If you or someone you love experiences a mental health crisis, it can be challenging in the moment to know what to do or who to call. Sometimes, 911 is the right choice – especially if someone is in immediate, serious danger. But we also know calling the police can invite deadly force into a situation that might benefit from an earlier intervention or a different approach.
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“There are instances where people are armed or threatening themselves and others that will predominantly be a police call,” said Leonard Swanson, the head of the crisis response initiative at Wayne State University’s Center for Behavioral Health and Justice. He said the first step to decide how to respond is understanding what is happening and what resources are available.
People who are in crisis don't often know they are in crisis, he said, “and may not think to call someone other than 911. Family or friends or people who are around them might not know who to call either.”
Swanson’s own experiences highlight just how challenging the situation can be. “About ten years ago, I suffered my own mental health crises where I was convinced I was enlightened, and that every thought that came into my head was imbued with the power of God. I didn't have insight that this was not normal or was irrational and that I needed help,” he said. “Actually, it was a dangerous situation.”
One way you can determine when to get help, Swanson said, is to consider if the person’s needs are greater than their own ability to meet them. He said that was the case for himself during the crisis he experienced.
After that, there are factors to consider when deciding what additional support is needed to help de-escalate a crisis. If the person in crisis doesn’t pose a threat to themselves or others, perhaps the police don’t need to be involved – but figuring out who to call instead can still be a challenge, especially in the moment. We created this guide to help you get the care and support you need if you’re ever faced with a mental health crisis.
“I think the biggest challenge is for people knowing where to go to access care,” said Melissa Moody of the Detroit-Wayne Integrated Health Network, or DWIHN, which is one of dozens of county-level community mental health agencies in Michigan. Each one has its own capabilities and partner organizations, but many, including DWIHN, offer 24-hour hotlines for crisis support.
“A lot of times someone just needs to talk to somebody,” said Moody. But while some situations can be handled through a conversation with a behavioral health specialist, others require more hands-on attention or longer term support.
DWIHN works with more than 300 partner organizations to help with everything from crisis intervention and acute care in an in-patient setting to employment support after an individual feels stable. Their crisis hotline can serve as a resource to help navigate mental health resources to find out what best suits one’s needs, bearing in mind insurance considerations.
In some places, mobile crisis units are an option. In Wayne and Oakland counties, New Oakland Family Centers offers a 24/7 mobile service for young people experiencing a mental health emergency. Anyone — a parent, a child, a police officer, or a school employee — can request the service, said Amelia Jackson, director of crisis services. She said a brief screening over the phone (you'll be asked about age, location, insurance, and symptoms) will determine eligibility. The program serves youth 17 and under in Wayne County, and 21 and under in Oakland. New Oakland's 24/7 hotline is 877-800-1650.
Even with help navigating various options for mental health care, there can still be hurdles to getting the help that’s needed. Stigma can be a major issue for the individual, but there are also systemic issues.
One of the main ones, according to Robert Sheehan – who oversees a state association of public mental health organizations – is a growing shortage of qualified behavioral health providers.
“It's the deepest and most prolonged workforce shortage we've seen in mental health in 60 years, probably since the beginning of mental health," Sheehan said.
Sheehan noted that the vacancies include nurses and psychologists, as well as social workers and residential care providers.
With rising rates of anxiety and depression triggered by the pandemic, Michigan and other states have found an already existing gap in behavioral health widen. So addressing needs as they arise is vital, Sheehan said – as is maintaining ongoing care for people in need.
Family members of people diagnosed with serious mental health issues who struggle to maintain wellness can petition the state for ongoing mental healthcare. More than 100 Assertive Community Treatment teams across the state provide services including case management, psychiatric care, rehabilitative treatment, and housing support.
Moody, of DWIHN, said those services can also include ensuring that people have their basic needs met in terms of housing and food. “It might be just a lot of life situations and stressors going on that can really exacerbate a preexisting condition,” she said. “So [our goal is] really trying to get some stability in those households.”
Caring for someone who has a mental illness can also take a toll on the mental health of loved ones, she added.
Family members in that position might benefit from educational workshops and support groups, like those offered through the National Alliance on Mental Illness’ state and local chapters. Community mental health organizations might also be able to point caregivers and family members to additional resources to care for themselves while caring for others.