Illustration of male doctor and distressed woman among mental health imagery.

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

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 continue to grow.

They’re spurred by the increasing recognition of the need for specialized crisis care for people with mental health conditions and neurodivergence, 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. 

“The crisis care-continuum has broadened locally and nationally. Knowing your local resources can empower you to be prepared if a crisis arises,” said Nasuh Malas, M.D., M.P.H., a psychiatrist who directs Child and Adolescent Psychiatry at Michigan Medicine, the University of Michigan’s academic medical center.

“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, remember that it’s better to seek help sooner than later. And don’t give up on yourself or the person you’re trying to help.

Language note: Professionals often use terms like “behavioral health” or “substance use disorders” to describe some of the services listed below, while members of the general public might say “mental health” or “addiction.” 

For a truly life-threatening situation 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 (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.

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 (also called self-harm), experiencing a drug or alcohol crisis, or having any other mental health crisis including panic and anxiety attacks or psychotic symptoms.

Or use the webchat function at 988lifeline.org. You’ll be connected to a trained counselor, usually someone in your state or region.

You can call if you’re worried about someone else’s immediate safety or want to help someone you’re with.

The 988 service has special options for people who are veterans or who speak Spanish, and videophone services for people who are Deaf or hard-of-hearing.

Said Malas, “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.”

Another general mental health crisis service that offers support via text message, webchat or WhatsApp is the Crisis Text Line. Text the word HOME to 741741 or visit www.crisistextline.org.

There are also specialized hotlines and “warmlines” for different purposes:  

  • Veterans Crisis Line: Press 1 after calling 988 or text any word to 838255 
  • LGBTQ+ youth suicide hotline: Call the Trevor Project at 1-866-488-7386, text the word START to 678678, or use webchat at www.thetrevorproject.org/get-help (Note: the 988 Lifeline no longer has a specialized service for LGBTQ+ individuals due to a federal policy change.) 
  • Eating disorders: 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 visit www.allianceforeatingdisorders.com 
  • First responders in Michigan (police, fire, EMT, corrections and emergency dispatchers): Call 1-833-34-STRONG or visit fst5.org to reach Frontline Strong Together. 
  • 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 www.samhsa.gov/find-help/helplines/disaster-distress-helpline
  • Urgent or ongoing support for mental health or substance use situations: call 1-800-950-NAMI (6264), text NAMI to 62640 or visit www.nami.org/support-education/nami-helpline/ to reach NAMI, a national mental health organization. The NAMI website includes a list of “warmlines” in each state that offer ongoing peer support for people with mental health conditions or in recovery from drug or alcohol issues. 

A growing number of cities and counties have mobile mental health crisis units.

These aren’t ambulances – they’re 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 the web for “Mobile Crisis Intervention Services” or “Behavioral health mobile unit” and your county or city name.

For instance, in southeast Michigan, there are mobile units serving anyone in Washtenaw County, anyone in Wayne County including Detroityouth in Oakland Countyadults in Oakland and Genessee Counties, and anyone in Macomb County.

Other counties in Michigan may have mobile services; check this list.

Some law enforcement agencies also have hired or trained staff to respond to mental health emergencies, often 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 help get it dispatched to your location. Once the team arrives, they’ll assess the situation and recommend next steps.

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 CountyWayne County including DetroitOakland County, and Macomb County.

Other counties have locations, too; they’re listed here.

There’s also a virtual urgent care option for mental health for southeast Michigan.

If you have a center like this in your area, you can find it through a web search, 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.

Some major hospitals, such as U-M Health’s main University Hospital and C.S. Mott Children’s Hospital, have special areas where someone 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 crisis care-continuum has broadened locally and nationally. Knowing your local resources can empower you to be prepared if a crisis arises.” -Nasuh Malas, M.D., M.P.H. 

The expert teams at these sites can determine if someone needs to be admitted for a hospital stay or 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. 

For instance, U-M Health’s Michigan Clinical Consultation & Care (MC3) program is now offering this service for emergency providers in one northern Michigan health system.

A growing number of 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 called day treatment programs or partial hospitalization programs (PHP for short.) They 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.

“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,” Malas explained.

“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.”

U-M Health and its C.S. Mott Children’s Hospital offers PHPs for adults with anxiety, depression and bipolar disorder; teens with anxiety and depression, and teens and young adults with eating disorders. The University of Michigan Health-Sparrow system, which is also part of Michigan Medicine, offers an adult PHP.

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.

They’re also at home for weekends and holidays.

Someone might need to attend a PHP for one, two or more weeks, depending on what the 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.  

Find PHPs through the federal government’s FindTreatment.gov treatment locator. Insurance coverage may vary.

Called IOPs for short, these programs 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 an option for “stepping down” after a PHP or an inpatient stay.

U-M Health offers IOPs for adults with addiction to drugs or alcohol (substance use disorder) and for teens and young adults with eating disorders.

Like PHPs, these programs may specialize in a certain condition or age group, and may only accept patients who have had another level of care first. Insurance coverage can vary.

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 because of 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 – for a few days or weeks in a unit of a regular hospital – or longer-term in specialized facilities.

U-M Health has acute inpatient units in Ann Arbor for children and teens at C.S. Mott Children’s Hospital, and for adults at University Hospital.

U-M Health-Sparrow has inpatient psychiatric units in Lansing for people over age 18 and for adults over 60, and Michigan Medicine partners with the VA Ann Arbor Healthcare System for inpatient psychiatric care for veterans.

There are 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 of 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 to help keep someone from getting to a point where they require psychiatric hospitalization.

Find inpatient programs through the federal government’s FindTreatment.gov treatment locator.

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.

Different from psychiatric hospitals, these places offer round-the-clock access to care and support as well as recreation and other activities. Often, programs recommend several months of care.

Insurance coverage for this level of care varies greatly, and some facilities may only accept payment from patients or their families.

Find residential programs through the federal government’s FindTreatment.gov treatment locator.

If you, or someone you live with, had a mental health crisis, it’s important to take steps to improve safety in the case of another crisis.

This may include:  

  • Store mental health emergency numbers in your phone or post them in a visible place like a refrigerator. 
  • 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. Consider downloading an app that can store safety plan information – there are several available for major mobile devices.  
  • Update 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.