IN CASE OF EMERGENCY
- Call 911 immediately if a person is an immediate threat to him/ herself or others (violent, threatening violence, suicidal), and explain that there is a psychiatric emergency. Request a Crisis Intervention Team (CIT) officer if one is available. Many police departments have received training through the CIT program so that officers will be better able to de-escalate a situation and work with the family and individual to link them to services. Click here to see Suicide and Suicidal Risk section.
- Crisis Text Line – A free, anonymous, text-based support network available 24/7. Simply text “Got5” to 741-741 to start a texting conversation with a trained volunteer Crisis Counselor who can help you get through a difficult moment.
- 9-8-8 national mental health crisis call, text or chat line, beginning July 16, 2022 for anyone who is suicidal, experiencing a mental health or substance use-related crisis, or in any other kind of emotional distress. Connects to trained counselors who are part of the National Suicide Prevention Lifeline.
- Crisis Services (716) 834-3131 if the person is in crisis but not an immediate threat to themselves. An Outreach Counselor will determine the appropriate level of service which may include a telephone assessment or a face-to-face assessment by a team of 2 professionals, including at least one licensed social worker or mental health professional. Services are available 24 hours a day by calling 716-834-3131 and asking for an Outreach Counselor.
- Crisis Services is the mobile unit of the Erie County Medical Center’s Comprehensive Psychiatric Emergency Program (CPEP), also known as the emergency room (ER) for those in a mental health crisis. Even though a loved one is in crisis, Crisis Services or the police may determine the ER is not the best place for your loved one.
- Do not attempt to take a person to the hospital if they have refused to go. Call for an ambulance by calling Crisis Services (716) 834-3131 or the police for assistance. If they determine the person must go to the hospital, they have a legal basis for doing so.
- Even if you feel a person needs hospitalization, Crisis Services or the police may take them to the hospital. A person may not be considered lethal to themselves, despite a family’s recent observations of such behaviors, if dangerous comments or actions are not presently observed by the outreach team or police. Have a copy of pertinent psychiatric and medical records available for the professionals involved.
- Provide the police or Crisis Services with a written list of the person’s threatening behaviors or verbal threats. Keep calling them if the behaviors repeat themselves.
Tips for Families During Crisis:
- Remain calm and in control of your own feelings
- Listen attentively with compassion to the person’s concerns
- Speak softly and in simple sentences
- Keep your body language non-threatening
- Do not take the person’s words personally or respond in kind
- Avoid authoritarian, challenging or condescending statements
- Avoid arguing with the person or other family members
- Respect the person’s space. Do not touch the person or behave intrusively
- Comply with requests that are not endangering or irrational
- Try to find a way to permit the person to feel “in control”
- Remove yourself and others to safety if the person is at risk for violence
More on Crisis Services:
716-834-3131
100 River Rock Drive, Suite 300
Buffalo, New York 14207
http://crisisservices.org/
Fees: Most major insurances
Emergency Mental Health Response Services can assist with individuals who are currently experiencing, or have recently experienced, a mental health crisis.
Mobile Outreach Program: The Mobile Outreach Program is the mobile unit of Erie County Medical Center’s Comprehensive Psychiatric Emergency Program (CPEP). This program provides community-based mental health intervention to individuals in Erie County who are experiencing a mental health crisis. The main goal of the program is to divert individuals from unnecessary presentations at local psychiatric emergency rooms and to provide these individuals the services they need in order to remain safely in the community. Call 716-834-3131 and ask for an Outreach Counselor. Note: as of April 2022, Mobile Outreach services are temporarily suspended on weekends. They suggest the following, as appropriate for your loved one:
o Recovery Options Made Easy (ROME) 24-Hour respite and peer support
o Spectrum Urgent Mental Health and Addiction Care Clinic (U-MHACC)
When operating, the Mobile Outreach Program receives referrals from other community mental health agencies, family members, police, friends, neighbors, landlords, or anybody else concerned about the welfare of an individual who appears to be experiencing a mental health crisis. Criteria used in assessing the situation include deterioration of mental health status or an increase in mental health symptoms, coupled with acute emotional distress, thoughts of suicide or wanting to hurt oneself, thoughts of harm to others, physical aggression to others, and/or refusal of psychiatric or medical care because of impaired insight or judgment.
Please note that you and/or your health insurance company may be charged for on-site assessment, transportation to the hospital and/or an emergency room visit. You should always put safety first in deciding to call. We mention the possibility of a charge so that you will not be surprised if you receive an invoice.
The following services are available:
- Telephone Assessment: Staff is able to provide assessment over the phone, and determine appropriate levels of intervention.
- Assessment: A team of two professionals, including at least one licensed social worker or mental health counselor, can provide face-to-face mental health evaluation and lethality assessment for the individual in crisis. Generally, this is done in the individual’s home, but can also be done at any safe and private location in the community, such as a counselor’s office, a medical facility, or a police station. The goal of the assessment is to stabilize the crisis and assess for the need for referral to additional community services.
