Note: All Health Lab content including health news, best practices and research insights are for informational purposes only and are not a substitute for professional medical guidance. Always seek the advice of a health care provider for questions about your health and treatment options.
Transcript
Host:
Welcome to Health Lab, your destination for news and stories about the future of healthcare.
Today we’re talking about how to get help during a mental health crisis.
Please be aware that this episode has mentions of suicide and self-harm.
Whether it’s suicidal thoughts or actions, an anxiety attack, worsening depression, risky substance use, rage, hallucinations or dangerous impulses, more help is available now for people dealing with a variety of mental health crises.
But when a mental health crisis happens, it can be hard to know what to do.
And it can be scary, whether you’re the one in crisis, or it’s your child, partner or parent, or your friend, neighbor or coworker.
Fortunately, new options for helping people during and after a mental health crisis have launched across the country in recent years, and those resources continue to grow.
These efforts are spurred by the increasing recognition of the need for specialized crisis care for people with mental health conditions, and the importance of early intervention.
Since many of these services are new, or have expanded into more areas in recent years, you might not know about all of them.
Dr. Nasuh Malas, a psychiatrist who directs Child and Adolescent Psychiatry at Michigan Medicine, says, “The crisis care-continuum has broadened locally and nationally. Knowing your local resources can empower you to be prepared if a crisis arises. The advent of 988 has opened up ready 24/7 access to mental health crisis support that has been a game changer. There are new services arising too, including urgent care services, crisis stabilization units, mobile crisis teams, crisis residential services, respite services, as well as intensified outpatient services such as partial hospitalization programs and intensive outpatient programs.”
He notes that people who live with a mental health condition and their loved ones can also take steps to prepare for possible crises so they know what to do if one happens.
In any crisis, it’s crucial to remember that it’s better to seek help sooner than later. And to not give up on yourself or the person you’re trying to help.
So, what are the different levels of crisis and post-crisis care?
And a quick note here before we jump in: healthcare professionals often use terms like “behavioral health” or “substance use disorders” to describe some of the services we’re going to discuss, while members of the general public might use the terms “mental health” or “addiction” to discuss the same topics.
Now, back to the levels of crisis and post-crisis care that are available.
First, and the most well-known is calling 911.
For truly life-threatening situations involving imminent danger, or a very serious physical injury related to a mental health situation, call 911 just like you would for any other emergency.
More first responders now have special training to handle a serious mental health crisis or a drug overdose. And they can call for specialized help as needed.
If you think that someone who you’re with has overdosed on an opioid such as heroin or a prescription painkiller, and you have a dose of naloxone (also known as Narcan) available to you, tell the 911 operator you have it.
They may instruct you to give the person this rescue medication even before emergency responders arrive.
There are also several mental health hotlines that provide help by call, text or chat.
Any time of the day or night, every day of the year, no matter where you may be, the 988 Suicide and Crisis Lifeline offers free help to people experiencing suicidal thoughts, making or voicing an active plan to attempt suicide, injuring themselves on purpose (self-harming), experiencing a drug or alcohol crisis, or having any other mental health crisis including panic and anxiety attacks, or psychotic symptoms.
You can call 988 from any phone, or text any word to the number 988 from a mobile phone. 988 also has a webchat function that you can access at 988lifeline.org. You will then be connected to a trained counselor, usually someone in your state or region.
And you can also call if you’re worried about someone else’s immediate safety, or want to help someone you’re with.
The 988 service also has special options for people who are veterans; a dedicated Veterans Crisis Line that you can access by pressing 1 after calling 988 or?texting any word to 838255. Options for people who speak Spanish, and videophone services for people who are Deaf or hard-of-hearing are also provided.
Dr. Malas says, “The 988 service has been a tremendous resource since its inception and implementation, saving countless lives and giving individuals rapid access to mental health crisis support. This has been particularly important for our youth and young adults who are increasingly using cellphone and texting technology to communicate and interact, and finding 988 to be a more accessible way to get help.”
Due to a recent and significant federal policy change, the 988 national suicide hotline has removed its specialized “press 3” option for the LGBTQ+ community on Wednesday, July 17, 2025. The “press 3” option was dedicated to connecting people in the LGBTQ+ community who were in crisis to mental health professionals specifically trained in and familiar with the LGBTQ+ community, and LGBTQ+ issues.
While the “press 3” option has gone away on the 988 hotline, it is crucial to know that there are still resources available for LGBTQ+ people experiencing a mental health crisis, or for those who have someone in their life in the LGBTQ+ community who needs help.
The Trevor Project has a 24/7 crisis hotline for LGBTQ+ youth that can be reached by calling 1-866-488-7386, or by texting the word START, that’s S-T-A-R-T, to 678678, or you can use the webchat function on The Trevor Project website, by going to: www.thetrevorproject.org/get-help/.
All of the resources mentioned in this episode will be linked in the description in the show notes.
Another general mental health crisis service that offers support via text message, webchat or WhatsApp is the Crisis Text Line. People can access this resource by texting the word HOME, that’s H-O-M-E, to?741741, or by visiting crisistextline.org.
