Navigating A Mental Health Crisis In Massachusetts

Experiencing a mental health crisis is overwhelming for the individual involved and their loved ones. A crisis, also referred to as a “nervous breakdown,” can affect anyone at any time. Someone does not need to have a diagnosable mental illness to have a mental health crisis.

The intensity of a crisis can stir emotions in other people, and reasonably so; however, heightened emotions can make it difficult to determine how to de-escalate the situation. Actions taken in the moment can be crucial to ensuring the health and safety of the person in crisis and even sometimes those around them.

State Of Mental Health In Massachusetts

For the last several years, the U.S. has experienced a mental health crisis, and the state of Massachusetts is no exception. More than one in five adults have a mental illness in Massachusetts, with 14% of adults reporting persistently poor mental health, and nearly 5% of adults having serious thoughts of suicide, according to the 2023 Community Health Equity Survey (CHES) Mental Health Report and the Massachusetts Medical Society.

In February 2023, findings from a study by KFF, formerly the Kaiser Family Foundation, indicated that 30.8% of adults in Massachusetts had symptoms of anxiety and/or depressive disorder. The same study stated that between 2011 and 2021, the rates of drug overdose deaths more than doubled, from 12.7 deaths per 100,000 people to 36.8 deaths per 100,000 people. In 2023, 21.6% of people in Massachusetts had a behavioral health-related visit, according to Massachusetts’ Center for Health Information and Analysis (CHIA).

While mental illness and substance abuse can increase the risk of having a mental health crisis, it’s both possible and common to experience a crisis without a diagnosable mental illness. Life is filled with moments that are emotionally taxing, devastating, and paralyzing, and depending on any number of factors, any one of these moments can feel too difficult to bear. The experience is highly subjective, and what causes a mental health crisis for one person may not do the same for another. Further, a person may experience a mental health crisis at one point in their life, but a similar incident may not cause the same effect at another stage. Because of the unpredictable nature of life, it’s impossible to foresee whether someone will have a mental health crisis or not at any given point.

How To Identify A Mental Health Crisis

A mental health crisis occurs when a person’s level of emotional distress and/or stress brought on from life circumstances affects their ability to think and act rationally, compromises their capacity to perform basic care for themselves, and/or poses an immediate concern for their own safety and/or the safety of others. The terms “mental health crisis” and “nervous breakdown” are often used interchangeably, but the latter is a non-medical term. Someone experiencing a mental health crisis requires support from medical professionals. When a crisis occurs, it signifies that previously used coping mechanisms are no longer working and additional intervention is needed. Anyone can experience a mental health crisis at any time.

There are many telltale signs for identifying if you or someone you know is experiencing a mental health crisis. Some signs may present simultaneously, and others may present sporadically.

Signs that may be indicative of a mental health crisis include:

• being unable to perform day-to-day tasks
• displaying aggressive and/or violent behaviors
• experiencing hallucinations, delusions, paranoia, and/or psychosis
• feeling sudden and intense changes in mood, e.g., fluctuating between anger, anxiety, depression, guilt, hopelessness, rage, shame, panic, and/or periods of mania
• getting one’s affairs in order
• giving away prized possessions
• having thoughts, or making threats or attempts, to harm oneself or others
• increasing substance use
• isolating uncharacteristically
• neglecting personal hygiene
• partaking in risk-taking behaviors
• withdrawing from loved ones

While the above-mentioned signs are indicative of a mental health crisis, there are some signs that are cause for taking immediate action.

Seek help immediately if you or a loved one experiences any of the following:

• being verbally and/or physically abusive
• failing to eat or sleep for days
• having delusions or hallucinations
• isolating excessively
• making threats or attempts to harm oneself or others

Stressors Contributing To Mental Health Crises

There are many life experiences, isolated and combined, that can cause someone to experience a mental health crisis. However, what causes one person to have a crisis may not affect another person similarly. Aside from life stressors, many other variables may contribute to a mental health crisis, such as how someone typically handles stress, having a mental, emotional, and/or physical health issue, history of trauma, current lifestyle, and more.

Factors that may increase the risk of having a mental health crisis include:

• academic stress
• access to a firearm
• community risk factors, e.g., discrimination, lack of access to health care, overcrowding, pollution, violence, etc.
• drug or alcohol use
• familial dysfunction
• family history of substance abuse and/or mental illness
• genetic predisposition
• history of mental illness
• job loss
• loss of a loved one
• medical diagnosis
• military combat
• natural disaster
• previous suicide attempt
• relationship changes, e.g., separation, breakup, divorce, estrangement, etc.
• relationship conflict, e.g., physical, emotional, and/or sexual abuse, violence, bullying, high conflict, etc.
• social isolation
• trauma

3 Steps For Dealing With A Mental Health Crisis

Dealing with a mental health crisis can be overwhelming for the person in crisis and their loved ones. Having knowledge of the general steps to take, and the resources available for people experiencing a mental health crisis in Massachusetts, can help to maintain safety and deescalate the situation.

Step 1: Determine If There Is An Emergency

Most people, if not all, will face overwhelming situations in their lives. Again, what is overwhelming for one person may not be overwhelming for another. While some behaviors are normal responses, like crying after a breakup or being angry with a friend over a disagreement, other behaviors aren’t. Examples of abnormal reactions to stressors that may signify a mental health crisis include being unable to shower, eat, or get out of bed after a breakup or making threats to physically harm a friend.

If you aren’t sure what may constitute an emergency, it’s best to err on the side of caution. If someone displays any of the above-mentioned signs that warrant immediate intervention, call the 988 Suicide and Crisis Lifeline or engage one of the other resources listed in step three. As a general guide, consider if there is a risk to safety and/or concerns about someone’s ability to function as normal. When in doubt, reach out—and don’t hesitate to do so.

