Mental Health First Aid: How to Help Someone in Crisis
This article is general information published by the practice of Dr. Sholeh Toobaei, Specialist Psychiatrist, Dubai. It has not yet been individually reviewed by a clinician and is not a substitute for personal medical advice. Published: 1 September 2026.
Scope: This article provides general guidance on how to support someone experiencing mental health difficulties. It does not replace professional training in Mental Health First Aid.
The first aid analogy
When someone has a heart attack, you do not need to be a cardiologist to help. You call an ambulance. You keep them calm. You follow basic first aid principles. The same is true for mental health crises.
You do not need to be a clinician to recognise that someone is struggling. You do not need a degree to offer support. What you need is awareness, a few practical skills, and the willingness to act.
Mental Health First Aid (MHFA) is a globally recognised programme modelled on physical first aid. It teaches lay people — not professionals — how to recognise, understand, and respond to signs of mental health conditions and substance use difficulties. The core skills are: recognising the signs, offering support, encouraging professional help, and knowing when it is an emergency.
What mental health distress looks like
Mental health problems do not always look dramatic. Often they look like a person changing — gradually or suddenly — in ways that are noticeable to people who know them. Here are the most common signs:
Changes in mood. Prolonged low mood, unexplained crying, unusual irritability or anger, extreme mood swings, unusual anxiety or worry, feeling hopeless or helpless.
Changes in behaviour. Withdrawing from friends and activities, changes in work performance, increased use of alcohol or drugs, neglecting personal care, changes in eating patterns, sleep changes (too much or too little).
Changes in thinking. Difficulty concentrating, memory problems, paranoid thinking (believing people are out to get them), hearing or seeing things that are not there, obsessive or compulsive behaviours, thoughts of self-harm or death.
Changes in physical health. Unexplained aches and pains, changes in weight, constant fatigue, physical symptoms that do not respond to treatment.
None of these signs alone means someone has a mental health condition. Stress, illness, grief, and life changes can all produce similar symptoms. But a cluster of changes — especially if they are sudden or significantly different from the person's usual self — is worth paying attention to.
The ALGEE action plan
The Mental Health First Aid programme uses the ALGEE action plan. Five steps that any person can follow:
A — Approach the person. Start a conversation. This is the hardest step for most people. You are worried about saying the wrong thing. But not saying anything at all is more likely to be wrong. A simple "I have noticed you seem different lately, and I am concerned" opens the door. You do not need to be a therapist. You need to be a person who notices and cares.
L — Listen without judgment. This is not the time to give advice, to minimise their feelings, or to try to "fix" the problem. Listen. Let them talk. Do not interrupt, do not judge, do not dismiss. The goal is not to solve their problem in this conversation. The goal is to make sure they feel heard.
G — Give support and information. Reassure them that what they are experiencing is real and that help is available. Do not offer diagnoses or treatment advice. Do not say "everyone goes through this." Do say "This sounds really hard. I am here for you."
E — Encourage professional help. Gently suggest that professional help may be useful. You are not diagnosing them. You are normalising help-seeking. "What you are going through sounds like something a professional could really help with. Would you be open to talking to someone?"
E — Encourage self-help and other support. Support the person in taking steps that help their own wellbeing — reconnecting with friends, maintaining routine, physical activity, sleep. Encourage them to lean on their support network.
What to say
The following phrases are genuinely helpful:
"I have noticed you seem different lately, and I am concerned." "You do not have to go through this alone." "What you are feeling is real, and it makes sense given what you are going through." "I am here for you, even if I do not fully understand." "Would you be open to talking to someone who can help?" "Is there anything I can do right now to help?"
What not to say
These responses, however well-intentioned, are not helpful:
"You just need to think positive." — Hopelessness is a symptom, not a choice. "Other people have it worse." — Minimising their pain does not reduce it. "You are overreacting." — Their reaction is real, even if the trigger seems small to you. "Have you tried just exercising?" — While exercise is beneficial, reducing a clinical condition to a lifestyle change is dismissive. "It is all in your head." — Mental health conditions are medical conditions. They are, technically, "in the brain." That does not make them less real or less serious. "Tough it out." — This is the single most harmful thing you can say to someone struggling with their mental health.
Recognising specific situations
Different situations call for slightly different responses. Here is what to watch for:
Depression. The person may have stopped caring about things they used to enjoy. They may be sleeping all day, not eating, not answering calls. The approach: gentle persistence. Keep reaching out. Do not take withdrawal personally. Offer practical help — a meal, a ride, sitting with them.