There are also other specialized hotlines and “warmlines” for different purposes.
People with eating disorders can call the Alliance for Eating Disorders at 1-866-662-1235 between?9 a.m. and 7 p.m. Eastern time Monday through Friday, or by visiting their website at: www.allianceforeatingdisorders.com.
First responders in Michigan (police, fire, EMT, corrections and emergency dispatchers) can call 1-833-34-STRONG or visit fst5.org (that’s the number five) to reach Frontline Strong Together.
For disaster survivors: Anyone experiencing emotional distress related to disasters such as tornadoes, hurricanes, wildfires, floods or major violent events can call or text the national Disaster Distress Helpline at 1-800-985-5990, or visit their website which will be linked in the description for this episode.
For urgent or ongoing support for mental health or substance use situations, people can call 1-800-950-NAMI (that is, 6264), or text NAMI?to 62640 or visit their website. NAMI is a national mental health organization, and their website includes a list of “warmlines” in each state that offer ongoing peer support for people with mental health conditions, or people who are in recovery for drug or alcohol issues.
There is also a growing number of cities and counties in the United States that have mobile mental health crisis units.
These aren’t ambulances, but rather they are regular vehicles with trained staff who can come to any location where someone needs an in-person level of mental health crisis response.
You can find out if one serves your area by searching online for “Mobile Crisis Intervention Services” or “Behavioral health mobile unit” and your county or city name.
For example, in southeast Michigan, there are mobile units serving anyone in Washtenaw County, anyone in Wayne County including Detroit, youth in Oakland County, adults in Oakland and Genesee Counties, and anyone in Macomb County.
Additionally, some law enforcement agencies also have hired or trained staff to respond to mental health emergencies, often through working with their local public mental health authority.
If you call 988, the counselor may be able to see if there’s a service for your area and get help dispatched to your location. Once the team arrives, they’ll assess the situation and recommend next steps.
There are also drop-in mental health crisis centers.
Most people have visited an urgent care center for a physical health problem that needs treatment but isn’t serious enough to go to an emergency department.
Now, mental health urgent care centers have begun opening around the country.
They’re sometimes called drop-in mental health crisis centers or Crisis Stabilization Units. Many are part of Certified Community Behavioral Health Clinics that offer multiple kinds of evidence-based mental health care.
Specially trained staff and soothing environments can help get someone through an immediate crisis and connect them with resources for follow up care.
These centers offer an alternative to going to the emergency department for mental health crisis care. They may even offer care for up to several days, as an alternative to a mental health hospitalization.
Some centers offer crisis?residential?services to people who might qualify for admission to an inpatient psychiatric hospital bed, but who can receive care in a less-intensive setting.
In southeast Michigan, there are drop-in centers available in Washtenaw County, Wayne County including Detroit, Oakland County, and Macomb County.
If you have a center like this in your area, you can find it through a web search, using your county government’s website, or a 988 Lifeline counselor.
You may want to call before going, to make sure the service meets your needs or the needs of the person you’re helping.
There is also psychiatric emergency care and day programs or partial hospitalization programs. Some major hospitals have special areas where people can get comprehensive care for a mental health emergency.
Other hospitals have opened Emergency Psychiatric Assessment, Treatment and Healing Units (called EmPATH units for short) within their emergency departments.
The expert teams at these sites can determine if someone needs to be admitted for a hospital stay, or if they can safely leave and get follow-up care elsewhere.
General hospital emergency departments may not have mental health specialists available in person, but can call them for consultations on specific patients.
A growing number of these programs help people who have had a recent mental health crisis, or who could avoid a crisis if they received more intensive help than their regular therapist, psychologist, psychiatrist or primary care provider can give through outpatient appointments.
These are often called day treatment programs or partial hospitalization programs – PHP for short. These programs can help someone avoid getting admitted to a psychiatric hospital, or provide a ‘step down’ to a lower level of care after a psychiatric hospitalization.
Partial hospitalization programs often specialize in teens, adults, or people with specific conditions such as anxiety, depression, eating disorders, drug or alcohol issues, or obsessive-compulsive disorder.
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Dr. Malas notes, “Day programs, such as intensive outpatient programming and partial hospitalization, provide tailored, evidence-based programming that increase the frequency and duration of therapeutic services for those who require higher levels of care. This helps mitigate use of hospitals and emergency rooms, and also allows them to stay in their local communities while practicing the skills they are learning in natural environments at home or in the community.”
Partial hospitalization programs usually involve going to a treatment center for most of the day, and having group and individual therapy sessions, and therapeutic activities.
At the end of each weekday, patients go home for dinner and sleep, and they are also at home for weekends and holidays.
Someone might need to attend a PHP for one, two or more weeks, depending on what their treatment team recommends.
If a tween or teen goes to a PHP, their parents or guardians will need to attend regular meetings with the treatment team as well.
You can find PHPs through the federal government’s FindTreatment.gov treatment locator, which will be linked in the description for this episode. Insurance coverage for these services may vary.
