Responding to a Different Type of Emergency: Identifying Mental Health Crisis Warning Signs and Symptoms

The emergence of a mental health crisis can occur suddenly and often involve a significant shift in a person’s emotional or psychological state. For public safety personnel and first responders, these crises are often compounded by cumulative trauma, workplace pressures/culture, and difficulties with quick/efficient access to mental health supports. Police officers, paramedics, firefighters, correctional officers, healthcare professionals, and many other critical incident response personnel routinely encounter high-stress scenarios, which can have a lasting psychological impact.

What Is a Mental Health Crisis?

A mental health crisis is any situation in which a person’s behavior, emotions, physiological response, or thinking becomes so intense or dysregulated that it poses a risk to their well-being or the safety of others, or severely impairs their ability to function in daily life. It is not necessarily a formal diagnosis, but rather a critical point of emotional, psychological, or behavioral instability that requires immediate intervention.

For some, a mental health crisis may involve active suicidal thoughts, a loss of reality (psychosis), or severe panic attacks. For others, it may present as emotional shutdown, erratic or risky behavior, or a complete withdrawal from social or professional responsibilities. Importantly, a mental health crisis can develop over time or appear suddenly and without warning.

A crisis may include:

• Intense emotional distress or overwhelm that is difficult to self-manage

• Inability to care of oneself or meet basic needs

• Increase in risky behaviors (i.e., increased substance/alcohol use, driving recklessly, getting into confrontations/fights, excessive spending/gambling, risky sexual behavior).

• Significant cognitive difficulties: difficulty organizing thoughts, concentrating, planning, problem solving

• Thoughts or behaviors that pose an imminent risk to self or others (e.g., suicidal or homicidal ideation)

• Loss of contact with reality (delusions, hallucinations)

• Inability to function at home, work, or in social settings

In the context of public safety personnel and first responders, a crisis may also manifest as the sudden collapse of coping mechanisms after prolonged exposure to trauma or stress. These individuals may continue to “perform” under pressure—showing up for work, responding to emergencies—until their emotional threshold is breached and they are no longer able to cope with the overwhelming stress being accumulated, often resulting in burnout, emotional breakdowns, or dangerous behaviors.

A mental health crisis is a medical and psychological emergency—not a sign of weakness. It requires prompt attention, support, and often, professional treatment. Recognizing it early can mean the difference between manageable recovery and long-term complications.

Recognizing the Warning Signs

Early identification of common signs/symptoms of mental stress allows for timely support, de-escalation, and access to appropriate interventions —reducing the risk of prolonged psychological distress, self-harm, burnout, or long-term psychological harm. This is especially vital for public safety personnel, who often delay seeking help due to stigma, fear of job-related consequences, or the ingrained habit of prioritizing others over themselves. By understanding and responding to the subtle cues of emotional, behavioral, cognitive, and physical distress, peers, supervisors, and loved ones can intervene before a crisis reaches a dangerous tipping point. In some cases, early action can be life-saving and career-preserving.

Common signs/symptoms of mental distress include:

Emotional Signs

• Emotional Numbing or Detachment: Especially prevalent in those repeatedly exposed to trauma. They may describe feeling “nothing” even in situations that should be emotionally significant.

• Irritability or Rage: Heightened emotional reactivity due to accumulated stress and/or lack of rest.

• Hypervigilance: An exaggerated state of alertness, often described as “being on edge” all the time.

• Guilt and Shame: Particularly survivor’s guilt or taking disproportionate or inappropriate blame  after traumatic calls or incidents where others were harmed.

• Overwhelming Grief: Inability to process loss—whether for a fallen colleague or a traumatic event with a child or victim.

• Sense of Futility or Helplessness: Feeling like the work makes no difference, often expressed as “What’s the point anymore?” or “We don’t even really help people anymore”.

Behavioral Signs

• Substance Use and Self-Medication: Using alcohol, cannabis, drugs, or misusing prescription medications to sleep, numb, or escape.

• Social Withdrawal: Avoiding friends, colleagues, or family events; spending excessive time alone or sleeping.

• Compulsive Overworking: Taking extra shifts to avoid dealing with personal life or emotional pain.

• Loss of Interest in Hobbies: Activities once loved (e.g., sports, fishing, family time) no longer bring enjoyment.

