How to help a stranger on the street in a mental health crisis

You’re walking down the street, and you encounter someone crying.

Or perhaps the person seems worked up in another way — screaming at the air or rocking back and forth in distress.

A disquieting feeling follows. Do you attempt to say something? Call emergency services? Or, perhaps the likeliest option, avert your eyes, cross the street and keep moving?

It’s not an easy situation to confront. And yet, how to help someone in mental health distress — whether a stranger or a friend — is an essential question in California.

Around 20% of adults in this state have a mental illness, according to the federal Substance Abuse and Mental Health Services Administration, although not every person with a mental illness goes through a crisis, and some people with no previously diagnosed illnesses experience breakdowns. The incidence of mental health problems is considerably higher among unhoused Angelenos — 51% of whom have a mental illness, according to a Times analysis of data from the city’s homeless population count in January 2019.

“If you notice someone who is choking or someone who is having chest pain and bending over … that wouldn’t stop you from asking, ‘Hey, are you having heart pain? Are you having chest pain? Are you having trouble breathing?’” said Dr. Curley L. Bonds, chief medical officer for Los Angeles County’s Department of Mental Health. But many of us don’t react the same way to people in a mental health crisis, Bonds said.

“I think so often, we don’t ask and we don’t activate emergency response because we’re afraid, and we’re trying to be polite,” he continued, “and that person may subtly be trying to reach out.”

Here’s some expert advice about how to recognize when a stranger is in mental distress and how to help without adding harm.