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What is a Mental Health Crisis (Part 2)

Author: Rahma A. Azmi

Trigger Warning: The following article contains content about suicide

Important fact: anyone who is feeling suicidal can bring themselves to the nearest government hospital (not private hospitals), approach the emergency ward, and inform the nurses that they are struggling with suicidal thoughts. The hospital will take over and provide relevant care and support until the person is stabilised.

In What is a Mental Health Crisis (Part 1) it was discussed how to know when someone is going through a mental health crisis, what to do, and how to respond when witnessing someone in a mental health crisis. In this second part, preventative/safety measures along with self-care measures are introduced.

Q4. What are some preventive/safety measures that can be taken? How to identify triggers and create a safe environment?

By Jonathan Au

When a person is going through a mental health crisis, it is common for unpredictable outcomes and behaviours to occur (e.g., suicidal ideation, self-harm, etc.). Coming up with a safety plan can be a helpful tool for individuals to address escalating behaviours or symptoms of crises. A safety plan should be created by the person with the mental health crisis together with their family and/or friends. The best time to develop this plan is when things are going well.

Here are five steps to help take preventive measures and come up with a safety plan:

Step 1: Identify and list down warning signs or triggers

  • While there are general warning signs, triggers can be highly individualistic in nature, making it difficult to identify. Thus, it is important to listen and assist in a non-judgmental way.

  • Look out for situations or events that tend to create overwhelming feelings, such as fear, anxiety, and anger.

  • Certain situations which may be triggering include being isolated without social contact, not having enough sleep, financial struggles, conflict/arguments with loved ones or friends, overwhelmed by the amount of work tasks

  • Thoughts may include “when I notice I’m skipping meals, thoughts of suicide/self-harm surface”, “... reminds me of abuse I’ve experienced”

Step 2: Identify and list down coping skills

  • Make a list of certain things they can do as they're going through a mental health crisis. This can consist of anything that provides comfort or some distraction from the crisis.

  • Be mindful of the limited access to resources and be non-judgmental when helping others come up with their coping resources

  • Some ways to cope may be taking a warm, relaxing bath or shower; watching their favourite YouTube channels (ensure they are not triggering); taking deep breaths; listening to music; painting or making art; journalling; and many more.

Step 3: Identify and list down social contacts

  • Have a list of contacts (minimum three names and phone numbers) one can reach out to during a mental health crisis in case one is unable to distract themselves with self-help/coping measures. It's important to have more than one contact in case they are unavailable.

  • Examples of social contacts: a close friend, a parent, a partner

Step 4: Identify and list down professional assistance resources

List down available professional resources, along with their phone numbers, email address, clinic/hospital address (if applicable) and other pertinent contact information.

  • This is a good place to keep a number of mental health crisis hotlines:

  • 24 Hour Hotlines:

  • BeFrienders - 03-7627 2929

  • Talian Kasih - 15999

  • Women's Aid Organisation - 03-3000 8858

  • Tenaganita - 012-335 0512 or 012-339 5350

  • Others:

    • AWAM: Telenita Helpline - 016-237 4221 or 016-228 4221 (9:30AM - 5:30PM Mon-Fri)

    • Buddy Bear Childline - 1800-18-2327 (12PM - 12AM Everyday)

    • General Emergency - 999

  • Note that this isn't a comprehensive list of available hotlines. There are many more out there, but having a few listed can make a big difference.

Step 5: Make the environment safe

  • Discuss access to anything harmful or lethal. Identify measures to secure lethal means, be it someone who can help or by locking the lethal means and passing the key to someone

  • Utilise personal resources they can engage in to influence safety in their environment

  • Going to another location until the urges or crisis have passed, e.g., leaving the house and going for a walk

Once a safety plan has been developed, ensure it is easily and safely accessible. If they begin to experience any of the warning signs or triggers listed in the safety plan, have them proceed through the steps they've previously outlined, one by one, until they are feeling safe again. This gives them something to do and can distract them from the mental health crisis.

Q5. How do I take care of myself after helping someone out of a mental health care crisis?

By Erin Indriani

Witnessing or involving yourself with people with mental health crises can be quite stressful and, to some extent, traumatizing, depending on the severity of the situation. It is common to have an emotional response following such an instance. After going through a stressful/traumatic experience, it is best to try to notice how it affects you and take necessary measures. You can do this through:

  • Validating your emotions – Everyone has a different reaction and that is okay. How you feel about the experience is personal and unique to you. It is common to elicit unexpected emotions when exposed to stressful/traumatic experiences, but it is important to accept your feelings as it is necessary to help you heal.

  • Give yourself time – It takes time for you to process what has happened to yourself and others during and after a traumatic/stressful experience. Be compassionate towards yourself.

  • Relaxing – Try to do things that can help you to be at ease. Relaxation may help to reduce your stress level which in turn helps to process the situation better.

  • Get support from your social circle – It can be comforting to be surrounded by people you trust, such as family and friends. Reach out and tell them what support you need from them, such as a listening ear or just to be there for you.

  • Talk about it – It is okay to share and express your feelings and thoughts that you experienced. Talking often helps to release stress. Talk with people you trust, at your own pace.

  • Practice self-care – Self-care is not only a destressing strategy but also helps increase emotional resilience and reconnect with yourself. It is essential to remember to take care of yourself too. Your physical needs are as important as your emotional needs.

An ounce of prevention is worth a pound of cure. While it is good to be prepared should something happen to you or a loved one, it is always best to try to prevent a mental health crisis. This can be done by cultivating daily healthy habits such as deep breathing, journal writing, exercise or light stretching, eating healthy, relieving stress, getting good sleep, maintaining social relationships, etc.

If you are worried about someone in your life and believe they require further assistance, Thrive Well offers various mental health services, such as mental health screening, therapy, career guidance, etc. To learn more, find out on our website or follow Thrive Well on social media.

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