Who can call a state of emergency

Psychiatry, Psychosomatics & Psychotherapy

Crisis / Emergency: Acute mental crisis

Mental crises can affect anyone, regardless of age, education, occupation, origin and social status. A crisis can result from a short-term stress, such as a shock reaction due to a real dangerous situation, or it can be the result of a long-term, cumulative stress. The causes of acute emotional distress are diverse and can be triggered, for example, by experiences of loss or disappointment, traumatic experiences, psychosocial conflicts, life-changing circumstances or upheavals, uprooting or loneliness as well as mental illnesses such as psychosis, depression or anxiety disorders. People with pre-existing mental illnesses are often more susceptible to crisis situations.

An acute crisis involves the loss of inner balance that people feel when they are confronted with situations or circumstances that they cannot cope with at the moment because the usual behavioral strategies do not work or collapse. In such a situation, thinking and feeling are often disturbed. The thoughts turn in circles, are scattered and cannot be brought to an end in a meaningful way. Sometimes your own feelings are difficult to perceive. On the other hand, they can also be so intense that they are difficult to control and, for example, fear, anger, hopelessness, loneliness or sadness appear overwhelming and threatening. Basically, different symptoms can occur with different intensity, such as tension, fear, aggressiveness, confusion or a narrowing of perception up to delusions and hallucinations.

As soon as there is an immediate danger to oneself or others (especially suicide) in a corresponding situation, one should not hesitate to contact a psychiatric emergency service immediately, the Ambulance Service (112) or notify the police.

If you are currently in a mental crisis, you can:

  • go to or call your doctor,
  • Contact a clinic (or a hospital) with a psychiatric department,
  • Contact the medical (psychiatric) on-call service (nationwide tel .: 116 117),
  • or contact an offer of help or advice for acute crisis situations (see addresses below):


  • Telephone counseling
    anonymous, free advice at every day and
    Night time under the nationwide telephone numbers 0800 - 1110111 or 0800 - 1110222 or www.telefonseelsorge.de
  • Children's and youth telephone "number against grief" www.nummergegenkummer.de
    Free advice from Monday to Friday 3:00 p.m. to 7:00 p.m. on the nationwide telephone number: 0800 - 111 0 333
  • In every German city there are psychological counseling centers, counseling centers for marriage, family and life issues, psychosocial counseling centers, and social psychiatric services. However, these facilities are not available around the clock and consultation appointments may have to be made - they are only of limited help in acute crises.


  • Telephone counseling
    Anonymous, free advice at any time of the day or night within each federal state on the telephone number 142
  • Immediate psychiatric aid
    By phone, outpatient, mobile: advice at any time of the day or night on 01-31330


  • Telephone counseling "The presented hand"
    www.143.ch anonymous, free advice at any time of the day or night on the telephone number 143


Mental emergency may require immediate assistance

If there is a mental breakdown, people sometimes need professional help immediately, which brings about rapid relief and clarification. The more dramatic the acute crisis, the more active action is required from the environment. The intensity and duration of a crisis can also lead to suicidal, suicidal thoughts and impulses. In such an escalation there is the possibility to call the emergency doctor, who can initiate relief through acute pharmacological care and, if necessary, admission to a clinic for psychiatry and psychotherapy. As an immediate measure, there is also the option of going to an emergency admission at the Clinic for Psychiatry and Psychotherapy. There, relief discussions and, if necessary, pharmacological therapy are carried out and further measures are advised. If necessary, the offer of further care by the psychiatric institute outpatient clinic, day clinics or an inpatient admission will also be discussed.

Not every mental crisis requires professional support

Many crises can be mastered alone, with the help of people close to you or with temporary support from people you trust. People in mental crisis situations may also be able to activate their own resources in order to overcome the crisis. It is essential that they are not left alone - their family, friends and acquaintances signal their support and offer discussions. Basically, it is helpful to lower the stress level, counteract overstimulation, give those affected a feeling of security and reduce stress. In order to support people in their self-regulation, it can be helpful, for example, to encourage and accompany them to do what their experience shows is good for them, such as going for a walk, recording routines or tidying up the apartment or cooking something .

Relaxation exercises, on the other hand, are often not advisable in severe crisis situations, because they intensify the internal consideration and can lead to further tension.

However, it is often difficult for people in psychological distress to accept outside help. Family and friends should therefore motivate and support the person concerned to accept professional help and, if necessary, obtain information about possible help from the social psychiatric service in the place of residence or from a counseling center.

If the measures of stress reduction, relaxation and the clarifying discussions in the environment do not lead to overcoming the crisis, those affected can turn to various professional contact points. Such contact points include the social psychiatric service in the health department of every city, psychosocial contact and advice centers, psychiatric institute outpatient clinics or doctors specializing in psychiatry and psychotherapy.

Technical support: Dr. Christa Roth-Sackenheim, Andernach (BVDP), Dr. Iris Hauth, Berlin (DGPPN)