Mental health first aid: helping in the moment
You don’t need to be an expert to help. Noticing, listening and staying with someone can make a real difference.
By the numbers
What research says about everyday helpers.
What is mental health first aid?
First support until professional help is in place, or the moment passes.
Most of us know a little physical first aid. Mental health first aid is the same idea: noticing when someone is struggling, offering calm support, and helping them connect with the right help. You don’t diagnose or treat. You stay human and steady.
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- A: Approach, and assess for risk of suicide or harm
- L: Listen without judging
- G: Give reassurance and information
- E: Encourage appropriate professional help
- E: Encourage self-help and other support
The steps can be used in any order. They are a guide, not a script.
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The World Health Organization describes psychological first aid as humane, supportive and practical help for people going through serious crisis events. It respects people’s dignity, culture and abilities.
Look, listen, link
- Look: check for safety, urgent needs and people in serious distress
- Listen: approach, calm the person, and ask about their needs and worries
- Link: help them reach information, loved ones, practical help and services
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First aiders don’t diagnose or give therapy. Psychological first aid does not push people to talk about what happened or analyse their feelings. Your job is to help someone feel safer, calmer and connected to help.
Notice and approach
Spotting that someone is struggling, and opening the door gently.
Signs someone may be struggling right now
- Breathing fast, shaking, or saying they can’t calm down
- Crying, or seeming numb or “not there”
- Saying things like “I can’t do this anymore” or “What’s the point?”
- Seeming confused, very frightened or suspicious
- Pulling away from people, or acting very differently from usual
How to approach
- Check it’s safe for you and for them.
- Find a quiet, private moment if you can.
- Say what you’ve noticed, gently: “You seem really upset. I’m here.”
- Ask an open question: “How are you doing, really?”
- If they don’t want to talk now, let them know you’re around later.
Listen without judgement, and reassure
The heart of helping: be present, not perfect.
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- “Thank you for telling me.”
- “That sounds really hard.”
- “You’re not alone. I’m here.”
- “What would help most right now?”
- “It makes sense you feel this way.”
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- “Just calm down” or “Snap out of it”
- “Others have it worse”
- Arguing about whether their feelings make sense
- Jumping in with your own story
- Promising to keep a secret if someone’s safety is at risk
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- Put your phone away and face them
- Let them finish before you speak
- Sum up what you heard: “It sounds like…”
- Allow silence; it gives people room to think
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Reassure them that what they’re feeling is a real, common experience and that help works. Share simple information about where to get support, if they want it.
If someone may be thinking about suicide
Ask directly, stay with them, and connect them with help.
If you’re worried, ask clearly: “Are you thinking about suicide?” Asking does not put the idea in someone’s head. Studies suggest talking about it may reduce suicidal thoughts.
The 5 action steps (#BeThe1To)
- Ask: “Are you thinking about suicide?”
- Be there: listen, and stay connected.
- Help keep them safe: ask if they have a plan, and help put time and distance between them and anything they could use to hurt themselves.
- Help them connect: call or text 988 together, or reach a trusted person or professional.
- Follow up: check in over the next days and weeks.
Reducing access to highly lethal means lowers suicide rates. Increasing connection and following up after a crisis also protect people.
Panic attacks and overwhelming anxiety
Frightening, but not dangerous. Help them ride the wave.
A panic attack is a sudden rush of intense fear with physical symptoms like a racing heart, sweating, shaking, chest pain, shortness of breath or dizziness. Most last 5 to 20 minutes. They are frightening, but not dangerous.
How to help
- Stay calm and stay with them.
- Help them stay where they are, somewhere quieter if possible.
- Breathe slowly with them: in through the nose, longer out through the mouth.
- Remind them it will pass and they are safe.
- Help them focus on something calm, like what they can see around them.
- Afterwards, offer water and a quiet moment.
After a frightening event
Accidents, violence, disasters or bad news: steady, practical comfort.
Psychological first aid helps people in the first hours and days after a crisis. Core actions include making contact, promoting safety and comfort, helping people steady themselves, meeting practical needs and connecting them with loved ones and services.
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- Help them get somewhere safe and quiet
- Offer water, a blanket or a seat
- Help them contact someone they love
- Keep away crowds, cameras and gawkers
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Psychological first aid guidance warns against pressing people for details of what happened or pushing them to share feelings. Listening without pressure is enough.
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- Speak slowly and calmly
- Invite them to feel their feet on the floor
- Name a few things you can both see
- Breathe out slowly together
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Many strong reactions ease with time, rest and support. If they stay strong for weeks, or get in the way of daily life, encourage the person to reach out for professional help.
When someone seems confused or out of touch with reality
Stay calm, don’t argue, and acknowledge their feelings.
Sometimes a person may see or hear things others don’t, or hold frightening beliefs that aren’t based in reality. To them, these experiences feel completely real.
How to help
- Acknowledge their feelings without agreeing or arguing: “I can’t see it, but I can tell you’re scared.”
