National Mental Health Crisis Hotlines

Mental health has become an increasingly critical aspect of overall well-being. Despite growing awareness, many people still don’t recognize the signs of a mental health crisis or know where to turn for help. This guide aims to bridge that gap, providing comprehensive information about mental health crises, their causes, and the various resources available for support.

From understanding the types of mental health issues that may lead to a crisis to navigating the barriers to treatment, this guide covers a wide range of topics. Most importantly, our team has provided a curated list of resources, including crisis hotlines, organizations dedicated to specific demographics, and self-screening tools for those in need. Remember, seeking help is a sign of strength, and support is always available.

If you or someone you care about is experiencing a mental health crisis, immediately call 911 or contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

National Resources For People At Risk For Mental Health Crisis

Below is a list of the resources available for people in need of a crisis hotline.

Mental health hotlines you can call during a crisis:

• National Suicide Prevention Lifeline 1-800-273-TALK (8255) — A 24/7, free, and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States.
• National Alliance on Mental Illness (NAMI) HelpLine 1-800-950-NAMI — NAMI will provide information about local support services and treatment options.
• Crisis Text Line — A global not-for-profit organization providing free mental health texting service through confidential crisis intervention via SMS message. Text MHA to 741741 to reach the Crisis Text Line.

Organizations for LGBTQ+ people experiencing mental health issues:

• LGBTQ Hotline 1-888-843-4564 — Provides confidential peer support, information, and local as well as national resources for callers of all ages.
• It Gets Better Project 1-800-322-3722 — A nonprofit organization with a mission to uplift, empower, and connect lesbian gay, bisexual, transgender, and queer youth around the globe.
• The Trevor Project 1-866-488-7386 — The world’s largest suicide prevention and crisis intervention organization for LGBTQ young people.
• Trans Lifeline 1-877-565-8860 — The Trans Lifeline provides trans peer support for the transgender community. The helplines are primarily staffed by trans people.

Crisis hotlines for family issues:

• National Domestic Violence Hotline 1-800-799-SAFE (7233) — This hotline is an immediate link to lifesaving help for victims, providing information and assistance to adult and youth victims of family violence, domestic violence, or dating violence.
• National Child Abuse Hotline 1-800-422-4453 — A 24-hour hotline dedicated to the prevention of child abuse, offering crisis intervention, information, and referrals to emergency, social service, and support resources.
• National Maternal Mental Health Hotline 1-833-852-6262 — This hotline is free, confidential, and available 24/7 for pregnant women or women who just had a baby.
• Rape Abuse and Incest National Network (NAINN) 1-800-656-HOPE — RAINN carries out programs to prevent sexual violence, help survivors, and ensure that perpetrators are brought to justice.
• Stopbullying.gov 1-877-696-6775 —This federal government website, managed by the U.S. Department of Health and Human Services, provides information on bullying, cyberbullying, who is at risk, and how to prevent and respond to bullying.

Mental health resources for older adults:

• National Council on Aging 1-210-653-6161 — A trusted national leader working to ensure that every person can age well, offering resources on health, finances, and more for older adults.
• SAGE LGBT Elder Hotline 1-877-360-LGBT (5428) — Connects older LGBTQ+ adults and caretakers with friendly responders.

People with co-occurring mental health and substance use disorders:

• National Substance Abuse Hotline 1-866-210-1303 — A 24/7, free and confidential treatment referral and information service (in English and Spanish) for individuals and families facing mental and substance use disorders.
• Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Finder — A confidential and anonymous source of information for persons seeking treatment facilities in the United States or U.S. territories for substance use and mental health problems.

For military veterans experiencing mental health crises:

• U.S. Department of Veterans Affairs (VA) 1-800-698-2411 — Provides care and federal benefits to veterans and their dependents, including comprehensive mental health services.
• National Veterans Foundation 1-888-777-4443 — Serves the crisis management, information, and referral needs of all U.S. veterans and their families through the management and operation of a toll-free helpline for all veterans and their families.
• Veterans Crisis Line — Connects veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline, online chat, or text. Dial 988 then press 1 or text 838255 to find help.
• Wounded Warrior Project 1-888-997-2586 — Offers a variety of programs, services, and events for wounded veterans of the military actions following September 11, 2001.

Mental health self-screening tools:

• Heretohelp — Provides information about mental health and substance use, including online screening self-tests for well-being, mood, anxiety, and risky drinking.
• Mental Health America — This resource offers a variety of mental health screening tools to help people understand and gain insight into their mental health.
• Talkspace — An online therapy platform that offers a free mental health assessment to match you with a licensed therapist.

What Happens On A Mental Health Crisis Hotline?

Mental health crisis hotlines serve as a crucial lifeline for people experiencing acute emotional distress or contemplating self-harm. When someone calls a crisis hotline, they are usually answered quickly by trained crisis counselors.

