Guide to Finding Help in a Mental Health/Substance Use Crisis

What do you do when you need medical help? You most likely start by asking your family, friends and professionals for referrals and suggestions. You can somewhat easily make an appointment with a primary care doctor, a local pharmacy, an urgent care or walk into an emergency room.  The options for medical help are relatively straightforward, and the path to accessing medical help can usually begin immediately with no stigma attached. 

What do you do when you need mental health and/or substance use help? Pause for a moment and truly think about this.  Are you as quick to ask friends or family for help? Are you suffering silently, hesitant to ask for help? Is your primary care doctor equipped to handle your needs? Are you/or a loved one already in crisis and need immediate help? If you are new to this world of navigating mental health and/or substance use disease, most likely you don’t know where to turn to for immediate help.  

A few questions to ask yourself: are you looking for help for someone over the age of 18 or under? Do you have health insurance? Does your insurance cover mental health/substance use treatment? Where do you live? Every state and every county within that state has different resources, protocols and systems in place. The laws and rules can also be different for those under the age of 18. Do you know what a psychiatric hold is? Do you know if your state allows holds for substance use? Do you know what happens by law in your state if an individual is still not competent after 72 hours? These are a few of the many questions you may never have thought about or had to think of. 

When you have a child who is exhibiting mental health and/or substance use concerns, it usually makes asking for help that much harder. Many family, friends and professionals do not know where to refer you or do not have the knowledge or experience to offer you the help you need. A psychiatrist or therapist may not have an appointment available for months. A program available last week may no longer be available this week due to funding or other unexpected circumstances. 

Therapists, Psychiatrists, Doctors and treatment programs can choose not to treat you or take your case. Do not be surprised if your first attempts at finding help are far from your last. Stay strong, trust your gut, keep asking questions, and never give up hope. 

What to do when you think things may be beginning to escalate: 

-If a child is a minor (under the age of 18), the first place to seek non-emergency help would be to call your pediatrician and check in with them. If you are over the age of 18, you would call or go see your primary care doctor.  

-If the situation warrants something more involved or has escalated to a crisis, GO to the closest emergency room or call 911. Preferably, go to an emergency room with a well-established mental health division as part of its hospital program. 

-If you call 911, you will be asked several questions about the person in crisis. Do they have access to a weapon? Are they a threat to themselves or others? These types of emergencies can be responded to by various agencies, depending on where you live. 

-Emergency rooms/local hospitals are usually quick fixes to what may be a bigger issue, which will require you to establish a relationship with a therapist and/or psychiatrist or other treatment provider for ongoing treatment.

-Address the medical emergency of any crisis first. No treatment facility will be able to admit a person until they are medically stabilized. 

-Once a person is medically cleared from the hospital, they will often be immediately discharged, whether you have a post-hospital plan in place or not.  Depending on the care needed after a hospital visit or stay, you may need to find an inpatient and/or outpatient program quickly. 

-As a parent or caregiver needing immediate care for a loved one, this can be very scary and very confusing. Always trust your gut. You do have choices. Those choices are often made under duress. Try to take deep breaths, think clearly, ask a lot of questions and be an advocate. Your loved one needs you to be their support, as they oftentimes are not in a clear mental space to advocate for themselves. 

-Do not assume because you have a doctor to help you that they are the right fit for your child/loved one or situation. Sometimes it may take multiple attempts to find the right fit. 

-Do not assume that a primary care doctor or an emergency room doctor will know the resources available to you or the appropriate options for your child. Even if your child has been triaged by a psychiatric professional in a hospital setting, that does not mean they know your child better than you know them. 

-Finding help is often a multiple-step process, getting passed from one person/place to another to eventually get to where your child needs to be. It is exhausting. It is time-consuming. Your loved one is worth it, and your patience and diligence are helpful. 

-The first place you turn to for help may not be the last; the first doctor will not be the last. And if you are that lucky, you should be living in Vegas. Remember, you are your loved one’s advocate, and they need you to keep going and get them the help they need. 

-Not everything is straightforward. Insurance, availability of beds and other challenges come into play. Familiarize yourself with your insurance policy and what it covers for benefits, copays, hospital stays and which doctors/hospitals are covered under your plan. 

-Do not be surprised if you must pay out of pocket for the help you need. This is not uncommon. 

-When do you start finding help?  Ideally, start looking before you are in crisis. Make a list of options for when plans A, B, and C don’t work out. 

-It is possible that the best doctor, the best program and the best option for help for you or your loved one may not be in your town, county or even your state. 

-If your child/loved one is dealing with a mental health crisis, it can be a process to get them evaluated and the immediate help they need. Buckle up for at least a 72-hour adventure.  

-Stabilization is often the first goal in a mental health emergency. 

-Medical treatment, detoxification, and stabilization are the preliminary goals of a substance use emergency.

-Always carry Naloxone (Narcan) in case of an unexpected overdose.

-Familiarize yourself with some of the terms used for levels of care in both mental health and substance use programs:

IOP (Intensive Outpatient Treatment

PHP (Partial Hospital Program). Residential Treatment 

Detox (Detoxification from drugs/alcohol)

-Support your child/loved one, talk to them, advocate, listen, never shame them. Mental health and substance use crises are the result of a complicated disease. 

-Read up on resources in your area. To name a few: Mental Health of America, ADAMH, NAMI, 988 Suicide and Crisis Line, Prevention Action Alliance and SAMHSA. 

-For those who live in Columbus, Ohio, the Franklin County Crisis Care Center recently opened its doors to serve those in a mental health/substance use crisis 24/7. Knowing that there was a 24/7 place to go in an emergency would have been a huge blessing to me and my family when there was nowhere like it to turn. 

-It takes time to get help. It takes time to have that help heal. Just like a serious medical condition, you often may need multiple appointments, try different medicines and therapies to feel better or find the right remedy to maintain the illness that is a part of your life. 

-Real life is not always as shown in the movies. Treatment is not entirely like on television or in the movies. It is very misleading to believe that you can go into a short-term program and you will be miraculously fixed and all will be well when you walk out. Many people navigating these diseases must maintain their illnesses with ongoing therapy, medicine and may attend multiple treatment programs throughout their lives. 

This information is intended to be a guide and provide some insight into navigating finding help for mental health and/or substance use. Everyone's circumstances, resources, and journey will be different. 

If you or a loved one is experiencing a mental health/substance use crisis, please reach out to your doctor for professional help, call 911 or go to the nearest hospital. 

NEVER GIVE UP HOPE!!!