- Don’t confront, criticise, laugh at or blame them
- Gently ask whether they feel like harming themselves or anyone else
- Keep conversations about the beliefs short and calm
- Keep yourself safe, and give them physical space
- Speak slowly and simply, with few people around
New or sudden changes like these need a health professional to assess them, since physical health problems can also cause confusion. NIMH notes that treatment lowers the risk of harm.
When someone is very angry or in danger
Keep yourself and others safe first. Then lower the heat.
Ways to calm things down
- Give them space, and keep a clear exit for both of you
- Keep your voice low and slow, and your hands visible
- Listen and name the feeling: “You’re really angry about this”
- Offer simple choices instead of orders
- Don’t argue, threaten or touch them without asking
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Call 911 if a life-threatening crisis is happening, such as a suicide attempt in progress, a weapon, or someone who is unresponsive or can’t breathe properly.
Tell the dispatcher
- That it is a mental health crisis
- Whether there are any weapons
- What the person needs and what has helped before
- If your area has crisis-trained officers or a mobile crisis team, ask for them
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Call or text 988 for support during a mental health or substance use crisis. You can call for yourself or for someone else.
Crisis care is built around someone to talk to, someone to come to you and somewhere to go. In some areas, 988 can connect you with a mobile crisis team.
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If someone may have taken too much of a substance, is very drowsy, can’t be woken, or is breathing oddly, call 911 and stay with them. Don’t leave them alone to “sleep it off”.
Following up, and looking after yourself
The help doesn’t end when the moment passes, and helpers need care too.
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Encouraging professional help, and self-help and other supports, are the last two steps of ALGEE. You might offer to help them find a provider or make the first call.
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Following up after a crisis is linked with fewer suicide deaths in high-risk groups. Even simple outreach, like a caring note, may help.
Try
- “Thinking of you. How are you today?”
- “Want to grab a coffee this week?”
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It is normal to feel drained, worried or upset afterwards. Talk it over with someone you trust (without sharing private details), rest, and do something calming.
You can call or text 988 for yourself too, if helping someone has left you struggling.
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You are a first aider, not someone’s whole support system. Bring in other people and professionals. That is part of helping, not a failure.
When and where to get help
Numbers to save before you need them.
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Call 911 for a suicide attempt in progress, a weapon, or a medical emergency.
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Call or text 988, or chat at chat.988lifeline.org. It is free and confidential, and text and chat are also available in Spanish. Veterans can press 1.
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Free, confidential support by text with a trained volunteer.
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24/7 crisis counseling for distress after natural or human-caused disasters, with interpretation in over 100 languages.
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Find A Helpline lists free, confidential helplines around the world. Check your local emergency number too.
📝 Worksheets for this guide
Fill these in privately in the app. Your answers stay on your phone.
Sources
- Mental Health First Aid USA (National Council for Mental Wellbeing). About Mental Health First Aid
- Mental Health First Aid USA (National Council for Mental Wellbeing). Frequently Asked Questions
- Mental Health First Aid Australia (originator of the program). Exploring the Mental Health First Aid Action Plan
- National Council for Mental Wellbeing (2026). Five Million People in U.S. Trained in Mental Health First Aid
- PLOS ONE (peer-reviewed, via PubMed Central) (2018). Systematic review and meta-analysis of Mental Health First Aid training: Effects on knowledge, stigma, and helping behaviour (Morgan, Ross & Reavley, PLOS ONE 13(5): e0197102)
- World Health Organization (WHO), War Trauma Foundation & World Vision International (2011). Psychological first aid: Guide for field workers
- Catholic Relief Services / World Health Organization. Psychological First Aid Pocket Guide (based on the WHO guide)
- National Center for PTSD, U.S. Department of Veterans Affairs, with the National Child Traumatic Stress Network. Psychological First Aid (PFA) Field Operations Guide
- 988 Suicide & Crisis Lifeline (#BeThe1To). #BeThe1To: The 5 Steps and the Evidence Behind Them
- 988 Suicide & Crisis Lifeline. Help Someone Else
- NHS (UK National Health Service). Panic disorder
- Mental Health Commission of Canada. Mental Health First Aid Guidelines: Psychosis
- Mental Health First Aid Australia (2023). Psychosis: First Aid Guidelines
- National Institute of Mental Health (NIMH). Understanding Psychosis
- National Council for Mental Wellbeing (2022). 988 Fact Sheet
- U.S. Government Accountability Office (GAO) (2025). Report GAO-25-107586 on SAMHSA’s behavioral health crisis services
- 988 Suicide & Crisis Lifeline. 988 Suicide & Crisis Lifeline
- National Institute of Mental Health (NIMH). Help for Mental Illnesses
- Centers for Disease Control and Prevention (CDC). Get Help Right Now (How Right Now)
- Crisis Text Line. Crisis Text Line
- Substance Abuse and Mental Health Services Administration (SAMHSA). Crisis Text Line (Disaster Behavioral Health Information Series)
- ThroughLine (partner of the International Association for Suicide Prevention). Find A Helpline
This guide is for education and self-care. It is not a diagnosis or a substitute for professional care. Please talk to a counselor or clinical provider about your health. Reviewed October 2026.