What to expect on a crisis hotline:

• Assessment — The counselor will assess the caller’s immediate safety and the urgency of the situation.
• Active listening — The counselor provides a non-judgmental, empathetic ear, allowing the caller to express their feelings and concerns freely.
• De-escalation — If the caller is highly agitated or in immediate danger, the counselor will work to calm them and ensure their safety.
• Problem-solving — The counselor may help the caller explore coping strategies or immediate steps to address their crisis.
• Safety planning — For callers at risk of self-harm, the counselor will work with them to create a safety plan.
• Follow-up — Some hotlines offer follow-up calls to check on the caller’s well-being.

It’s important to remember that crisis hotlines are not a substitute for ongoing mental health care, but they can provide crucial support during acute crises and help connect individuals with longer-term resources.

How Mental Health Crisis Are Caused

Mental health crises don’t typically occur overnight. They are often the result of a complex interplay of biological, psychological, and environmental factors. Common triggers may include severe life stressors such as job loss or divorce, chronic stress, traumatic experiences, drug or alcohol addiction, social isolation, and more.

What constitutes a crisis can vary from person to person. What might be manageable for one individual could be overwhelming for another. People experiencing an intense mental health episode may become a threat to themselves or others and should immediately seek the help of a healthcare professional.

Types Of Mental Health Issues That May Lead To Crisis

Various mental health disorders can potentially escalate into a crisis situation. Below are some of the most common disorders among people at risk for mental health crises.

Major Depressive Disorder

Major Depressive Disorder (MDD) is characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities. Symptoms may include persistent sadness or “empty” mood, feelings of hopelessness, irritability, decreased energy, and thoughts of death or suicide. In severe cases, MDD can lead to a crisis, particularly if the individual experiences intense suicidal ideation or attempts self-harm.

Post Traumatic Stress Disorder (PTSD)

PTSD can develop after experiencing or witnessing a traumatic event. Military personnel, law enforcement officers, paramedics, and other first responders are at increased risk for developing PTSD due to the extreme nature of their work environment.

Symptoms include:

• intrusive memories or flashbacks
• avoidance of reminders of the trauma
• negative changes in thinking and mood
• nightmares or sleep disturbances
• feeling detached from others

PTSD can lead to a crisis when symptoms become overwhelming or when the individual encounters triggers that intensify their symptoms.

Anxiety

Anxiety disorders encompass a range of conditions characterized by excessive worry, fear, or panic. Common types include generalized anxiety disorder, panic disorder, and social anxiety disorder. Symptoms may include restlessness, difficulty concentrating, sleep disturbances, and physical symptoms such as rapid heartbeat, sweating, or trembling. An anxiety crisis might occur when anxiety symptoms become so severe that they interfere with daily functioning or lead to panic attacks.

Bipolar Disorder

Bipolar disorder is characterized by alternating periods of mania (or hypomania) and depression. During manic episodes, a person with bipolar may have increased energy, euphoric mood, and impulsivity. During a depressive episode, bipolar individuals will exhibit symptoms similar to major depressive disorder.

Bipolar disorder can lead to crisis during severe manic episodes, where individuals might engage in dangerous behavior, or during depressive episodes where there’s an increased risk of self-harm or suicide.

Schizophrenia

Schizophrenia is a complex disorder that affects a person’s ability to think clearly, manage emotions, make decisions, and relate to others. A crisis may occur when psychotic symptoms become severe, causing the individual to lose touch with reality or act on delusional beliefs.

Symptoms of schizophrenia include:

• hallucinations
• delusions
• disorganized speech or behavior
• reduced emotional expression, lack of motivation

Obsessive-Compulsive Disorder (OCD)

OCD is characterized by recurring, unwanted thoughts (obsessions) and repetitive behaviors (compulsions). These may include intrusive, distressing thoughts or images, repetitive behaviors or mental acts performed to alleviate anxiety, significant distress or interference with daily life due to obsessions and compulsions, and more.

An OCD crisis might emerge when symptoms become so severe that they completely disrupt an individual’s ability to function or when the person becomes overwhelmed by their obsessions.

Dissociative Disorders

Dissociative disorders involve a disconnection between thoughts, memories, surroundings, actions, and identity. Types include dissociative identity disorder and depersonalization-derealization disorders. People facing dissociative disorders may experience memory loss of certain events or people, a sense of being detached from themselves, and a blurred sense of identity. A crisis can result from dissociative symptoms becoming severe, leading to confusion, distress, or dangerous behavior.

Rates Of Mental Health Disorders In The U.S.

Understanding the prevalence of mental health disorders in the United States helps contextualize the importance of crisis support services.

Recent data shows:

• An estimated 57.8 million adults in the United States have a mental illness. This is more than one in five adults.
• In 2021, 13.1 million adults experienced a serious mental illness, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
• Around 21 million adults in the U.S. have had at least one major depressive episode in the past year, based on data from the National Institute of Mental Health (NIMH).
• Anxiety disorders are the most common mental illness in the U.S., affecting nearly 40 million adults, or 18.1% of the population.
• PTSD affects approximately 3.6% of U.S. adults in a given year.

