This information has been compiled by NAMI PA, Main Line (https://namipamainline.org/). Nothing in this document should be considered legal advice; for legal advice, you should see an attorney.
I. Resources for Coping with a Crisis
If you or someone you know is having a mental health crisis, call the crisis line for your county or you can call 911 (e.g. if there is immediate danger of physical harm). In Southeastern Pennsylvania the crisis numbers to call are:
Bucks County: 800.499.7455 (or for children and adolescents 877.435.7709)
Chester County: 877.918.2100
Montgomery County: 855.634.4673 (or for children and adolescents 888.435.7414)
Delaware County: 855.889.7827
Philadelphia County: 215.686.4420
These crisis lines provide access to staff who are specifically trained for dealing with mental health crises and may provide better help and reduced risk of arrest. Someone is available 24/7 to assess the situation, arrange for an in-person evaluation, and/or make referrals as needed.
You can also call one of the following national hotlines to be referred to the closest crisis center:
Crisis Text Line: 741-741
For advice on coping with a crisis, see:
For advice on getting treatment during a crisis, see:
- Navigating and Understanding the Inpatient Hospitalization System
If you experience problems in communicating with healthcare providers due to HIPAA regulations, the following documents should be helpful:
In some situations when an individual is involved in a serious and potentially life-threatening psychiatric emergency or severe behavioral health crisis and is unwilling or unable to consent to treatment, state law authorizes court-ordered inpatient or outpatient mental health treatment without the individual’s consent. For inpatient treatment, this process is known as involuntary commitment or civil commitment; for outpatient treatment, the term “assisted outpatient treatment” (AOT) is often used. Criteria and procedures vary in different jurisdictions. The following websites provide general information on the involuntary commitment process, as well as specific information for Montgomery County and Allegheny County in Pennsylvania: http://mces.org/PDFs/MCES_Quest_June_2003.pdf and http://www.alleghenycounty.us/Human-Services/About/Contact/MH-Commitment.aspx. In Pennsylvania, the initial involuntary inpatient commitment process is known as 302, and commitment for extended involuntary inpatient treatment (if inpatient treatment is needed for more than five days) is known as 303. The hearing for a 303 may provide the opportunity to communicate with your loved one’s psychiatrist if you have had trouble doing this in the inpatient setting.
For advice on coping with the criminal justice system, see https://namipamainline.org/info-resources/criminal-justice-resources/.
The National Missing and Unidentified Persons Database allows the general public to add new missing persons, add physical and circumstantial details, photographs, dental contacts and other critical pieces of information, create and print missing persons posters and track cases (https://www.findthemissing.org/). Additional resources and advice are available at www.outpostforhope.org and http://www.nami.org/missing.
II. Advice on Avoiding a Crisis and Preparing for a Crisis
Helpful advice for avoiding and/or preparing for a crisis can be found at:
Treatment programs such as assertive community treatment (PACT) can help to prevent mental health crises or relapse. Many resources for finding treatment, including free or low-cost treatment, are available in “How to Get Government Services” (https://namipamainline.org/info-resources/how-to-get-services/) and “Introduction to Services for Individuals with Mental Illness and their Family Members In Southeastern Pennsylvania” (https://namipamainline.org/info-resources/intro-to-services/). For additional information, contact your local NAMI affiliate (http://www.nami.org) and/or your County Office of Behavioral Health or Mental Health.
A Mental Health Advance Directive allows a person with mental illness to indicate his/her treatment preferences and designate a Power of Attorney for health care who can be authorized to make treatment decisions on his/her behalf in the event of a mental health crisis. Advice to help you understand Advance Directives and decide if you want one is available at http://www.nami.org/Learn-More/Mental-Health-Public-Policy/Psychiatric-Advance-Directives-(PAD). Directions and forms for a Mental Health Advance Directive and Power of Attorney in Pennsylvania are available at http://drnpa.org/File/publications/directions-for-using-the-combined-mental-health-advance-directive-declaration-and-power-of-attorney-form.pdf. Additional information and advice on mental health advance directives is available at http://www.nrc-pad.org/index.
If you have concerns that a crisis may arise, it is helpful to notify the police and other first responders in advance that a household includes a person with a severe mental illness, so the police can respond in an informed manner if an emergency arises. Knowing a person’s medical situation ahead of time can be important for quick and educated responses that increase safety and the likelihood that the person will receive appropriate treatment rather than arrest during a crisis. The Pennsylvania Premise Alert System (http://www.papremisealert.com/) provides families with a uniform method to alert first responders with information about persons who have mental illness. Only legal guardians, those with Power of Attorney, or the person with the mental illness can complete this form. Copies of the completed form should be given to the local police. The information will be put into the 9-1-1 system for future use. The information should be updated every year or two. A similar form for residents of Philadelphia is available at http://philadelphia.nami.org/policefiremedadainfoform.pdf. This form also should be given to the local police. The Vial of Life project provides important information for first responders when a person is unable to communicate this information. Information about medications, copy of advance directive, etc. is put in the vial, and the vial and a Vial of Life decal are put on the refrigerator. A second decal is placed on the front door. Since this is not a wide-spread program in this area it’s probably a good idea to notify fire/police that you have this information available. A Vial of Life kit is available at http://vialoflife.com/?gclid=CJ_EkNvkkqECFd1n5QodrVJ_Mw.
NAMI’s Family-to-Family course includes sections on working to avoid crises and planning a family procedure for responding to crises. In addition, valuable skills that can improve your loved one’s long-term prognosis can be learned in Family-to-Family (https://namipamainline.org/support/family-to-family-education-basics-programs/ and http://www.nami.org/Find-Support/NAMI-Programs/NAMI-Family-to-Family) and in workshops offered by Mental Health Partnerships’ Training and Education Center (https://www.mentalhealthpartnerships.org/tec/). Advice on effective communication skills, problem-solving and conflict resolution is available at https://namipamainline.org/info-resources/advice-coping-with-smi/.