How to Respond to a Stranger in Mental Distress

If you are concerned for your safety, the best course of action is usually to leave the situation as soon as possible, said Schroeder Stribling, the president and chief executive of Mental Health America, a nonprofit group focused on advancing mental health. If you’re on the subway, for example, change cars, or get off and wait for the next train.

If you cannot leave, continue to monitor the situation. If someone is making verbal threats, balling up their fists or physically getting closer to people in an aggressive manner, stay calm and avoid confrontation, said Dr. Jessica Kovach, the chair of psychiatry and behavioral science at the Lewis Katz School of Medicine at Temple University. Don’t make eye contact — especially prolonged eye contact, which might be perceived as threatening, Dr. Kovach advised. Also avoid any physical stance that could seem aggressive, like crossing your arms.

Call for help

If you are being threatened or feel that you are unsafe, “walking away and calling for help is the most important thing you can do in those moments,” said Dr. Jhilam Biswas, director of the Psychiatry, Law, and Society Program at Brigham and Women’s Hospital.

Calling for help is also the best thing to do if you don’t feel you’re in danger but think that you need to act. “Getting to a phone, getting to a security guard, getting to somebody who can call for the appropriate level of care is really the number one, two and three thing to do here,” said Dr. Richard Patel, a professor of psychiatry at the University of California, San Francisco, and an attending physician in the psychiatric emergency room at Zuckerberg San Francisco General Hospital.

Many cities have help lines and mobile crisis response teams that serve as an interface between the police and mental health providers and are trained to help people in acute distress. In New York City, for example, you can call 888-NYC-WELL to connect with mental health professionals. If you call 911, specify that you are calling about a mental health emergency and request a crisis intervention team if one is available, said Megan Rochford, the director of the National Alliance on Mental Illness HelpLine Operations.