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5 tips for responding to mental health crises on our streets and subways

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In recent years, an increase in the number of distressing incidents involving a mental health crisis on our streets and in our subways has left many New Yorkers feeling overwhelmed, fearful, confused and angry. As we navigate these events, we at The Bowery Mission believe it’s crucial to give ourselves time and space to acknowledge our emotions and find solace within a community of care. In the aftermath of any tragedy, taking time to process our responses is not only healthy but helps us empathize with others, embrace our shared humanity and take steps toward building a more just society.

Similarly, as we read headlines, we at The Bowery Mission believe it’s critical to educate ourselves on the complexities of homelessness and mental illness so that we, 1) are not misled by harmful stereotypes, and 2) can learn how to respond to difficult situations in a more informed manner. While media coverage tends to highlight the most extreme circumstances and incidents, the majority of people experiencing severe mental health crises on our streets or in our subways are not confrontational or aggressive. In fact, they are far more vulnerable to becoming victims of violence themselves. And yet most of us do not feel equipped to understand or respond effectively to the crisis situations we encounter in our daily lives in New York City.

How can we navigate these challenging moments with genuine empathy and compassion? How can we promote a safe and supportive environment for everyone — including our neighbors in crisis? In this article, we aim to provide practical guidelines for how to respond safely and well to difficult situations. As you read these tips, keep in mind they are intended to provide some useful tools rather than prescribed responses to every circumstance. Each situation is unique, and can be extremely complex, so it’s also important to use your best judgement, respect your limitations and be kind to yourself in the aftermath.

#1. Make an informed decision.

If you observe someone who is behaving erratically or appears to be in distress, it’s normal to feel scared or confused about what to do. To ensure the safety of yourself and others, pause to assess the situation before determining a course of action. What options are available and which would be the most appropriate and the most safe for the situation? As best as you can, suspend any preconceived notions you may have about the person or their situation, keeping in mind that past traumas may be impacting their current behaviors. Take some deep breaths, and center your attention on the present. By remaining calm, composed and self-aware, you can help foster an environment of stability and security for everyone, while also promoting greater clarity for how to proceed.

#2. Know when and how to call for help.

Sometimes, no matter how much we may want to help, the situations we encounter on our streets and subways may exceed our personal capacity to handle safely. Anytime you observe someone in crisis, don’t hesitate to seek assistance from a trained professional. If there is no imminent risk of danger, a great option is to call or text 988, a free, 24/7 hotline for anyone experiencing any type of mental health-related distress. If someone appears to be an immediate danger to oneself or others, find a safe location and promptly call 911. Describe the facts of the situation in as much detail as possible, avoiding any potentially inflammatory language and calmly request assistance from an emergency responder.

Crisis versus Emergency: What’s the Difference?


A crisis situation requires prompt attention, but is not immediately life threatening. Someone in crisis may be showing signs of difficulty, distress or trouble.

What to do: Call or text 988 to consult with a counselor.


An emergency situation demands immediate response. In an emergency, the person’s behavior causes you to fear for their safety, your safety or the safety of others.

What to do: Promptly call 911 to request support from an emergency responder.

Source: New York City Department of Health and Mental Hygiene

#3. Focus on personal space.

When we see someone in crisis, it’s normal to want to intervene directly. However, sometimes the most helpful thing we can do is avoid anything that might exacerbate the situation or cause further distress. Pay attention to the person’s body language. If they appear agitated, anxious or uncomfortable, consider taking a step back to give them space to breathe and calm down. If you are in a public or crowded setting, consider gently encouraging others to do the same. Keep in mind that for someone in crisis, loud and crowded environments have a tendency to escalate tension, trigger negative reactions and contribute to feeling overwhelmed.

#4. Prioritize mutual empathy and respect. 

As much as possible, seek support and avoid acting alone. However, if the person directly addresses you and you feel comfortable having a conversation, focus on maintaining an understanding and non-judgmental approach. Using a calm and reassuring tone, actively listen to their concerns and validate their feelings. If the person challenges you or says something hurtful or intentionally provocative, keep in mind that your safety and well-being matter too. While it is important to show compassion, it is equally important to maintain safe and healthy boundaries. Depending on your comfort level, you can steer the conversation to something more constructive or politely excuse yourself.

#5. Practice self-care afterward. 

Witnessing someone in the midst of a serious crisis can evoke strong emotions and take a toll on your own well-being. It’s normal to feel sad, angry or upset about what you’ve seen. If you’ve recently encountered a difficult situation, be kind to yourself. Take care of yourself by debriefing the incident, processing any emotions that may have arisen with trusted friends, family members or a mental health professional. You might also consider carving out room in your schedule for activities that help you relax and recover, like physical exercise, time outdoors or your favorite hobbies.

More Ways to Help

If you want to do more to help our neighbors in crisis, you are not alone. New York City is home to dozens of organizations committed to building a safer, more caring city for everyone. If you’re interested in learning more about how to respond to mental health crises on our streets with compassion and competence, consider enrolling in Mental Health First Aid or similar community training programs. This course will teach you how to identify, understand and respond to signs of mental illnesses, giving you the skills you need to provide initial help.

Volunteering at a place like The Bowery Mission is another great way to channel your desire to help New Yorkers experiencing homelessness, mental illnesses and crises of all kinds. At The Bowery Mission, volunteers have the benefit of working alongside staff who have comprehensive training in Non-Violent Crisis Intervention (NCI), which emphasizes the importance of empathy, active listening and choosing a response appropriate to the level of crisis. Together, we can make a difference in the lives of people facing challenging circumstances of all kinds and create a ripple effect that fosters a more caring city for everyone.