How can I support someone in psychological crisis?

Dave Burke | Features

Date posted: 10 Oct 2025

How can I support someone in psychological crisis?

Source: ChatGPT

Colin sat on the edge of his seat in my office, his eyes darting around the room as if searching for something. Then he said: “I know this is going to sound weird but it’s true. I was watching TV this morning, and the announcer gave me a message to pass on to you today."

The message from the newsreader was nonsense, and I began to suspect that Colin was experiencing psychosis; he was a bit delusional, and his thought processes pretty scrambled.

The necessity of a plan

Every church needs a plan to help people experiencing a psychological crisis. Over the years I have supported people having suicidal thoughts, who have self-harmed, and many having panic attacks. Colin and I were having a calm conversation, and he was in control of himself. Others were clearly a danger to themselves or others. When someone is in crisis, we need to know what to do.

We should pray, and if that person is calm enough, pray with them. Ask their permission, pray briefly and calmly using simple language.

It will help if we have trained the pastorally active people in our fellowship in mental-health first-aid so that they can recognise a crisis and respond appropriately. For example, if someone discloses that they are having suicidal thoughts, how do we know if they are at high risk?

Questions to ask

Three questions can help us discern this:

First, has that person planned how they might take their own life?
Second, do they have the means at hand to do so?
Third, have they attempted suicide previously?

Someone who has a plan and has the means indicates high risk. Alcohol reduces inhibitions and increases impulsivity; a few drinks may lead to a tragedy. The risk is higher if that person has attempted suicide before.

It should be obvious by now that our pastoral carers need confidence, knowledge, and the competence to handle such a conversation. That is why good training is essential.

'Mental health first aid kit'

The pastoral team also needs to know where to refer people in crisis – we need a "mental health first aid kit." This will include contact numbers for emergencies and for less urgent mental health support.

Samaritans ^[1] is a wonderful crisis support service available on the phone; SHOUT ^[2] does the same by text message. I have worked as a volunteer for SHOUT and they are very effective. But if you need to get professional help quickly in the UK, you have four options:

NHS Direct – call 111 - the person you are supporting will need to talk to the call handler. Select the mental health option, and the call handler will risk-assess that person and decide what course of action would be advisable.
Accident and Emergency - take someone to a local hospital with an A&E department. NHS England are planning to open emergency mental health facilities to divert pressure from A&E watch the press for details.
Initial Response Team (Crisis Team). To find this, Google "Crisis Team [your location]". Available 24 hours, seven days a week, throughout the year.
Call 999 and ask for the police – this may sound drastic but if you are concerned that an individual might be at high risk, or a danger to other people, and they won’t seek help, this is your only option. As their resources allow, the police will do a welfare check on that person and take the necessary action.

Your emergency action plan should include all of this, anticipating the needs of a person in crisis. The pastoral team in your church should know what it is and be trained to follow it. You will find my Mental Health First Aid kit on my website if you would like an example. ^[3]

Colin became increasingly agitated as we talked, and I became worried that he might be a danger to himself. He was admitted to hospital later that day and received some excellent treatment. Today he is alive, healthy, and has not experienced symptoms for years. Most crises have a happy ending, preparing for one helps to ensure it!