What is a mental health crisis?

Everyone goes through rough patches, so how do you know when your situation has reached the level of "crisis?" Here are risk factors to take very seriously:

1. Thoughts - Recurrent thoughts of harming yourself or ending your life. This includes passive thoughts of wishing you could go to sleep and not wake up.
   
2. Plan - Making a plan to harm yourself that details how  you would go about taking your life.
3. Means - Having access to the means to go through with your plan.
   
4. Intent - Committing to going through with your plan to harm yourself or take your life.

Other factors that suggest seeking immediate help include having hallucinations, dangerous substance use, eating disorder symptoms, depression or severe mental illness symptoms that impact your ability to take care of your basic needs.

What happens if I am feeling unsafe?

You have options depending upon how high your risk level is and based on your willingness to take steps to decrease your risk. If you do not currently have a therapist or can't reach your therapist, call the following numbers:

Wake County
Holly Hill Hospital 24/7 Assessment Center 1 800-447-1800
Mobile Crisis and Assessment 1 877-626-1772
9-1-1
Durham County
Durham Recovery and Response Center 1 800-510-9132
9-1-1

If you call your therapist, they may want to meet with you immediately, may provide phone coaching, or may determine that your risk level requires you be evaluated at a hospital.

What is like to be hospitalized for safety?

The thought of going to the hospital for a mental health emergency can seem scary. Knowing what to expect can help.

Voluntary Commitment - When you go to the hospital of your own choice, you will be assessed by a counselor, social worker, or nurse with training in mental health issues. They will determine whether you are at imminent risk for self harm. If your assessment provider decides you probably aren't safe to leave, they will recommend hospitalization and start the commitment process. Things to expect:

• You will not be able to keep your cell phone or other personal items (jewelry, any clothing with ties, belts, etc) with you at the hospital.
• You will likely be given a urine drug screen as standard procedure.
• You may have to wait in an ER setting for several hours.
• Ability to contact loved ones and supports may be limited after you are admitted.
• You may be transported to another facility if there is not room at the hospital.
• Depending on your level of need you may be placed on a 72 hour hold, or recommended for longer term care up to two weeks.

Things to bring:

• Clothes
• List of medications and actual medication. If you are taking oral contraceptives, be sure to bring your pills with you. Staff will likely hold them rather than let you keep them, but they will administer your birth control pills.
  
• List of phone numbers of family, friends, supports, other providers that you may want to contact while you are in the hospital

Involuntary Commitment - If you communicate that you are feeling unsafe, but are not willing to go to the hospital, you may qualify for an involuntary commitment. Your therapist or loved one may call 9-1-1, or Community Intervention Team (a group of police officers that are trained to intervene in mental health emergencies) and let them know they are concerned for your safety. Police officers or sheriffs are then dispatched to find you, and will help get you to the nearest hospital for evaluation.

In the hospital, you will meet with an individual therapist, have group therapy, unstructured time, and meet with a psychiatrist at regular intervals.

What happens when I get out?

You will meet with the same team regularly while you are in the hospital, and they will help to coordinate a discharge plan. If you are currently meeting with a therapist, your discharge coordinator will contact that therapist to make sure you have an appointment for when you get out. You may also be recommended to a different level of care such as partial hospitalization or Intensive Outpatient Therapy.