Mental Health in a Crisis: How to Recognise and Respond

🟨 ⚠️ Need Immediate Help?
If you’re experiencing a mental health crisis, or you’re worried about someone else:

📞 Call 999 if someone is in immediate danger
📞 Contact NHS 111 for 24/7 urgent mental health support

You are not alone, support is available now.

Mental health crises don’t always happen at home. They can unfold in the most unexpected moments, even at work. During a check-in, in the middle of a team call, or while someone’s quietly powering through their inbox. For HR professionals and people leaders, understanding how to recognise and respond to a mental health crisis is not just a professional skill,  it’s a vital part of building a safe, supportive workplace.

What Is a Mental Health Crisis?

A mental health crisis is a period of intense emotional distress in which someone may no longer be able to function, think clearly, or ensure their own safety. It doesn’t always involve suicidal thoughts, but it often includes feeling out of control, deeply overwhelmed, or disconnected from reality.

• It may look like a full emotional breakdown, a psychotic episode, or complete withdrawal.
• It might be triggered by trauma, chronic stress, burnout, or sudden loss.
• Some people experience panic attacks, dissociation, or severe anxiety, while others might describe a “shut down” or numbness.
  

Every crisis is unique. What’s important is how we recognise and respond. Let’s discover more in the next section.

Recognising the Signs: Common Mental Health Crisis Symptoms

Recognising early signs of mental health crisis symptoms can help prevent escalation and ensure the individual gets the help they need. Symptoms to watch out for include:

• Emotional signs might include visible panic, hopelessness, crying, or emotional numbness. The person may seem overwhelmed by even small tasks or appear highly distressed without clear cause.
• Behavioural signs can range from agitation or outbursts to sudden withdrawal or silence. A typically calm colleague may become irritable or impulsive, or suddenly disappear from a team meeting without providing a reason.
• Physical signs include shaking, disorientation, fatigue, or rapid breathing. The person may say they haven’t slept, feel physically ill, or look visibly unwell.
• Verbal cues are critical. Listen for phrases like “I’m not okay,” “I can’t do this anymore,” or “I don’t feel safe.” These may be said directly, or hinted at in more subtle ways, like “I just want to disappear.”

In a work context, these signs can be easy to miss. Someone who’s withdrawing may be seen as unmotivated. A colleague who lashes out might be labelled as difficult. But what looks like disengagement underperformance could be a call for help. Stress, burnout, and emotional distress don’t always show up as tears or visible breakdowns. Sometimes, they show up as silence, avoidance, or uncharacteristic behaviour. That’s why creating a psychologically safe environment, where people feel able to say “I’m not okay,” is so important.

What to Do in a Mental Health Crisis: Steps to Support Individuals

Stay calm and ensure safety

Your first priority is to stay grounded yourself. Speak slowly, keep your tone gentle, and model steadiness through your voice and body language. If the person is in a crowded or overstimulating environment, invite them to move to a quieter, private space if possible. Make sure there’s no immediate physical danger, and reassure them they are safe. Example: “Let’s find somewhere quieter where we can sit down. You’re safe here.”

Talk and listen without judgment

Remember, you don’t have to have all the answers. The most important thing is to create a safe emotional space where the person feels heard. Avoid rushing to offer solutions or minimising their feelings (“It’s not that bad” or “Don’t worry”). Instead, listen attentively and reflect back their feelings with simple, validating phrases.
Example: “It sounds like you’re going through a really hard time. I’m here for you.”

Call 111 or guide them to A&E if urgent

If the person seems at risk of harming themselves or others, or if you’re unsure how serious the situation is, call NHS 111 for urgent mental health advice. They can assess the situation and direct you to the right help, whether that’s a crisis team, A&E, or immediate intervention. If it’s an emergency, for example, if someone has already harmed themselves or is actively at risk, call 999 straight away. Offer to stay with them while you call, or make the call together if they feel unable to do so alone.🗣️

Sample script: “It sounds like you’re overwhelmed right now, and that’s completely okay. You don’t have to figure this out alone. Would it feel okay if we called for some extra support together?”

📥 Explore this downloadable resource to learn more about assessing the risk of suicide and encouraging professional guidance.

When Crisis Happens at Work

Knowing how to deal with a mental health crisis at work is essential. Crises don’t wait for the ‘right’ moment. They can emerge in a team meeting, a check-in, or a quiet afternoon of emails. Leaders, managers, and HR professionals play a crucial role in how supported an individual feels during and after a crisis. Here’s how to respond thoughtfully:

• Create a compassionate, private space: When someone is visibly distressed at work, privacy matters. Offer a safe, quiet room away from colleagues where they can decompress without feeling scrutinised. Let them know explicitly that their well-being matters more than the immediate work at hand, and that they are not being judged or evaluated in this moment.
• Relieve pressure immediately:  Even if deadlines loom or projects are critical, mental health comes first. Clearly and compassionately give permission for the person to leave work for the day, take a break, or reduce their workload temporarily, without requiring detailed explanations.Example: “Right now, your well-being is the most important thing. Please take the time you need.
• Use available workplace support channels: Remind the employee that professional support is available, whether through an Employee Assistance Programme (EAP), HR, or external resources like OpenUp services. Offer practical help, such as sitting with them while they call an EAP counsellor, arranging a taxi home if needed, or contacting a trusted family member on their behalf if appropriate.

📝 Important note for leaders: Follow up within 24–48 hours to check in to show continued care and support. A simple “How are you feeling today?” can rebuild trust and emotional safety after a crisis event.

🟩 Manager’s Mental Health Crisis Checklist
Is the person physically and emotionally safe right now?
Do they have someone they trust with them or nearby?
Do emergency services or a helpline need to be contacted?
Have you followed up after the incident with care and discretion?

Planning for the Future: Prevention & Preparedness

It’s easier — and often safer — to respond to a mental health crisis when you’ve prepared for it in advance. Thoughtful preparation doesn’t eliminate all crises, but it builds emotional infrastructure so people know how, where, and when to seek help.

Here’s how to plan ahead: 

• Create personal safety plans: Encourage employees to create individual mental health safety plans when they are feeling well, rather than waiting for a crisis. 

These plans can outline personal warning signs (such as sleep disruption, withdrawal, or racing thoughts), preferred coping strategies (such as breathing exercises or reaching out to a specific person), and key emergency contacts. A safety plan acts as a roadmap when someone’s thinking may be clouded by stress, panic, or despair, offering clear steps to follow.

• Normalise regular well-being check-ins: Checking in on mental health shouldn’t just happen during performance reviews or after problems arise. 

Embedding simple, genuine well-being conversations into regular team meetings, asking, “How are you really doing today?” builds trust and openness. Even if someone declines to open up immediately, knowing they could speak honestly without fear of judgment lays critical groundwork for earlier intervention if distress arises later.

• Train mental health first-aiders: Just like physical first-aiders, mental health first-aiders are trained to notice signs of emotional distress early, offer initial support, and guide people towards professional help. 

Having trained peers in every team, department, or office normalises emotional care and ensures crises don’t fall through the cracks simply because managers or colleagues feel unprepared or overwhelmed.

OpenUp’s Role in Supporting Crisis Prevention

At OpenUp, we help organisations create the kind of culture where mental health is cared for consistently, not just when there’s a crisis. Through therapy, self-guided tools and training, we support teams in strengthening their well-being.We’re also developing a dedicated crisis helpline, designed specifically for workplace emergencies, because the right support should be available the moment it’s needed.