CrisisWhat to Do in a Mental Health or Substance Crisis in Los Angeles: A Step-by-Step Guide. How to tell what kind of help you need, who to call, what to say, and what to do once the crisis has passed.

A crisis can make it hard to think. This guide is meant to be read now, while things are calm, so you know what to do if things are not. Save the key numbers in your phone today:

• 911 for immediate danger, a medical emergency or an overdose.
• 988 (call or text) for the 988 Suicide and Crisis Lifeline, 24/7, free and confidential.
• (800) 854-7771 for the LA County Department of Mental Health ACCESS Help Line, 24/7.
• (844) 804-7500 for LA County Public Health’s Substance Abuse Service Helpline, for substance use treatment referrals.

Emergency: call 911. Someone is unconscious or not breathing normally, may have overdosed, has a weapon, has made a suicide attempt, is seriously injured, or is about to hurt themselves or someone else.

Crisis: call or text 988. No one is in immediate physical danger, but someone is talking about wanting to die, is very agitated or confused, or is seeing or hearing things others do not. They may have stopped eating or sleeping for days, or be using heavily in a way that scares you.

Urgent or routine: call for an appointment. Someone is struggling, maybe drinking more, withdrawing, or slipping at school or work, but is safe today. This is the time to call their doctor or therapist, the ACCESS Help Line, or a provider like us to set up an assessment.

Trust your instincts. You know this person. If something feels very wrong, it is reasonable to call 988 or 911 and let the professionals help decide.

A trained crisis counselor will listen, help you calm the situation, and talk through options. You can also chat at 988lifeline.org, and text and chat are available in Spanish.

In Los Angeles County, 988 is part of the county’s crisis system. LA County DMH calls 988 its preferred, “no wrong door” way to reach crisis care. When needed, a mobile team can be sent in person.

Mobile crisis teams. LA County DMH sends field intervention teams to people in a mental health crisis. These include its own Psychiatric Mobile Response Teams (PMRT) and contracted Mobile Crisis Outreach Teams. According to DMH, you can request one by calling the ACCESS Help Line at (800) 854-7771 or by calling 988 from an LA County area code. Response times vary, so if the situation turns dangerous while you wait, call 911.

When you call, tell the dispatcher:

• That this is a mental health or substance use emergency, if it is.
• The exact address, including apartment number and gate code.
• The person’s name, age and what is happening right now.
• Whether there are any weapons in the home.
• Any diagnosis, medications or substances you know about.
• Whether the person has been violent before, or has never been.

You can ask whether a mental health responder is available. While you wait, keep your voice low and calm, give the person space, remove anything dangerous if it is safe to do so, and do not argue. Unlock the door and turn on an outside light so responders can find you.

The CDC lists these signs of an opioid overdose: the person cannot be woken, breathing is slow, shallow or stopped, skin is discolored (especially lips and nails), and pupils are very small.

The CDC’s steps are:

• Give naloxone if you have it, and call 911.
• Try to keep the person awake and breathing.
• Lay the person on their side to prevent choking.
• Stay with the person until emergency help arrives.

Naloxone nasal spray is sold over the counter in California, and LA County offers it free at select library branches and public health access points. Keep it at home if anyone in your family uses opioids or any street drugs, since many are mixed with fentanyl. See our LA resources directory for where to get it, and our guide on fentanyl and naloxone for more.

A safety note on withdrawal: Stopping alcohol or benzodiazepines suddenly can be medically dangerous. Talk to a doctor first. Signs like shaking, confusion, seeing things or a seizure after someone stops drinking are an emergency. Call 911.

A 5150 is a California hold of up to 72 hours so a person in crisis can be assessed and evaluated. It can happen when, because of a mental health disorder or a severe substance use disorder, someone is a danger to themselves, a danger to others, or gravely disabled. Families cannot place a hold themselves. Police and certain trained professionals authorized by the county make that decision, and the best thing a family can do is share clear, honest information about what they have seen. Our guide on 5150 holds, CARE Court and conservatorship explains what happens next and the other legal options.

• Ask about follow-up before discharge. With your loved one’s permission, ask the hospital or crisis team about appointments, medication and who to call if things get worse.
• Book the first appointment fast. Aim for a therapy or psychiatry visit within days, not weeks.
• Make the home safer. Lock up or remove firearms, extra medicines and alcohol for a while.
• Write things down. Keep a short record of dates, what happened, medications and providers. It helps every future conversation.
• Make a crisis plan together. When things are calm, agree on warning signs, coping steps and who to call.
• Get support for yourself. Families carry a lot. Groups like NAMI, Al-Anon and Nar-Anon are free.

If your loved one refuses help after the crisis, read how to help a loved one who won’t accept help. If they are coming home from treatment, see after treatment: the first 90 days.

We are one organization with several areas of service. Blackburn Clinical Services offers therapy, psychiatry, testing, family services and a Concierge Outpatient Program for teens. Blackburn Recovery Services offers case management, intervention and family support. Blackburn Monitoring offers drug and alcohol testing, and Blackburn Mentoring offers one-on-one mentoring and coaching. Not sure which fits? Read case management, mentoring or therapy.

• 988 Suicide and Crisis Lifeline
• Los Angeles County Department of Mental Health
• LA County DMH: Alternative crisis response and field intervention teams
• LA County Public Health SAPC: Substance Abuse Service Helpline
• CDC: Responding to an overdose
• LA County Public Health: Overdose prevention
• California DHCS: Naloxone Distribution Project

Our Where to start page walks through the options, and our page for families explains how we work with loved ones. You can also call us at (888) 305-5422 or email info@theblackburngroup.org. Terms you hear along the way are explained in our glossary.

If someone is in crisis, call or text 988 to reach the 988 Suicide and Crisis Lifeline. In an emergency, call 911.

• 5150 Holds, CARE Court and Conservatorship
• Relapse Warning Signs
• Signs a Teen Needs Mental Health Support

All guides →