Intensive outpatient programs, or IOPs for short, are programs that bring together small groups of patients with similar conditions for a few hours a day once, twice or three times a week.
IOPs serve as a step between regular weekly or biweekly mental health appointments, and partial hospitalization programs.
They offer another option for “stepping down” – in this case after a PHP or an inpatient stay.
Like PHPs, IOPs may specialize in a certain condition or age group, and may only accept patients who have had another level of care first, and again, insurance coverage can vary.
There is also psychiatric hospitalization available when needed. When someone has a very serious mental health crisis, they may qualify for hospitalization in a specialized hospital unit.
If they have suffered serious physical injuries during a mental health crisis, or due to an eating disorder, they may be hospitalized in a general hospital unit, but with mental health professionals visiting them regularly.
Psychiatric hospitalization can be acute – a stay for a few days or weeks in a unit of a regular hospital – or a longer-term stay in a specialized facility.
There are also special rules about hospitalizing someone who doesn’t want to be hospitalized.
Mental health professionals trained in crisis care can advise on when someone meets such standards and can be hospitalized for a mental health crisis to protect their safety and the safety of others.
Insurance coverage and state funding for this level of care can vary, and even once an insurance plan has authorized an inpatient stay, patients may find themselves waiting in an emergency department for days until a bed opens up.
Because of a nationwide shortage of psychiatric hospital beds, many states, counties and cities have invested in alternative crisis services, to try and step in with help that can prevent people from getting to a point where they require psychiatric hospitalization.
There is also residential treatment. When someone has a severe substance use disorder, a severe eating disorder or another condition that requires long-term therapeutic support to develop skills and slowly transition back to the community, they may be a candidate for a residential treatment facility.
After any mental health crisis, it is important to take steps to improve safety in the case of another crisis. If you, or someone you live with, has had a mental health crisis, these steps can include:
Storing mental health emergency numbers in your phone or posting them in a place you will see them, like a refrigerator door.
If a safety plan was made as part of crisis care, make sure everyone listed in the plan knows what to do in case of another crisis and review the plan regularly, updating as needed. You can also consider downloading an app that can store safety plan information, as there are several safety planning apps available for major mobile devices.
Updating the medical ID in the individual’s mobile phone to include any mental health diagnoses and medications, so that first responders and emergency providers have access to it if needed.
Removing firearms, knives, razors and scissors, household chemicals and unneeded medication from the home, or locking them up. Firearms should always be stored in a locked case or with a gun lock, and ammunition should be kept separately. More information about safe firearm storage is available from the U-M Institute for Firearm Injury Prevention. It also offers information on Extreme Risk Protection Orders, or “red flag” provisions, which can be used when someone with access to firearms is an immediate risk to themselves or others.
A reminder that all Health Lab content including health news, best practices and research insights are for informational purposes only, and are not a substitute for professional medical guidance. Always seek the advice of a health care provider for questions about your health and treatment options.
For more on this story and for others like it, visit michiganmedicine.org/health-lab where you can also subscribe to our Health Lab newsletters to receive the latest in health, wellness and medical research information to your inbox each week. Health Lab is a part of the Michigan Medicine Podcast Network, and is produced by the Michigan Medicine Department of Communication. You can subscribe to Health Lab wherever you listen to podcasts.
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James Donaldson is a Washington State University graduate (’79). After an outstanding basketball career with WSU, he went on to play professional basketball in the NBA with the Seattle Supersonics, San Diego/L.A. Clippers, Dallas Mavericks, New York Knicks, and Utah Jazz. He also played for several teams in the European Leagues in Spain, Italy, and Greece, and he toured with The Harlem Globetrotters to wrap up his career. James was an NBA All-Star in 1988 while playing center for the Dallas Mavericks. In 2006, James was inducted into the Pac-10 Sports Hall of Fame and also the Washington State University Athletic Hall of Fame. In 2010, James was elected as a board member for the NBA Retired Players Association.
James frequently conducts speaking engagements (motivational, inspirational, educational) for organizations, schools, and youth groups.
In 2010, James was the recipient of the NBA Legends of Basketball ABC Award, awarded for outstanding contributions in Athletics–Business–Community.
He believes in being a role model for success and professionalism to the scores of young people to whom he devotes so much of his time. He currently serves on several boards and committees and is a member of many organizations.
James believes in developing relationships that create a “Win-Win” environment for everyone involved, and in being the best he can be!
For more information about James Donaldson or to request he speak at your event, contact him at:
James Donaldson is the author of “Standing Above The Crowd” and “Celebrating Your Gift of Life” and founder of the Your Gift of Life Foundation which focuses on mental health awareness and suicide prevention, especially pertaining to our school aged children and men.
If you’re interested in having James come and speak to your group of young adults, business entrepreneurs, aspiring political and community leaders, and athletic teams, please contact him at jamesd@yourgiftoflife.org and or leave a personal message for him at 1-800-745-3161. Keep up with him and read about how he is reaching out and making a difference in the lives of so many around the world at www.yourgiftoflife.org
