This is not a site for personal disclosure of mental health distress or suicidal thoughts or behaviours.

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There isn’t always a clear line between distress and crisis.

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Someone is experiencing a mental health crisis when they are at risk of hurting themselves or others. 
If you or someone you know is in crisis, call a helpline, 9-1-1 or emergency services immediately or go to your nearest emergency department. If possible and appropriate, ask which option they prefer. 

Get them help right away, but the Golden Rules still apply.

Say What You See

Golden Rule #1

If you notice changes in someone’s thoughts, feelings and behaviours that are intense, long lasting and negatively impacting their life in a big way, you need to speak up. Stick to the facts. Don’t judge. Don’t make assumptions. If you think someone is suicidal or might intentionally hurt themselves, be clear and direct and ask them. You may feel uncomfortable asking, but it can be as simple as, “Are you thinking about suicide?” They could lie, they could be offended, they could get upset, but at least they’ll know you care and that you’re there to talk to.

Show You Care

Golden Rule #2

Don’t leave them alone. Stay with them until they get the professional help they need, or as long as it is safe for you to be there.

Hear Them Out

Golden Rule #3

If they’re willing to talk, listen and make them feel heard. Ask follow up questions to better understand the situation and don’t be afraid to ask tough questions. E.g. “Are you hurting yourself?” “Are you thinking of ending your life?” “Do you have a plan?” Talking about self-harm or suicide won’t put an idea in their head that is not already there. It’s important to ask directly so you can get them the help they need.
 

Know Your Role

Golden Rule #4 

At this point they need professional help, and your role is to be a friend and do what you can to keep them safe until help arrives. Don’t promise not to tell anyone; if their life is at risk, getting help trumps keeping a promise. Set boundaries to keep yourself safe and take care of yourself too. It can be really hard to see someone you care about struggling or in crisis. Don’t try to handle it on your own.
 

Connect to Help

Golden Rule #5

Immediately contact a caring adult you trust or call 9-1-1 or emergency services for help. If possible and appropriate, ask which option they prefer. If you need to call 9-1-1 or emergency services, be prepared to answer some questions. Tell them where you are as specifically as possible, describe the situation and the help you need so they can understand the severity of the situation you’re in. Be cooperative and patient and allow them to go through their assessment questions.
 

Questions from the community

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What if they ask me not to tell anyone?

What if they ask me not to tell anyone?

It’s important to preserve trust in your relationship, but you also have to prioritize their safety. It depends what the secret is, but if their life is at risk then explain that you can find a way to discreetly get them the help they need. You can say something like, “I need you to know that I can’t keep this a secret” and work to create a plan you’re both comfortable with. If they are not cooperative in that, you have to do the tough work of telling someone else anyway. Sometimes it’s specific like they don’t want you to tell their parents. In this case, maybe you can agree on someone else you can go to. In any case, if someone is in crisis, their safety is your first priority and your relationship comes second. You can stay loyal to your friend by caring for them and getting them the help they need.
What if they don’t want me to get help or get mad when I do?

What if they don’t want me to get help or get mad when I do?

Put your say what you see skills to work and tell them what it is that makes you feel the need to bring in professional help. Hear them out and be sensitive to their past experiences and their concerns. Don’t assume you have all the answers, but find a solution that works for them. If your gut tells you that they’re in crisis; call a helpline, 9-1-1 or emergency services. If possible, don’t leave them alone. As long as you aren't in danger, stay with them until help comes.
 
What if they disclose self-harm to me online or I notice something on social media?

What if they disclose self-harm to me online or I notice something on social media?

If you think this person is in immediate danger and you know their location, call 9-1-1. If you do not think they are in immediate danger then you can use the Golden Rules to reach out to this person to offer your support. Don’t jump to any conclusions or try to fix things. Your role is to be there, listen and connect them to helpful resources and professional services. Some social media platforms like Twitter and Facebook have reporting tools. If they are not in immediate danger but you don’t feel comfortable reaching out to them directly, you can report your concern. For example, Twitter will assess your report, contact the reported user and let them know that someone who cares about them identified that they might be at risk. Twitter will provide the reported user with available online and hotline resources and encourage them to seek help.
What if they end up in a hospital, should I go visit? What can I expect?

What if they end up in a hospital, should I go visit? What can I expect?

There is significant stigma attached to hospitals, psychiatric wards in particular, but in reality hospitals are places for healing and often having visitors come by to bring comfort, a laugh or just some distraction is an important part of the recovery process. People struggling with their mental health can be admitted to hospital for a number of reasons; to assess new symptoms, for monitoring while medication is adjusted, for therapy, for treatment of any number of medical conditions associated (or not) with their mental illness, or if they’re at risk of self-harm or suicide. Here are some ways you can offer support to a friend in the hospital.
  • Ask staff ahead of time about rules regarding visiting times and items not allowed on the unit
  • Bring them their favourite items of clothing, moisturizer (hospitals are really dry!), or some other comfort from home
  • Get creative and make them something they’ll appreciate
  • Have fun, play a game, make them laugh
  • Be friendly and non-judgemental with other patients on the unit as well as your friend
  • Literally just be there. Your presence alone can be a huge comfort.
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Find more info

Be There's Golden Rules are a framework to guide you, but there are lots more resources out there.

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Additional Resources

In an emergency:

This is not a site for personal disclosure of mental health distress, suicidal thoughts or behaviours. If you are in crisis, please call a helpline, 9-1-1 or emergency services or go to your nearest emergency department for assistance.

If someone’s thoughts or behaviours threaten the safety of themselves or others, then this is what’s called a mental health crisis. Call a helpline, 9-1-1 or emergency services. If someone has recently hurt themselves, but is no longer in danger, follow Be There’s Golden Rules and connect them to resources in their area.

Being there for someone experiencing a mental health crisis is different than supporting someone through less severe mental health distress, but the same Golden Rules apply. Learn how the Golden Rules apply and how to Be There in a Crisis.

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