When Someone You Are Supporting is Experiencing an Acute Psychiatric Crisis

There is a large spectrum of issues that people can be dealing with when they utilize peer support within post-secondary schools. These issues can range from stress and overwhelm with one’s course load, to dealing with a serious mental illness, or even suicidal ideation.

The word crisis can have different meanings to different people. Like any mental health struggle, a crisis can affect us at any point on a continuum. When we say “acute psychiatric crisis” we are talking about a situation that requires professional intervention, which could mean a call to 911 or a stay in a local hospital psychiatric ward.

The free dictionary defines acute psychiatric crisis this way:

A generic term for a situation in which a person is mentally volatile, suicidal, psychotic, or suffering from acute mental decompensation.

Notice and Question Judgements Around Mental Illness

We must always give the utmost respect to people we work with. This means that we listen deeply and give them our attention no matter what issue they’re facing. It’s important to remember that an issue that may seem small to you, may be felt very differently by someone else. There is so much we can’t understand about another person’s experience. Remember that you have a different worldview and different experiences than the other person; when you notice judgements arising, pay attention to them. It is essential that we notice and question our judgements rather than simply believing our thoughts as objective truth. When we don’t challenge these thoughts they can cause harm.

Remember that it is normal to feel judgemental in this work from time to time; our goal is not to be free from judgment (as we’ve discussed, all humans judge!). Rather, our goal is to notice and challenge our judgements when they arise. Get curious about the judgement and remind yourself that you don’t know the whole story. Put empathy and compassion into practice, and offer a generosity of assumption. It’s important that we notice and suspend any of our own judgements when supporting someone else.

Something else to keep in mind is that our judgements may have been influenced by something said by someone on our team. It can be common to share information about people between team members in an effort to support each other. However, sometimes that information can actually just be a judgement in disguise. If that is the case, we must be careful to challenge those judgements too. When we share information with others on our team we must keep our opinions, judgements, assumptions, and biases out of it and as much as we can–just share facts.

Remember the Basics

In peer support work, it’s important that we learn to recognize the signs of when things are becoming unmanageable for the person, and know when it’s the time to refer them to a counselor or other professional within the institution.

When someone you are supporting is experiencing a mental health crisis, please keep the following in mind:

  • Know your role and be clear on your role description
  • Know your school’s policies and procedures on what to do in emergency and crisis situations. What is expected of you? Who do you call? When do you need to call? Who can support you if you encounter an emergency?
  • Even if you know about a certain diagnosis or have experienced the same issue, do not ever give clinical advice
  • Though you might have some education about medications and other treatments, peer support workers never offer advice about medications or clinical treatments
  • Consider taking extra trainings such as Mental Health First Aid or ASSIST & SAFER suicide prevention trainings
  • If someone is dealing with a crisis related to a past trauma, remember that peer support workers aren’t trained as trauma counsellors. Do not offer support or advice that can be perceived as trauma counselling

What You Can do in the Moment

When supporting someone who is experiencing a mental health crisis, here are some of the valuable things you can do in the moment:

  • Provide emotional support and connection.
  • Listen. Listening, and perhaps supporting someone to reframe their thinking, is very supportive for someone experiencing a crisis.
  • If the person consents, advocate for the needs of the person you are working with, in situations where their needs are not being attended to.
  • If it is a crisis situation, and you assess that the person is in danger of hurting themselves or others, seek support from a professional right away.
  • Share powerful practices that can relax the nervous system during crisis (like
    deep breathing exercises).
  • Offer empathy and your presence. Just being there can make a world of difference for someone!
  • Hope. Consider that one’s hope is like a balloon. When someone is in acute crisis, they may not be able to hold their own balloon. You get to hold it for them.
  • Support your peer to access important resources that they may be unable to access on their own, because of the crisis.

If appropriate, and the person is receptive to hearing your story–share your past experience with crisis and any transformative, hope-filled moments that supported a shift in you.


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Post-Secondary Peer Support Training Curriculum Copyright © 2022 by Jenn Cusick is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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