Safety in the next 5 minutes
You found the right page, and you're doing the right thing by being here. Your job tonight isn't to fix everything — it's to keep everyone safe and get the right help moving.
If you only do three things
- If anyone is in danger right now, call 911 — say "psychiatric emergency" and ask for a CIT officer.
- Crisis, but no immediate danger? Call or text 988 — they'll help you pick the safest next step.
- Don't argue with delusions. Your goals are safety, calm, and getting the right crisis system involved.
What to do, in order — pick your door
Danger right now? Call 911
Weapons, violence, suicidal or homicidal threats, dangerous driving, fire risk, severe agitation, a medical emergency, or any situation where the person cannot be kept safe. Ask for a Crisis Intervention Team (CIT) officer if one is available.
Crisis, not violent? Call or text 988
The U.S. Suicide & Crisis Lifeline can help you decide the safest next step and tell you about local mobile crisis, crisis stabilization, and psychiatric emergency options.
Will they go? Offer a face-saving path
“Let's get help with sleep and stress tonight.” Avoid labels like “crazy” or “delusional.” You are on the same side.
If they refuse: the evaluation pathway
If they refuse and appear unsafe, ask crisis services, the ER, or the county court exactly what to file for an emergency psychiatric evaluation. (Step 4 of this guide walks you through it.)
Is this an emergency? The red flags
This does not diagnose anyone — it helps you choose the safest next action based on what is happening right now.
- Threats of suicide, homicide, serious violence, or “I can't go on.”
- Weapons, physical aggression, fire-setting, barricading, or severe agitation.
- Unsafe driving, wandering, disappearing, or trying to leave while clearly impaired.
- Psychosis: hallucinations, paranoid beliefs, bizarre fixed beliefs, or responding to voices.
- No meaningful sleep for multiple nights with escalating energy, speed, anger, or impulsivity.
- Giving away or sending large amounts of money, being exploited, or unable to protect finances.
- Refusing medication or all treatment because they do not believe anything is wrong.
- Not eating/drinking, not bathing, severe confusion, or inability to manage basic needs.
- Substances, medication changes, steroids, stimulants, or medical symptoms may be involved.
What to say to them, right now
Your roadmap — everything in this guide
Make the right call — with the exact words
You don't have to figure this out alone. The people on these lines walk families through this every single day. Copy a script below to your phone and read it out loud — it's what they're for.
If you only do three things
- Call or text 988 — ask whether mobile crisis can come to you.
- For immediate danger call 911 — say “psychiatric emergency,” ask for a CIT officer.
- Copy the scripts below so the words are ready when your mind goes blank.
Try the gentle path first — briefly, if it's safe
Voluntary help
Use calm language. Offer help for sleep, fear, exhaustion, stress, or safety. Don't argue about delusions. If they agree, go to a psychiatric emergency service, ER, crisis stabilization center, or their psychiatrist.
Crisis response
Call 988 for guidance and ask whether mobile crisis can come to you. Call 911 for immediate danger, violence, weapons, unsafe driving, medical emergency, or if mobile crisis is unavailable.
Your phone scripts — read them out loud
Getting them seen — and heard
A calm ER visit tonight beats a perfect argument that never ends. Your written record of what's really been happening is more powerful than anything you can say in the moment.
If you only do three things
- Offer a face-saving reason to go: help with sleep, stress, and safety.
- Bring ID, insurance, medication bottles — and your written, dated timeline.
- Hand the staff your written collateral. You can always give information, even when they can't share it back.
How to talk without making it worse
✅ Use this approach
- Listen more than you talk.
- Reflect the emotion, not the delusion.
- Find shared goals: sleep, safety, fear reduction, dignity.
- Offer choices: “ER or crisis center?” “Now or after we pack a bag?”
- Keep your voice low, body relaxed, exits clear.
🚫 Avoid this
- “You're crazy.”
- “That never happened.”
- Long logical debates.
- Mocking, shaming, cornering, grabbing.
- Threats — unless required for safety.
| Goal | Say this |
|---|---|
| Listen | “Help me understand what feels most frightening right now.” |
| Empathize | “That sounds terrifying. I can see why you feel unsafe.” |
| Agree | “We both want you safe and able to sleep.” |
| Partner | “Would you let me help with the next step so tonight is calmer?” |
At the ER or psychiatric hospital
🎒 Before arrival
- Bring ID, insurance, and medication bottles/list.
- Bring your written timeline and evidence.
- Bring screenshots, bank records, texts, or police reports if relevant.
- List medical conditions, allergies, substances, and recent medication changes.
🚪 At intake
- Ask how to submit collateral information.
- Warn them the person may “hold it together” briefly.
- Ask the team to weigh recent behavior over days/weeks — not just the calm moment.
- Ask about discharge criteria and next steps if they refuse voluntary admission.
Don't let anyone miss a medical cause
Severe mania or psychosis can be part of bipolar disorder — but medical issues, substances, medication reactions, neurologic and endocrine problems, infection, and sleep deprivation can look identical. This matters most when symptoms are new, late in life, unusually abrupt, confused/delirious, or medically complicated.
Write it down: your collateral packet
Crisis teams, hospitals, and courts respond to specific, dated behavior — not general worry. Fill in what you know, build the packet, then copy it to your phone or download it. Nothing you type here is saved or sent anywhere — it stays on your screen only.
If they refuse help — the legal pathway
Refusal is part of the illness, not the end of the road. There is a legal path for exactly this situation, and families walk it every day. You only need to learn your county's version of it.
If you only do three things
- Ask crisis services, the ER, or the county court: “What do I file for an emergency psychiatric evaluation here?”