Step 2: Check In With Yourself Or Your Loved One

If you’re having a mental health crisis, do your best to be honest with yourself about the experience. Consider what you need or what may help you overcome the stress of the situation. Be clear about the depth of your feelings and whether you’re overwhelmed or unstable. Share how you feel with a trusted friend, family member, or professional, and don’t hesitate to ask for help. The sooner you get connected to the resources you need, the quicker you can recover.

Remember, there’s no shame in asking for help, and needing support to manage tough emotions is not shameful. Dealing with feelings is a normal part of the human experience. People respond to situations differently, and even the way someone handles events throughout their life, as an individual, will change. Getting help can empower you with the resources you need to regain your footing and maintain balance.

Step 3: Engage Outside Resources

It’s important to keep in mind that even though having a mental health crisis can feel lonesome and like no one understands, you’re actually never alone. There are many resources to help people overcome a mental health crisis in Massachusetts, and these resources can mean the difference between prevailing over the situation or continuing to hurt.

If you or a loved one are experiencing a mental health crisis, several in-person, virtual, and phone resources are available to help you.

Some of the in-person resources that you can access to help with a Massachusetts mental health crisis include:

• Community crisis stabilization: CCS is a short-term inpatient program and alternative to long-term rehab. CCS provides people with substance abuse and mental health issues with immediate overnight intervention, and treatment typically lasts for five days. CCS is covered by MassHealth and some commercial insurance providers, and provides individual, group, and family therapies, as well as medication management and crisis intervention and planning.
• Emergency department services: If you don’t know what to do, who to call, or how to handle the situation, or if the person in crisis experienced a medical emergency, go to the hospital or call 911. Although emergency departments offer limited support for behavioral health crises, medical professionals can assess the person in distress, make recommendations for their care, and provide referrals, as well as stabilize their condition if there is a medical concern.
• Mental health providers: If the person in crisis sees a counselor, therapist, social worker, psychologist, or psychiatrist, then it may be a good idea to contact the professional and inform them of the emergency situation. Their counselor may be able to schedule an emergency session, advise them on their next steps, and/or determine whether to take additional action.
• Residential rehabilitation: In some situations, residential treatment for a period of time is the most suitable route of care. Inpatient treatment allows people to receive immediate and comprehensive support, while also experiencing a separation from their home environment, encouraging change and progression.

If someone is brought to a treatment center for a mental health condition, they may enter treatment voluntarily, involuntarily, or be placed on an emergency hold. Voluntary admission is always preferred and is associated with the best long-term outcomes, according to the National Alliance on Mental Illness (NAMI). Involuntary commitment requires a court order through the state, which is possible under Section 35 of Massachusetts State Law. If an emergency hold is issued, the person is kept in a hospital setting for up to 72 hours to ensure safety and evaluate their condition.

Some of the phone resources that you can access to help with a mental health crisis in Massachusetts include:

• Massachusetts Behavioral Health Help Line (BHHL): BHHL is a free call, text, and chat service operated by the Massachusetts Behavioral Health Partnership and available to state residents 24/7. People who use the service are connected to a trained staff member regarding crisis services, mental health assessments, referrals, substance abuse, and more. Staff members remain engaged with those using the service until connecting them with the next step, and every communication is followed up with. Call or text BHHL at 833-773-2445 (BHHL) or start a live chat via the BHHL website.
• 988 Suicide & Crisis Lifeline: People experiencing a mental health crisis, substance abuse issues, thoughts of suicide, or emotional distress can call, text, or chat via the 988 website to connect with trained mental health counselors. The line is available 24/7 in all 50 states, and there are also resources for family and friends who are concerned about a loved one in crisis.
• Crisis Text Line: Available nationwide, the Crisis Text Line consists of trained, volunteer crisis counselors who offer free, confidential support 24/7. By texting HOME to 741741, people are connected with a crisis counselor who can talk them through difficult situations and experiences, with topics including anxiety, depression, eating disorders, suicide, self-harm, gun violence, and more.
• Substance Abuse and Mental Health Services Administration’s (SAMHSA) Disaster Distress Helpline: SAMHSA’s helpline is a free resource available nationally that connects callers with crisis counselors who are trained to listen and counsel people through emotional crises. The line can be accessed by calling 1-800-985-5990 or texting TalkWithUs to 66746.
• 911: Calling 911 is not recommended unless there is a medical emergency; however, if safety is a concern, or you don’t know how to access help, then dial the emergency line. If you call 911, inform the dispatcher that you or your loved one is experiencing a mental health crisis.

Mental Health Treatment At Bedrock

If someone experiences a mental health crisis in Massachusetts, they may benefit from the Pathways program at Bedrock. Pathways is an alternative to inpatient hospitalization and can also serve as a step down after treatment at a psychiatric hospital. Medical and behavioral health professionals at BRC use trauma-informed treatment to help reduce or alleviate symptoms of mental health conditions including anxiety disorders, depression, post-traumatic stress disorder, bipolar disorder, schizophrenia, and more.

Various treatment methods are incorporated to help people manage their mental health and maintain stability. Individual treatment plans vary from person to person depending on their needs.

The Pathways program at BRC may include:

• aftercare planning
• dual disorder treatment
• evidence-based therapy
• medication management
• peer-led support groups
• psychoeducation
• stabilization services
• wellness activities

Access Support For Mental Health

If you are dealing with a mental health issue or having a mental health crisis, you don’t have to handle it alone. Help is available whenever you’re ready. Call Bedrock Recovery Center for more information today.