help to interrupt his thoughts and distract him from his purpose.

  1. Ask if he plans to hurt himself or someone else, or if he has already done so.
  2. the 2 men continue speaking.
    Do you think you really might kill yourself?
    I think about it all the time! And now I'm going to do it!
  3. Ask how he plans to do it, and if he has the means to do it. The more specific the plan, the more serious the problem.
  4. How would you do it?
    I have a gun. I'm going to do it when the kids leave for school.
  5. Ask the person to make an agreement that he will not hurt himself or others. Take away the means he would use to hurt himself or others.
Can you agree that you will not hurt yourself today?
Maybe just for today.
Will you let me hold on to your gun — just for today?

Making an agreement like this can keep someone OK long enough to get more lasting help. Do not leave him alone. Stay with the person, or have family members or friends stay with him. Make sure he stays sober and does not drink alcohol or use drugs. Alcohol or drugs can further cloud his judgement and make self-harm more likely. It may be helpful to seek the help of spiritual or community leaders who he respects. Following up to see that he continues to get help, and to show that you care about him, is important. See the chapter on Mental Health (in development) for more on how to give ongoing support.

Asking someone if he wants to kill himself does not make him more likely to do so.



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