Anxiety and panic. The person may be shaking, sweating, breathing rapidly, convinced something terrible is about to happen. The approach: stay calm. Speak slowly and softly. Guide them through slow breathing. "Breathe in for four seconds. Hold for four. Out for six." Stay with them until the episode passes.
Psychosis. The person may be experiencing hallucinations or delusions. They may be frightened, confused, or paranoid. The approach: do not argue with what they are experiencing. You do not have to believe their reality to validate their fear. "I can see this is really frightening for you. I am here and you are safe."
Substance use crisis. The person may be intoxicated, withdrawing, or experiencing a drug-related emergency. The approach: ensure their physical safety. If they are unconscious, having seizures, or having trouble breathing — call 998 (ambulance) immediately.
Suicidal thoughts. The person may talk about wanting to die, about being a burden, about having no reason to continue. The approach: take it seriously. Ask directly: "Are you thinking about hurting yourself?" Asking does not put the idea in their head. It gives them the opportunity to tell the truth. If they are, ask about their plan. If they have a plan and the means to carry it out — this is an emergency. Call 999 (police) or 998 (ambulance) or go to the nearest emergency department.
Knowing when to call for emergency help
Call 999 (police) or 998 (ambulance) in the UAE, or go to the nearest emergency department, if the person:
Has expressed thoughts of self-harm or suicide. Has a plan to harm themselves or others. Is currently experiencing a psychotic episode (hearing voices, seeing things that are not there, severe paranoia). Has become violent or is a danger to themselves or others. Is unconscious, having a seizure, or experiencing a medical emergency related to substance use. Has attempted self-harm.
In a mental health emergency, your role is not to treat. Your role is to ensure safety and get professional help.
The role of the helper
Supporting someone with a mental health condition can be emotionally taxing. It is important to look after your own wellbeing:
Set boundaries. You can support someone without carrying their entire burden. It is okay to say "I care about you, but I am not qualified to help with this. Let me find someone who is."
Do not take it personally. Withdrawal, irritability, changed behaviour — these are symptoms of the condition, not personal rejections.
Know your limits. You are not their therapist. You are their friend, colleague, family member. Your role is to offer support, listen, and connect them with professional help. That is enough.
Take care of yourself. Supporting someone through a mental health crisis can be emotionally draining. Talk to someone about how you are feeling. Maintain your own routines, your own social connections, your own sense of perspective.
The Dubai context
Mental health first aid in Dubai has specific cultural considerations:
Stigma. In many cultures represented in Dubai, mental illness carries significant stigma. A person may be more willing to describe physical symptoms than psychological ones. "I cannot sleep" or "I have headaches" may be the way a person describes depression because that is the culturally acceptable language of distress.
Language. If you are supporting someone who is not fluent in English, communicate as clearly as possible. Use simple language. Do not use technology translation for crisis situations, but do your best to ensure understanding. Body language — a calm voice, a steady presence, open posture — is universal.
Community. In many cultures, the extended family or community is the first support system. Encourage the person to connect with their community if that feels safe and supportive. In some cases, a trusted community or religious leader can be a bridge to professional help.
Confidentiality. People in small expatriate communities — particularly in a city like Dubai where professional circles overlap — may worry about confidentiality. Reassure them that professional help is confidential. A clinician in the UAE is bound by medical confidentiality.
After the crisis
Once the immediate crisis has passed, the work is not over. Recovery is not a single event — it is a process.
Check in regularly. A few weeks after a crisis, the hardest part may be starting. People around the person often assume "they are okay now" and stop checking in. Keep checking in.
Encourage follow-through. If professional help has been recommended, help the person follow through. Offer to drive them to their appointment, wait with them, or come with them for moral support.
Be patient. Recovery is not linear. There will be good days and bad days. A setback is not a failure. It is part of the process.
When should I seek help?
If you are experiencing signs of psychological distress that are affecting your daily life — or if you are concerned about someone else — consider seeking a professional assessment. Mental health difficulties are common and treatable. The people who recover fastest are those who seek help early.
Seek urgent help — call 999 (police) or 998 (ambulance) in the UAE, or go to the nearest emergency department — if you or someone you know is in immediate danger, is having thoughts of self-harm, is experiencing a psychiatric emergency, or is in any way a danger to themselves or others. For non-urgent enquiries, use the appointment request form on this website. This practice does not operate a monitored telephone line, and a message sent through the form may not be read straight away.