What to Do in a Mental Health Crisis: A Step-by-Step Guide for Families

Overview

A mental health crisis is frightening, especially when it involves someone you love. Knowing what to do in the moment, before a crisis happens, can make the difference between a situation that escalates and one that gets the right help quickly.

This guide is written specifically for families and caregivers in the Tri-Cities, including those supporting a loved one with a developmental or intellectual disability. It walks through what to do before, during, and after a mental health crisis, in plain language, step by step.

Save these numbers before you need them:

• 988 — Suicide & Crisis Lifeline (call or text, 24/7)
• Comprehensive Healthcare Crisis Line: (509) 792-1747 or (800) 572-8122 — 24/7
• 911 — for immediate physical danger only

Step 1 — Recognize the Warning Signs

A mental health crisis doesn’t always look the same. For individuals with developmental or intellectual disabilities, signs may be behavioral rather than verbal. Know what your family member’s crisis looks like specifically — and watch for changes from their baseline.

General warning signs include:

• Talking about wanting to die, disappear, or hurt themselves or others
• Extreme withdrawal, hopelessness, or saying “there’s no point”
• Sudden calm after a period of depression (can signal a decision has been made)
• Severe agitation, aggression, or self-injurious behavior that is escalating or unusual
• Inability to care for basic needs — not eating, sleeping, or communicating
• Psychosis — seeing or hearing things that aren’t there, paranoia, confusion about reality
• Panic attacks that won’t de-escalate with usual strategies

For individuals with IDD, watch for:

• Significant increase in self-injurious behavior
• Extreme aggression or property destruction beyond typical patterns
• Complete shutdown or refusal to communicate or engage
• Signs of acute distress your family member cannot verbalize

Step 2 — Stay Calm and Stay Safe

Your calm is contagious. Before doing anything else:

• Take a breath. Your family member will respond to your emotional state — staying regulated helps them regulate.
• Lower your voice and slow your speech. Avoid commands, ultimatums, or raised voices.
• Create space. Remove other people, loud noises, and stimulation where possible.
• Don’t restrain unless there is immediate physical danger — physical restraint can escalate a crisis significantly, especially for individuals with IDD.
• Remove access to anything dangerous if you can do so without escalating — medications, sharp objects, firearms.

If you feel unsafe at any point, if there is immediate risk of physical violence, leave the room, get yourself and others to safety, and call 911.

Step 3 — Call the Right Number

This is one of the most important decisions in a crisis, and the right answer depends on the situation.

Call 988 or the Comprehensive Healthcare Crisis Line (509) 792-1747 when:

• Your family member is expressing suicidal thoughts or self-harm urges
• You are scared for them but the situation is not immediately physically dangerous
• You need guidance on what to do next
• You want to request a mobile crisis response
• You are a caregiver who is overwhelmed and needs support

Call 911 when:

• Someone is in immediate physical danger
• There is active violence or a weapon involved
• Your family member is medically unconscious or unresponsive
• The crisis is beyond what crisis professionals can safely manage remotely

If you call 911 for a mental health crisis:

• Tell the dispatcher immediately that this is a mental health crisis, not a criminal situation
• Mention any disability diagnosis, autism, intellectual disability, etc., so officers can be briefed before arrival
• Ask if a Crisis Response Unit or co-responder can be sent alongside officers
• Stay on the line and provide as much information as you can

Step 4 — Use the Crisis Line as a Guide

Don’t hang up after making the call. The crisis line can:

• Talk you through de-escalation techniques in real time
• Help you assess whether your family member needs to be seen in person
• Dispatch a Designated Crisis Responder (DCR) if involuntary evaluation may be needed
• Request the Youth Mobile Crisis Team for youth in crisis
• Help you decide whether to go to the Crisis Center or Columbia Valley Center for Recovery

If the crisis counselor recommends in-person care, they will tell you where to go and what to expect when you arrive.

Step 5 — Go In Person If Needed

If the situation requires more than a phone call, two local options are available with no appointment needed:

Comprehensive Healthcare Crisis Center
Walk-in crisis assessment, 8:00 AM–8:00 PM daily.
7404 W. Hood Place, Kennewick | (509) 792-1747

Columbia Valley Center for Recovery (CVCR)
The Tri-Cities’ first inpatient behavioral health facility. Sobering services, crisis stabilization, medical detox, and residential treatment. Care provided immediately regardless of insurance.
216 W. 10th Ave., Kennewick (former Kennewick General Hospital site)

Lourdes Counseling Center
Free, 24-hour walk-in psychiatric crisis services for adults 18+.
1175 Carondelet Drive, Richland | (509) 943-9104

When you arrive, tell staff immediately that you are there for a crisis. You will be seen as quickly as possible.