Factors That May Influence A Mental Health Crisis

Several factors can contribute to or exacerbate a mental health crisis.

Stressors At Home Or Work

Chronic stress from work or home environments can significantly impact mental health. This might include high-pressure job responsibilities, conflicts with coworkers or supervisors, financial stress, relationship difficulties, caring for a sick family member, or major life changes such as moving or divorce. When these stressors accumulate or become overwhelming, they can trigger or worsen mental health symptoms, potentially leading to a crisis.

Co-occurring Substance Abuse

The relationship between substance abuse and mental health is complex and bidirectional. Substance abuse can exacerbate symptoms of mental health disorders, interfere with medications used to treat mental health conditions, lead to new mental health problems, increase risk-taking behaviors, and worsen cognitive impairment. When substance abuse co-occurs with mental health disorders, it can significantly increase the likelihood of a crisis and complicate treatment.

Social Isolation And Loneliness

Prolonged social isolation or feelings of loneliness can significantly impact mental health and potentially lead to a crisis. Humans are social beings, and a lack of meaningful connections can lead to depression, anxiety, and in severe cases, suicidal thoughts. This factor has become increasingly relevant in the context of global events that necessitate physical distancing.

Chronic Physical Health Conditions

Living with a chronic illness or experiencing a sudden health crisis can have profound effects on mental health. The stress of managing symptoms, treatment regimens, and lifestyle changes, coupled with potential changes in independence or self-image, can contribute to the development of mental health issues or exacerbate existing ones.

Genetic And Biological Factors

While not typically immediate triggers, genetic predisposition, and biological factors can increase vulnerability to mental health crises. Family history of mental illness, hormonal imbalances, or neurochemical factors can influence an individual’s susceptibility to mental health issues and potential crises.

Understanding these diverse factors can help identify potential risks and implement preventive measures. It’s important to note that experiencing one or more of these factors doesn’t necessarily mean a crisis will occur, but awareness can promote early intervention and support-seeking behaviors.

Barriers To Treatment For People With Mental Disorders

Despite the prevalence of mental health disorders, many individuals face significant obstacles in accessing care. Understanding these barriers is crucial for improving mental health services and crisis support.

Stigma

Mental health stigma remains a significant barrier to seeking help. This can manifest as self-stigma, which is internalized shame or negative beliefs about having a mental health condition; public stigma, which involves negative attitudes or discrimination from others; and institutional stigma, which includes policies or practices that limit opportunities for people with mental health conditions. Stigma can prevent individuals from acknowledging their need for help or seeking treatment, potentially allowing their condition to worsen to the point of crisis.

Accessibility To Care

Access to mental health services is not uniform across populations or geographic areas. Barriers include a shortage of mental health professionals, especially in rural areas; long wait times for appointments; lack of transportation to mental health facilities; insufficient culturally competent care for diverse populations; and limited services for specific age groups such as children or older adults.

These accessibility issues can delay or prevent individuals from receiving necessary care, increasing the risk of mental health crises.

Limited Awareness

Many individuals may not recognize the signs of mental health problems or understand when to seek help. This can be due to a lack of mental health education in schools and communities, misconceptions about what constitutes a mental health problem, and difficulty distinguishing between temporary emotional struggles and more serious conditions. Improved mental health literacy could help individuals seek help earlier, potentially preventing crises.

Confidentiality Concerns

Fear about the privacy of mental health information can deter some individuals from seeking help. Concerns might include worry about employers or others finding out about their mental health condition, fears about how mental health diagnoses might affect future opportunities, and misunderstandings about the limits of confidentiality in therapy. Clear communication about privacy rights and the limits of confidentiality in mental health care is crucial to addressing these concerns.

Financial Barriers

The cost of mental health care can be prohibitive for many individuals. Issues include lack of insurance coverage for mental health services, high co-pays or deductibles, limited coverage for certain types of therapy or medications, and concerns about the long-term cost of ongoing treatment. Addressing these financial barriers is crucial for improving access to mental health care and crisis prevention.

Tips For People Seeking Mental Health Services

Below are some tips for people considering mental health services.

Helpful tips include:

• talk to a primary care physician — They can provide initial screenings and referrals to mental health specialists.
• check insurance coverage — Understand what mental health services are covered under your plan.
• research different types of therapy — Different approaches work better for different issues and personality types.
• consider telehealth options — Many providers now offer virtual sessions, which can increase accessibility.
• don’t hesitate to “shop around” — It’s okay to try different therapists to find the right fit.
• involve trusted family or friends — support from loved ones can be invaluable in the recovery process
• know crisis resources — familiarize yourself with local crisis hotlines and emergency services.

Seeking help for mental health issues is a sign of strength, not weakness. If you’re experiencing a mental health crisis, don’t hesitate to reach out to a crisis hotline or emergency services.

Published on September 17, 2024

Written by the Addiction Resource Editorial Staff