• Anger Outbursts or Increased Conflict: Especially in close relationships—short temper, yelling, or physical aggression.

• Neglect of Personal Hygiene: Decreased attention to grooming or appearance, especially in contrast to usual standards.

Cognitive Symptoms

• Increased frequency of Suicidal ideation: pervasive thoughts about ending one’s own life, making plans for how to complete the act, obtaining the means needed to complete the act.

• Flashbacks or Intrusive Memories: Vivid re-experiencing of traumatic events, often triggered by sounds, smells, locations, or sights.

• Nightmares or Disturbing Dreams: Persistent and distressing dreams related to past critical incidents.

• Dissociation: Feeling disconnected from oneself or surroundings, sometimes described as “watching life happen through a screen.”

• Hopeless or Catastrophic Thinking: Experiencing thoughts such as, “Things will never get better” or “There’s no way out of this.”

• Difficulty Making Decisions: Indecisiveness even about basic tasks, often tied to anxiety or overwhelm.

• Reduced Situational Awareness: Slower reaction times or missed details that can affect job performance and safety.

Physical Symptoms

• Chronic Fatigue or Exhaustion: Persistent tiredness that sleep doesn't resolve.

• Headaches and Muscle Tension: Especially in the neck, shoulders, and back—often signs of stress overload.

• Digestive Problems: Nausea, diarrhea, or stomach pain without clear physical cause.

• Frequent Illness: A weakened immune system due to chronic stress can lead to repeated colds or infections.

• Appetite Changes: Either significant increase or decrease in appetite and associated weight changes.

• Heart Palpitations or Chest Pain: Often mistaken for cardiac issues, these can be symptoms of panic attacks or anxiety.

Recognizing the early warning signs of a mental health crisis is especially vital for those in high-stress occupations. For public safety personnel, the culture of silence or invulnerability can delay crucial help-seeking behaviors. Building awareness and increasing accessibility to confidential, stigma-free support is critical.

Mental Health Crisis Resources

Below are organizations and services tailored to both the general public and public safety personnel in Ontario:

For All Residents of Ontario

• ConnexOntario (1-866-531-2600): 24/7 mental health, addictions, and problem gambling support and navigation.
  Website: www.connexontario.ca

• Gerstein Crisis Centre: (416-929-5200). Services include 24/7 telephone support, in-person mobile crisis team, community support referrals, substance use crisis management, follow-up and access to short-term crisis beds. Website: Gerstein Crisis Centre - Gerstein Crisis Centre | Gerstein Crisis Centre

• Distress and Crisis Ontario (DCO):
  – Connects users with local distress centres throughout Ontario, including chat/text options for frontline workers in crisis. Website:  https://www.dcontario.org

• Talk Suicide Canada (1-833-456-4566 or Text 45645): National and Ontario-accessible crisis line operated by trained responders.

• Distress Centres of Greater Toronto: Free, confidential support by phone and text to residents of Toronto, Peel, and surrounding areas.
  Website: www.dcogt.com

• BounceBack Ontario: Free guided self-help program for Ontarians 15+ experiencing mild-to-moderate anxiety or depression.
  Website: www.bouncebackontario.ca

Specialized Resources for Public Safety Personnel

• Ontario First Responders’ Mental Health (TEMA Foundation): Peer and clinical support, training, and education.
  Website: www.tema.foundation

• Canadian Institute for Public Safety Research and Treatment (CIPSRT)
  – Provides evidence-based mental health research and self-assessment tools for first public safety personnel and military members. Also provides internet-delivered cognitive behavioural therapy, also known as ICBT, tailored for current and former PSP and their spouses or significant others. CIPSRT | Online therapy for PSP (PSPNET)

• Badge of Life Canada: Peer-led mental health support and resources for first responders and public safety personnel.
  Website: www.badgeoflifecanada.org

• Wounded Warriors Canada: Offers trauma-resiliency programs, couples therapy, and peer support specifically for veterans, military, and first responders.
  Website: www.woundedwarriors.ca

• First Response Mental Health: Peer support driven digital mental health support tools and organizational wellness platforms for police, fire, EMS, and corrections. Website: First Response Mental Health | Mobile First Responder Wellness Solutions