By Dr Bibiana Chan
Over the past week, I found myself reflecting on two very different but connected situations I witnessed in the community.
In both incidents, a young person was in significant emotional or physical distress in a public space. In one situation, there was a family struggle that escalated into a very tensed situation. In another, a young woman appeared physically unwell and was initially refusing transport when paramedics arrived.
In both scenarios, I noticed how quickly uncertainty can unfold — not only for the person experiencing distress, but also for those trying to offer support appropriately.
These experiences reminded me of a frequently asked question:
When should we call emergency services during a mental health or emotional crisis — and when is it better to stay present and de-escalate?
This is no simple or straightforward answer – juggling between observing safety and avoid escalation! In Mental Health First Aid (MHFA) training developed by Prof Anthony Jorm and his wife, the guidelines suggest that our first responsibility is always safety — but safety is not always obvious in the moment.
Sometimes distress can look like:
- shouting or emotional outbursts
- leaving a home or space suddenly
- refusal of help
- confusion or agitation
- or physical symptoms that are not obvious or difficult to interpret
In these situations, bystanders are often left weighing two fears at once:
- the fear of “overreacting” and escalating the situation unnecessarily
- and the fear of “underreacting” and missing a genuine emergency
Both concerns are valid. MHFA teaches us ALGEE – a short and memorable mnemonic to remind us of the 5 key actions of an Action Plan:
A – Approach the person, assess and assist with any crisis
L – Listen and communicate non-judgementally
G – Give support and information
E – Encourage the person to get appropriate professional help
E – Encourage other supports
A helpful way to think about it is:
Is there immediate danger to life, safety, or ability to care for oneself?
If the answer is yes or unclear, emergency services are appropriate. If the answer is no and the situation is stabilising, calm presence and space may be more helpful.
Why these situations are often complex
What is not always visible in the moment is the broader context:
- language barriers
- cultural differences in understanding mental health
- fear of authority or systems
- previous trauma or healthcare experiences
- or fluctuating physical conditions that mimic emotional distress
This is why emergency responders often take a cautious approach — and why bystanders often feel uncertain about whether escalation was necessary. There is rarely a perfect answer in real time.
A personal reflection
These experiences have strengthened my belief that community mental health literacy matters deeply. If more people had access to simple frameworks for understanding distress, we might:
- reduce panic in crisis moments
- improve confidence in decision-making
- and support earlier intervention before situations escalate
At Community Flower Studio, our work has always been about prevention — using creative, non-clinical, and culturally accessible approaches to wellbeing so that support happens earlier, not only at crisis point.
A simple community checklist
When faced with uncertainty, I now find it helpful to pause and consider:
1. Is anyone in immediate physical danger?
- If yes → call emergency services
2. Is the situation escalating or out of control?
- If yes → call emergency services
3. Is the person unable to ensure their own safety or understanding?
- If unsure → seek emergency advice
4. Can calm presence, space, and time reduce distress safely?
- If yes → de-escalation and support may be appropriate
5. When in doubt, prioritise safety over uncertainty
Closing thought
Mental health crises rarely unfold in clear or predictable ways. What we can do as a community is not to become experts in diagnosis, but to become more confident in recognising risk, offering calm presence, and knowing when to seek help.
The goal is not to avoid emergency services at all costs — nor to default to them unnecessarily — but to respond with care, awareness, and humility in the face of complexity.
If anything, these experiences have reinforced my commitment to building mental health literacy through creative, accessible community spaces where support begins long before crisis.