- 9.45 Evaluation for Involuntary Transport: While the goal of an assessment is to stabilize the crisis and divert the individual from unnecessary presentation at a psychiatric emergency room, sometimes this is not possible. In order to preserve safety and prevent an individual from harming oneself or others, an involuntary transport to a psychiatric hospital is sometimes necessary. Staff is responsible for assessing whether an individual meets the criteria under Section 9.45 of the New York State Mental Hygiene Law for involuntary transport. If this is the case, the individual is transported to Erie County Medical Center for further evaluation by a psychiatrist who determines the need for psychiatric admission.
- Jail Diversion: This service is available to law enforcement officers who encounter an individual who appears to be mentally decompensated and has committed a low-level, non-violent, victimless crime. In lieu of arrest, law enforcement can contact the Mobile Outreach Program to provide assessment and a 9.45 evaluation to determine if a hospital transport or linkage to services is more appropriate for the individual than an arrest.
- Community Linkage: Staff link individuals in the community in order to maintain mental health and stability. Such linkages may include outpatient counseling, psychiatry, peer support, case management, social services, or housing.
- Consultation: Staff is available for consultation regarding the best course of action for an individual and can access psychiatric consultation 24 hours a day.
Note: as of April 2022, Mobile Outreach services are temporarily not available on weekends. You may still contact Crisis Services at 834-3131, 24/7, for other resource options.
CIT-Crisis Case Management Program
This program provides short-term crisis case management services to individuals with mental illness who interface regularly with law enforcement. Individuals must live in towns/jurisdictions whose police agency has a trained CIT team. Most referrals to this program come from CIT Officers, but referrals from other sources can be considered if the individual otherwise meets program criteria. The goal of CIT-Crisis Case Management is to decrease interactions with law enforcement and increase linkages with mental health services in the community, as well as diversion (when appropriate) from local psychiatric emergency rooms and jail. For more information see Crisis Services under Same Day and Urgent Care.
Mobile Transitional Support Program (MTS)
This program provides clinical intervention services to individuals that are being released from inpatient psychiatric stays at Erie County Medical Center and Buffalo Psychiatric Center. Referrals to this program can only be made by discharge planners at these two hospitals, through an arranged referral process. Individuals referred to this program will receive short-term clinical intervention and peer services from a team of MTS Counselors and Peer Counselors, while they are transitioning to ongoing outpatient services. The team works in collaboration with discharge planners, as well as outpatient service providers. The goal of this service is to keep individuals from presenting at local psychiatric emergency rooms for hospital re-admission, and to see that these individuals effectively transition back to the community and are securely linked with appropriate outpatient services identified in the discharge plan.
According to the CDC, nearly 45 thousand lives were lost to suicide in 2016, leaving behind thousands of friends and family members to navigate the tragedy of their loss.
Suicide rates went up more than 30% in half of states since 1999, including New York State.
More than half (54%) of people who died by suicide did not have a known mental health condition.
Source: https://www.cdc.gov/vitalsigns/pdf/vs-0618-suicide-H.pdf (2018)
Be Educated
One of the best things you can do if you know or suspect that your loved one is thinking about suicide is to educate yourself. Learning about suicide, what the warning signs are, and how it can be prevented can help you understand what you need to do as a member of their support system.
Risk Factors for Suicide
Research published by the CDC in 2018, (2016 data) found that about half of individuals who die by suicide experience mental illness. A number of other things may put a person at risk of suicide, including:
- A family history of suicide.
- Substance abuse: Drugs and alcohol can result in mental highs and lows that exacerbate suicidal thoughts.
- Intoxication: More than one in three people who die from suicide are found to be currently under the influence.
- Access to firearms. For information about Firearm Storage, click here.
- A serious or chronic medical illness.
- Gender: Although more women than men attempt suicide, men are four times more likely to die by suicide.
- A history of trauma or abuse.
- Prolonged stress.
- Age: people under age 24 or over 65 are at a higher risk for suicide.
- A recent tragedy or loss.
- Agitation and sleep deprivation.
Know the Warning Signs of Suicide
- Excessive worrying or fear; feeling like a burden, being isolated
- Feeling excessively sad or low, or trapped or in unbearable pain
- Confused thinking or problems concentrating and learning
- Extreme mood changes, including uncontrollable “highs”, or increased anxiety, anger or rage
- Prolonged or strong feelings of irritability or anger
- Avoiding friends and social activities
- Difficulties understanding or relating to other people
- Changes in sleeping habits (too little, or too much) or feeling tired and low energy
- Changes in eating habits such as increased hunger or lack of appetite, intense fear of weight gain or concern with appearance
- Changes in sex drive
- Difficulty perceiving reality (delusions or hallucinations)
- Inability to perceive changes in one’s own feelings, behavior or personality
- Increased alcohol or other substance use
- Physical ailments without obvious causes, such as stomach aches
- Thinking about suicide
- Inability to carry out daily activities or handle daily problems and stress
Source: NAMI, the National Alliance on Mental Illness, at www.nami.org.
