If you or someone you know is considering suicide, call 9-1-1, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text “MHFA” to 741-741 for 24/7 confidential counseling from the Crisis Text Line.

Peer pressure. Bullying. College applications. Extracurricular activities. High school students today face a number of personal challenges, and sometimes these challenges can be difficult to manage alone.

This pressure and stress can affect overall mental health and well-being now and in the long-term. One in five teens lives with a mental health challenge. This means that one in five teens around you is struggling with a mental health condition right now.

Do you know what to do if you see your neighbor, classmate or friend in need? Whether you are facing your own personal mental health challenge or you know someone else who is, the teen Mental Health First Aid (tMHFA) Action Plan will help you understand how to manage a crisis situation and help a friend when they need it the most.

The teen MHFA Action Plan
teen Mental Health First Aid teaches young people how to recognize the signs of mental health problems and crises, offer and provide initial support and enlist the help of a trusted adult. The most critical time to use this action plan is when a friend or peer is experiencing a mental health crisis, but the best time is before that crisis occurs.

1. Look for warning signs.
   Sometimes your friend might show multiple signs of a mental health or substance use challenge, but sometimes they might not show any.It’s important to know what signs of a mental health crisis are so you can recognize it right away. It’s also important to keep in mind that your friend is at especially high risk if they show one or more of these warning signs and has recently been through a difficult situation, such as an argument, relationship breakup, loss of loved one or bullying.Warning signs fall into different categories, but all indicate that there is risk of harm:Possible injury or death

   Looking for ways to hurt or kill themselves

   Threatening to hurt or kill themselves

   Acting recklessly or engaging in risky activities

   Talking, writing or communicating about death, dying or suicide (including in schoolwork, creative writing, artwork or online)

   Displays of rage or anger, being aggressive towards others, seeking revenge or threatening violence toward others

   Loss of purpose or direction

   Having no reason to live or no sense of purpose in life

   Having a sense of hopelessness or helplessness

   Feeling trapped like there’s no way out

   Dramatic changes in behavior or emotions

   Intense anxiety, agitation or paranoia

   Sudden changes in mood

   Withdrawing from friends

   Decline in school performance

   Changes in eating or sleeping patterns.

2. Ask how they are.
   If you see warning signs of a possible crisis, you should approach your friend immediately. Try to stay calm and talk to them in a respectful and caring way.Ask them how they’re doing and if there’s anything you can do to help. If your friend is open to getting help, call an adult you know and trust. If your friend gets angry, agitated or aggressive, it might be best to walk away and call an adult for help.

3. Listen up.
   We all need someone to talk to. It’s important that you take time to listen to your friend and believe what they tell you. Sometimes a person in a crisis will not be able to communicate very well, so just listen as best you can to understand your friend’s problem.
4. Help them connect with an adult.
   Warning signs of a mental health crisis need to be taken seriously and a responsible, trusted adult should be involved. Ask your friend which adult they would feel comfortable talking to. If your friend does not want to tell an adult, you could try explaining the reasons why getting support from an adult is a good idea.If your friend refuses to tell an adult about their problem, you may need to tell an adult yourself without your friend’s consent. Remember that your friend’s life and health are most important and an adult will be able to bring the help needed to keep your friend safe.
5. Your friendship is important.Once your friend is with a responsible and trusted adult and getting the support they need, it might be a good idea to reach out to them again. Ask your friend what help or support they would like from you and remind them that you are always going to be there for them as a friend. Remember that a good friend is someone who looks out for their friends in every way, including their mental health and well-being. And by taking these steps, that’s exactly what you’re doing.

Remember when there is risk of harm, the most important priority is safety and connecting your friend with a responsible and trusted adult who can assist them to reduce their risks and stay safe.  Never place yourself in danger while trying to help your friend, and do not try to take on more than you can handle. Taking care of yourself is an essential part of practicing effective teen Mental Health First Aid.

To learn more about how to help your peers who may be struggling with a mental health or substance use challenge, watch this video about the new teen Mental Health First Aid program, run by the National Council and supported by Lady Gaga’s Born This Way Foundation. This course teaches high school students how to identify, understand and respond to signs of a mental health problem or crisis among their friends. Right now, eight high schools across the country have trained students in teen Mental Health First Aid. We’re looking forward to expanding to more schools across the country in the coming years so every young person can #BeTheDifference.