- Bring specific, dated facts — your packet from Step 3 is exactly what they need.
- Never force medication at home. Get the person evaluated and ask about capacity instead.
How the legal route works
Legal treatment pathway
If the person refuses care but appears dangerous, gravely disabled, or unable to protect basic safety, ask about your local emergency evaluation, civil commitment, mental-health warrant, probate petition, or assisted outpatient treatment. Names and standards vary by state and county.
Seven questions to ask your local crisis team, ER, or court
- What is the name of the emergency psychiatric hold or evaluation process here?
- Can family file directly? If yes, where, and what form?
- What facts count — danger to self, danger to others, grave disability, inability to meet basic needs, financial exploitation?
- Who can transport the person — police, sheriff, mobile crisis, ambulance?
- How long can the person be held before a hearing?
- How do we request inpatient commitment or assisted outpatient treatment?
- What happens if the person refuses medication?
| Option | What it is | When it helps | Limits |
|---|---|---|---|
| Emergency hold / evaluation | Short-term involuntary evaluation when legal criteria appear met. | Immediate crisis, danger, severe impairment. | Usually short; may end without a court filing. |
| Civil commitment | Court-ordered inpatient or outpatient treatment. | Refusal of care plus danger, grave disability, or other local criteria. | Requires evidence and a legal process. |
| Assisted Outpatient Treatment | Court-ordered community treatment for some people with serious mental illness and repeated non-adherence. | Cycle of relapse, hospitalization, refusal, or poor engagement. | Availability and rules vary by state/county. |
| Guardianship / conservatorship | Court-appointed decision-maker for person, estate, or both. | Ongoing incapacity, medical decisions, financial protection. | Not the same as emergency hospitalization; powers vary. |
If they refuse medication
What family usually cannot do
Family generally cannot physically force medication at home. Do not hide pills in food, restrain the person, threaten them, or try to overpower them — it can be unsafe and legally risky.
What family can do
Get the person evaluated, provide collateral information, ask clinicians to assess decision-making capacity, and ask what medication-over-objection or court-order process exists locally.
Protect the money — and keep a record
Mania can empty an account faster than any thief — and the shame afterward is often the deepest wound. Acting today protects the person you love from their illness, not from themselves.
If you only do three things
- Call the banks and credit-card companies today — ask about freezes, alerts, and transfer recalls.
- Screenshot and save everything — transfers, texts, receipts.
- Report scams at ReportFraud.ftc.gov and ic3.gov.
Financial & digital safety
Mania can create real-world financial danger — sending large sums to strangers, risky investments, romance scams, impulsive purchases, shared passwords, or giving away personal information.
🕐 Same-day actions
- Call banks and credit-card companies.
- Ask about freezing cards, fraud alerts, transfer recalls, and unusual-activity blocks.
- Change passwords if accounts may be compromised.
- Preserve screenshots and receipts.
📢 Report
- Report scams to the FTC at ReportFraud.ftc.gov.
- Report internet/cyber fraud to the FBI IC3 at ic3.gov.
- File a local police report when money, identity, or exploitation is involved.
🛡️ Protect going forward
- Ask about daily transfer limits.
- Freeze credit if there is identity risk.
- Consider legal advice about joint accounts, power of attorney, guardianship/conservatorship, or protective orders where appropriate.
After the crisis — build a safer future
Getting through today was the hard part. Now build the plan that makes the next crisis smaller — or prevents it entirely. And take care of yourself: you've been carrying a lot.
If you only do three things
- Before discharge, get a written safety plan and a scheduled follow-up appointment.
- Build the relapse-prevention plan below while things are calm.
- Get support for you — NAMI Family-to-Family is free and built for exactly this.
Before they leave the hospital
- Ask for a written safety plan.
- Ask about medication, the follow-up date, and a crisis number.
- Ask what to do if symptoms resume tonight.
- Ask about PHP/IOP, case management, AOT, or community mental-health services.
Protection & stabilization
Protect money, notify trusted supports, coordinate with hospital staff, request discharge planning, consider guardianship or a mental-health attorney when appropriate, and build a future crisis plan once the person is stable.
Relapse-prevention checklist
- Identify early warning signs: less sleep, rapid speech, spending, irritability, paranoia.
- Agree on who can call the psychiatrist or family.
- Create a medication and sleep-protection plan.
- Discuss financial-safety limits during episodes.
- Make a written crisis plan or psychiatric advance directive if available in your state.
Resources worth saving
988 Suicide & Crisis Lifeline
Call, text, or chat 988 in the U.S., 24/7, for crisis support and local resource guidance. Spanish and specialized support available.
988lifeline.orgCrisis Text Line
Text HOME to 741741 — free, confidential, 24/7 support by text, for all ages.
crisistextline.orgNAMI — Navigating a Crisis
Family-oriented guide to warning signs, de-escalation, crisis resources, admission, and discharge planning.
nami.orgNAMI Family-to-Family
Free education program for family, partners, and friends of people with mental-health conditions.
nami.org/family-to-familyDBSA — Friends & Family
Support and wellness tools for families affected by mood disorders.
dbsalliance.orgTreatment Advocacy Center
State-by-state information on involuntary treatment and assisted outpatient treatment laws.
treatmentadvocacycenter.orgFindTreatment.gov
SAMHSA's tool for finding mental-health and substance-use treatment.
findtreatment.govNIMH — Bipolar Disorder
Symptoms, diagnosis, treatment, psychosis, and medical rule-out information.
nimh.nih.govReport fraud (FTC & FBI)
Report scams, wire transfers, and financial exploitation.
reportfraud.ftc.gov · ic3.govPhone numbers and programs change — please confirm before you rely on them.