Please know that some individuals show no signs or intentionally hide them. You may not have any forewarning and should not feel responsible if a person does complete suicide.
Is There Imminent Danger?
- Looking for a way to access lethal means (gun, stockpiling drugs, knives).
- Increased anger or rage
- Extreme mood swings, noticeable shift from anger or despair to calm
- Expressing hopelessness, threatening to kill oneself
- Talking, writing or posting about wanting to die
- Making plans for suicide, putting affairs in order, saying goodbye
Five Steps to Help Someone at Risk
- Talk openly and honestly about suicide. Don’t be afraid to ask questions such as “Are you having thoughts of suicide?” or “Do you have a plan for how you would kill yourself?”
- Keep them safe.
- Be there.
- Help them connect. Calmly ask simple and direct questions, such as “Can I help you call your psychiatrist?” rather than, “Would you rather I call your psychiatrist, your therapist or your case manager?”
- Follow up.
Find out how this can save a life by visiting: www.BeThe1To.comexternal icon
Suicidal thoughts or behaviors are both damaging and dangerous and are therefore considered a psychiatric emergency. Someone experiencing these thoughts should seek immediate assistance from a health or mental health care provider. Having suicidal thoughts does not mean someone is weak or flawed.
If you are unsure, a licensed mental health professional can help assess risk.
Preventing Suicide
It can be frightening and intimidating when a loved one reveals or shows signs of suicidal thoughts. However, not taking thoughts of suicide seriously can have a devastating outcome. If you think your friend or family member will hurt herself or someone else, call 911 immediately. There are a few ways to approach this situation.
- Remove means such as guns, knives or stockpiled prescription pills
- Calmly ask simple and direct questions, such as “Can I help you call your psychiatrist?” rather than, “Would you rather I call your psychiatrist, your therapist or your case manager?”
- Talk openly and honestly about suicide. Don’t be afraid to ask questions such as “Are you having thoughts of suicide?” or “Do you have a plan for how you would kill yourself?”
- If there are multiple people, have one person speak at a time.
- Ask what you can do to help.
- Don’t argue, threaten or raise your voice.
- Don’t debate whether suicide is right or wrong.
- If your loved one asks for something, provide it, as long as the request is safe and reasonable.
- If you are nervous, try not to fidget or pace.
- If your loved one is having hallucinations or delusions, be gentle and sympathetic, but do not get in an argument about whether the delusions or hallucinations are real.
- Some people do not share their thoughts of suicide and sadly suicide may not be prevented. Also, despite professional treatment, they may not overcome their suicidal thoughts.
If you are concerned about suicide risk and don’t know what to do, call Crisis Services at 716-834-3131 or the National Suicide Prevention Lifeline: 1-800-273- 8255. They have trained counselors available 24/7 to speak with either you or your loved one.
If you prefer not to talk, you can also use the Crisis Text Line, a free, anonymous, text-based support network that’s available 24/7. Simply text “Got5” to 741-741 to start a texting conversation with a trained volunteer Crisis Counselor who can help you get through a difficult moment.
Can Thoughts of Suicide Be Prevented?
Mental health professionals are trained to help a person understand their feelings and can improve mental wellness and resiliency. Depending on their training they can provide effective ways to help.
Psychotherapy such as cognitive behavioral therapy and dialectical behavior therapy can help a person with thoughts of suicide recognize unhealthy patterns of thinking and behavior, validate troubling feelings, and learn coping skills.
Medication can be used if necessary to treat underlying depression and anxiety and can lower a person’s risk of hurting themselves. Depending on the person’s mental health diagnosis, other medications can be used to alleviate symptoms.
Providing Support
Even if your loved one isn’t in a moment of crisis, you need to provide support. Let him/her know that they can talk with you about what they are going through. Make sure that you are actively and openly listening to the things they say. Instead of arguing with any negative statements that they make, try providing positive reinforcement. Active listening techniques such as reflecting feelings and summarizing thoughts can help your loved one feel heard and validated. Furthermore, reassuring your loved one that you are concerned for their well-being will encourage them to lean on you for support.
If Possible, Be Prepared
If your friend or family member has had suicidal thoughts in the past, it’s a good idea to have a crisis plan just in case. This means that you’ll need to work together to develop the best course of action if a crisis situation should occur.
(See: https://suicidepreventionlifeline.org/wpcontent/uploads/ 2016/08/Brown_StanleySafetyPlanTemplate.pdf)