Step 6 — If Your Family Member Refuses Help

This is one of the hardest situations a family faces. If your family member is in crisis but refuses to call for help or go in person:

• Keep talking. Don’t leave them alone if you can safely stay.
• Call the crisis line yourself. You can call 988 or (509) 792-1747 on behalf of someone else — counselors will guide you on what to do.
• Request a mobile crisis response. The Comprehensive Healthcare crisis team can come to you — call and ask for a mobile response. The Youth Mobile Crisis Team specifically serves youth in crisis at home, school, or in the community.
• Designated Crisis Responder (DCR). If your family member is a danger to themselves or others and refuses voluntary care, a DCR can evaluate them for involuntary treatment under Washington’s Involuntary Treatment Act (ITA). Request a DCR evaluation through the crisis line.

Step 7 — After the Crisis

Once the immediate crisis has passed, the work of preventing the next one begins.

• Schedule a follow-up appointment with a mental health provider as soon as possible — ideally within 72 hours of a crisis episode
• Debrief with your family member when they are calm: what triggered it, what helped, what they need you to do differently next time
• Create or update a Crisis Plan — a written document that captures warning signs, what helps, who to call, and what your family member wants to happen in future crises (see below)
• Take care of yourself. Witnessing a loved one’s crisis is traumatic. NAMI Tri-Cities offers free family support — call 1-800-950-6264 or visit namitricities.org

Build a Crisis Plan Before You Need It

The best time to make a crisis plan is when there is no crisis. A crisis plan is a simple written document, ideally made with your family member’s input when they are stable, that captures:

• Warning signs — what does it look like when a crisis is building for this specific person?
• What helps — calming strategies, sensory tools, preferred people, safe spaces
• What doesn’t help — what makes things worse for this specific person
• Who to call — in order: a support person, the crisis line, 911
• Key information for first responders — diagnosis, medications, communication style, sensory sensitivities, what to expect
• Preferences for care — preferred hospital or crisis center, medications they have or haven’t responded to, known allergies

For individuals with IDD who may not communicate verbally, consider a communication card, a laminated card your family member can carry that provides first responders with key information quickly.

Washington State’s free Crisis Planning Tool:
SAMHSA Crisis Plan Template

Quick Reference Card

988 Suicide & Crisis Lifeline → | Comprehensive Healthcare Crisis Services → | Lourdes Counseling Center → | Columbia Valley Center for Recovery → | NAMI Tri-Cities → | Local Mental Health Providers →

FAQ

What if my family member has autism and can’t communicate what they’re experiencing?
Trust behavioral signals over verbal ones. Call the crisis line and describe what you’re observing. Crisis professionals are trained to work with families whose loved ones communicate differently. Mention the autism diagnosis so they can tailor their guidance. If requesting in-person support, let the team know before they arrive so they can prepare for a non-verbal or differently communicating individual.

Should I call 911 or the crisis line first?
If there is immediate physical danger, call 911 first. In all other situations, the crisis line is typically the better first call. Crisis professionals can guide you in real time and dispatch the right response, including whether 911 involvement is appropriate.

What do I do if my family member has a weapon?
Get yourself and others out of immediate proximity, call 911, and then call the crisis line. Tell both dispatchers about the weapon and about any disability diagnosis so responders can be briefed before arrival.

Can I call the crisis line just because I’m overwhelmed as a caregiver?
Yes. You don’t have to be in crisis yourself, and your family member doesn’t have to be actively suicidal. If you are scared, overwhelmed, or don’t know what to do, that is enough reason to call. 988 and the Comprehensive Healthcare crisis line both support caregivers, not just the individuals in crisis.

What is a Designated Crisis Responder and when do I ask for one?
A DCR is a licensed mental health professional with the legal authority to evaluate someone for involuntary psychiatric hospitalization. Request one through the crisis line when your family member is in serious danger and refuses voluntary care. The DCR can conduct a formal evaluation and, if warranted, initiate an Involuntary Treatment Act (ITA) petition.