Someone you care about is struggling. Maybe they told you. Maybe you noticed. Maybe you're the person they called at 3am because they didn't know who else to ring.

This guide covers what actually helps — and the common things people do with good intentions that don't.

Types of Crisis You Might Encounter

The same supportive principles apply across different types of crisis, but the specific things to say and do differ:

  • Mental health crisis: Depression, suicidal thoughts or behaviour, severe anxiety, dissociation, psychotic episode
  • Sexual health crisis: Positive HIV or STI result, pregnancy scare, post-assault processing
  • Substance-related crisis: Overdose, difficult come-down, recognition that use has become a problem
  • Relationship crisis: Assault, coercion, a disclosure gone badly, the end of something important

The Overdose / Medical Emergency

If this is a medical emergency — someone is unresponsive, breathing unusually, has taken too much of something — this is not the time for this article.

Immediate steps:

  1. Recovery position (on their side, airway clear) — do it before anything else
  2. Call emergency services
  3. Tell them what was taken, approximately how much, when
  4. Stay with them until help arrives

Don't leave them alone to "sleep it off." Don't wait to see if they come round. Don't not call because you're worried about getting in trouble — in most countries, calling emergency services for an overdose doesn't result in prosecution for the caller.

See EMERGENCY: Overdose for the full protocol.

Supporting Someone in a Mental Health Crisis

If they're telling you they want to die or hurt themselves:

Take it seriously. Asking someone directly about suicidal thoughts does not plant the idea — this is a myth. Asking shows you're taking them seriously.

"Are you thinking about hurting yourself?" or "When you say you can't go on, are you thinking about suicide?"

If yes: Don't try to talk them out of it or provide reasons to live — this approach rarely helps and can feel dismissive. Do:

  • Stay with them or ensure someone is with them
  • Ask if they have access to means (medication, weapons) and help them create distance from those means where possible
  • Contact a crisis service together — many countries have crisis lines that can provide guidance while you're with the person
❗ Important

Crisis lines are resources for you too — not just for the person in crisis. If you're supporting someone and you're not sure what to do, calling a crisis line yourself to ask for guidance is appropriate and often helpful.

If they're in acute distress but not in immediate danger:

Your most important job is to be present without needing to fix it. Most people in crisis don't primarily need solutions — they need to feel heard and not alone.

  • Listen more than you speak.
  • Reflect back rather than advising. "That sounds really overwhelming" is more useful than "Have you tried..."
  • Don't minimise. "It could be worse" or "At least..." makes people feel worse, not better.
  • Don't rush to fix. Sitting with someone's pain is uncomfortable. The impulse to solve it or fast-forward to "you'll be okay" is about managing your discomfort, not their need.

Supporting Someone Through a Health Diagnosis

A positive HIV result, a new STI diagnosis, or an unexpected health finding lands differently for different people. Some people are practical and clinical about it; others are devastated.

Follow their lead.

Don't inject your feelings about it into their processing. "Oh no, I'm so sorry" may not be the first thing someone needs to hear if they're trying to be calm and practical. Read the temperature.

What usually helps:

  • Being present without pity
  • Practical offers: "Do you want company when you go to the follow-up appointment?"
  • Acknowledgment: "That's a lot to take in. How are you doing?"
  • Information, if asked — but don't give it unrequested unless it's urgent

What usually doesn't:

  • "At least it's treatable"
  • Sharing your opinions about how they contracted it
  • Treating them differently after the disclosure

A positive HIV result, in particular, does not change the person. It changes their medical care. Treating it like a tragedy — especially for an undetectable person on treatment — perpetuates stigma and is not helpful.

Supporting Someone After Sexual Assault

If a friend has disclosed that they've been assaulted:

Believe them. Without qualification. Your job is not to investigate; it's to support.

Don't ask "why did you..." or "couldn't you have..." These questions, even well-intentioned, communicate that you're assessing culpability. The answer is irrelevant to the support they need right now.

Ask what they need. "What do you need from me right now?" gives them agency in a moment when they've had agency taken from them. They might need practical help (getting to a clinic), company, distraction, or just to be heard.

Let them lead on reporting. Whether to report to police is their decision. Don't push either way. Information about options is useful; advocacy for a particular choice isn't.

The medical window. If the assault was recent — within 72 hours — there are time-sensitive medical options: emergency contraception, STI prophylaxis, forensic evidence collection. Gently mentioning that these options exist and that they have a window is useful. See EMERGENCY: Sexual Assault for the full guide you can share.

Your Own Wellbeing

Supporting someone in crisis, particularly over an extended period, takes a toll. Secondary trauma — absorbing the weight of someone else's pain — is real.

You are not required to be available 24/7. Setting limits on your availability is not abandonment; it's sustainability.

"I care about you and I want to be here for you. I also need to tell you when I'm struggling — is it okay if I do that?"

If you're absorbing a lot and it's affecting your functioning, talking to someone yourself — a therapist, a trusted friend, a support line for supporters — is appropriate and important.

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