It can be challenging to see a friend struggling with a health crisis but not recognizing the need for help, especially if it is an emergency. How can you help someone who needs to go to the hospital but does not want to or does not recognize the need?
Such circumstances can arise, for example, with individuals who are experiencing a mental health crisis. A mental health crisis can be due to factors like substance use or mental illness.
Situations can arise due to physical illnesses that impair cognition or intelligence, such as brain damage or head injuries.
It is always best, if possible, to get the individual to accept assistance willingly and openly. If that does not work, in most cases, you will need to respect their decision. It is essential to continue the conversation with warmth and respect.
Here are some helpful points
Explain: It is good to explain to the individual why you are concerned. Discuss their behavior as it is currently without labelling or diagnosing. For example, you can say, "I'm worried about you because I've noticed that over the past few weeks, you've seemed withdrawn, staying in your room, and not eating with us."
Listen: Ask them why they do not want help, listen to their responses, and ask more questions to understand better. For example, you can say, "Can I ask why you don't want to accept help?" It can also be helpful to summarize their answers to show that you understand. For instance, "Am I right in understanding that you're concerned that if you go to the hospital or the health center, you might feel worse?"
Offer to Help: Ask how you can assist. Perhaps offer to arrange an appointment, watch their pet, or help with household tasks. Offer to accompany them to their appointment or visit the emergency room. Let them know you are there and willing to help through the entire process.
Resources: You can suggest various resources for assistance, such as finding the right healthcare provider at the local health center, support groups, or self-help organizations.
Good information about resources can be found on the Mental Health Aid website.
If substance use issue, there are various resources available at SÁÁ.
Open Conversation: Maintain an open dialogue and make sure the option for accepting help remains open, even if it was initially declined. This increases the chances of success while respecting the person's boundaries.
Assistance from a Healthcare Professional: If your friend is receiving treatment from a healthcare professional, it may be possible to contact that professional or the family doctor. Keep in mind that healthcare professionals cannot provide information about the individual without their consent, but they can listen to what you have to say and provide guidance.
When to Intervene?
If there are signs of an acute and severe crisis, you should step in. These signs may include:
- Rapid and severe changes in behavior or thought patterns, such as incoherent speech or sudden isolation.
- Severe mood swings, like extreme agitation or depression.
- Threatening behavior or acts of violence towards themselves or others.
- Loss of touch with reality, such as hallucinations or delusions.
- Paranoia.
- Suicidal thoughts or attempts.
In such severe cases, you can contact emergency services or a crisis hotline for immediate help.
If the matter is not an emergency, you can contact a healthcare center, or call 1700 for guidance on the next steps from a nurse or doctor.
If the individual agrees to attend a consultation with a healthcare professional, it can be helpful to accompany them. You can go to the following places:
- Health centers: Information about the reception of health centers throughout the country can be found on the healthcare service website heilsuvera.is.
- The emergency mental health department at Landspítali hospital is open every working day from 12 PM to 7 PM and on Fridays from 1 PM to 5 PM. No appointments are necessary. More details about the emergency mental health department can be found on the healthcare service website heilsuvera.is.
- Hospital emergency departments accept people in acute mental distress. You can find all the hospital emergency departments in the country on their service website.
When the condition is severe, and there is a risk of needing to transfer the individual to a hospital for further assessment, you can request an evaluation by the attending physician at the regional health center. If the doctor attends the scene, the police will accompany him for safety reasons. The doctor may decide to transfer the individual to a hospital for closer examination if the condition is assessed as a severe illness and the person might be a danger to themselves or others.
If the matter is not urgent, you can contact the health center or call 1700 to get advice on the next steps from a nurse.
In emergencies, you can call 112 and request assistance.