Hesperian Health Guides
Chapter 4: People in crisis
When your community knows you as an activist, health worker, community leader, or involved neighbor, people turn to you for all kinds of support. Sometimes a person may be going through something that feels beyond what you can handle. Even if you plan to connect the person to a mental health professional, you may need to respond to a crisis or emergency by actively providing some direct help right away. This chapter discusses how to prepare in advance for crisis, how to de-escalate and calm a situation, and how to communicate with someone in crisis. Whether acting to prevent a situation from getting worse or facing what is already more clearly a crisis, the priority is always your own safety.
Your safety matters
Always be aware of your surroundings and use the way you move and speak to help calm (de-escalate) the situation:
- Stay close enough to a person so they can easily hear you, but out of their reach. There is no way to know if being close to them could make things worse for them or if they could become violent.
- If they have something that could be used as a weapon, try to move yourself and others away until help arrives. Request that they put it down. For example: “I am afraid you holding that makes all of us less safe. Would you be willing to put it down while we talk?” (See “Every crisis is different”.)
- If you are inside, position yourself so the person is not between you and the exit. Make sure exits are not blocked.
- Make sure someone knows where you are and, if necessary, will go to get help.
Consider physical health problems
When someone behaves unusually aggressively or strangely, they may be showing signs of a physical health emergency. You may not be able to get an answer from them directly, but you can ask friends or family with them if there is anything in their health history or current situation that might explain their behavior. Check if they wear a medical ID bracelet. Poisoning or medication overdose, drug use (especially methamphetamine), brain injury or stroke, a diabetic emergency, and serious blood infection (sepsis) can all cause signs that look like mental health emergencies.
This page was updated:18 Apr 2025