Mental first aid: How to respond when someone is struggling mentally or emotionally
Because not all wounds are visible and what you do (or don’t do) matters more than you think
You see someone fall and break their arm, you know what to do.
You hear someone choking, you call for help.
But what if someone’s mind is what’s hurting?
What if they’re anxious, panicked, dissociating, or clearly falling apart on the inside?
That’s when many people freeze. Or worse, say the wrong thing with good intentions.
Mental health struggles are everywhere at work, in families, on the street, even in ourselves. But unlike physical injuries, mental wounds can’t be bandaged. They need a different kind of care.
That’s where mental first aid comes in. It’s the psychological equivalent of CPR:
Immediate support to stabilize someone mentally and emotionally until professional help can step in.
What is mental first aid?
Mental first aid is not therapy. It’s not diagnosing, fixing, or offering deep solutions.
It’s about being present, responding safely, and doing no harm, especially in the first minutes or hours of distress.
Done well, it can prevent a downward spiral, reduce panic, and guide someone toward help. Done poorly, it can escalate fear, deepen isolation, or trigger more harm.
When might mental first aid be needed?
You may need to step in with mental first aid in moments such as:
Panic or anxiety attack
Emotional breakdown (crying, shaking, collapse)
Sudden withdrawal, dissociation or shutdown
Intense anger or explosive outbursts
Suicidal thoughts or threats
Signs of psychosis or disconnection from reality
After a traumatic event (accident, assault, loss, etc.)
The core principles of mental first aid
Stay calm and grounded
Before you help anyone, regulate yourself. Your calmness is a lifeline.
If you panic, lecture, or overreact, you add fuel to the fire.
Take a breath. Speak slowly. Soften your tone and energy. Be steady.
Ensure immediate safety
Is the person at risk of harming themselves or others? Are they in a dangerous location or situation?
If the answer is yes, calmly remove the danger. This could mean:
Moving them away from traffic, ledges, or harmful objects
Calling emergency services (112/911) if they’re suicidal, aggressive, or in a psychotic episode
Asking a nearby person for help if you're alone
Safety first. Always.
Connect with compassion, not control
Use non-judgmental presence. Say things like:
“I’m here with you.”
“You’re not alone.”
“It’s okay to feel this.”
“Let’s breathe together.”
“You don’t need to explain, I’ve got you.”
The goal is connection, not interrogation. You’re not here to fix it, you’re here to witness it.
How to respond in common situations
Panic attack or intense anxiety
What it looks like:
Hyperventilating
Shaking, sweating
Feeling of dying or losing control
Racing heart, numb limbs
What to do:
Speak slowly and gently
Help them regulate breathing: “Let’s inhale for 4... hold… exhale for 6.”
Offer physical grounding: “Feel your feet. Look around and name 5 things you see.”
Use present language: “You are safe. You’re not in danger. This will pass.”
What not to do:
Don’t say “Calm down”, it often has the opposite effect
Don’t minimize with “It’s all in your head” or “You’re fine”
Don’t touch without asking, touch can be triggering
Dissociation or emotional shutdown
What it looks like:
Dazed, disconnected, staring off
Slowed speech or movement
Can’t respond or engage
Emotionally flat or numb
What to do:
Speak softly, keep your energy low
Offer grounding: “Can you feel your feet? Can you hear my voice?”
Name the moment: “I think you might be dissociating. That’s okay. I’m here.”
Give space, but don’t walk away
What not to do:
Don’t raise your voice or try to “snap them out of it”
Don’t overwhelm them with questions
Don’t assume they’re ignoring you, they may be frozen internally
Emotional breakdown or crying spell
What it looks like:
Intense crying, sobbing, overwhelmed
Incoherent speech
Shaking, unable to function
What to do:
Be still. Let them feel. Don’t interrupt the release.
Offer tissues, water, or a comforting gesture (if welcome)
Validate gently: “You don’t have to hold this in anymore.”
Ask: “Would it help to talk, or do you just want company right now?”
What not to do:
Don’t try to fix or distract too quickly
Don’t offer unsolicited advice
Don’t joke to lighten the mood unless they do first
Suicidal thoughts or comments
What it looks like:
“I can’t do this anymore.”
“Everyone would be better off without me.”
Talking about death, giving away belongings
Sudden calm after deep depression
What to do:
Stay close and take it seriously
Ask directly (it won’t “plant the idea”):
“Are you thinking about ending your life?”If yes, ask:
“Do you have a plan?”
“Have you tried before?”
“Can we talk to someone together?”Call emergency services or crisis support if they’re at risk
Don’t leave them alone if they’re in danger
What not to do:
Don’t say “You’re just being dramatic” or “Think of your kids”
Don’t make them feel guilty
Don’t keep it secret, involve professional help
Psychotic episode (delusions, hallucinations)
What it looks like:
Seeing or hearing things others don’t
Confused speech
Paranoia or disconnection from reality
What to do:
Keep your tone calm and respectful
Don’t argue with their reality, instead, say:
“That sounds really scary. I’m here for you.”If safety is at risk, call for medical help
Stay with them until help arrives
What not to do:
Don’t challenge or debate their hallucinations
Don’t act frightened, stay grounded
Don’t label them “crazy” or laugh it off
General don’ts in mental first aid
Don’t minimize: “You’re overreacting” or “Others have it worse” only deepen shame
Don’t rush: Let them feel what they feel, at their pace
Don’t diagnose: You’re not a therapist. Be a bridge, not a solution
Don’t make it about you: “When I went through this…” is not always helpful in the moment
What to do after the crisis
Mental first aid doesn’t end once the person calms down. Follow up:
Ask if they want help finding a professional (therapist, doctor, counselor)
Check in the next day, even a short message means a lot
Encourage self-care: rest, hydration, nutrition, space
Take care of yourself too. Supporting someone in distress can be draining
Final thoughts: you don’t need to be an expert to make a difference
You don’t need to say the perfect thing.
You don’t need to solve their problems.
But you do need to be present, patient, and kind.
Mental first aid is about being a steady, safe presence in the storm.
Sometimes, that’s all a person needs to survive the darkest hour.
So learn the signs. Stay grounded. Respond with humanity.
Because mental wounds need care, too and you might be the one who saves a life simply by staying beside it.
#mentalfirstaid #mentalhealthsupport #psychologicalsafety #howtohelp
