By Dr. Janette Leal, Anthem Blue Cross and Blue Shield of Nevada

Most people don't plan for a mental health crisis. But millions will experience one this year, often with no clear idea of where to turn. It shows up during moments of loss, stress, illness, or major life changes. When it does, the first few days can feel overwhelming, emotional and urgent.

In 2025, more than 28 million adults with a mental illness did not receive any mental health treatment, highlighting the urgent need for clearer, faster paths to care. Navigation is key and what happens in the first 72 hours can make a real difference. Here's what individuals and families should know — before they ever need it.

1. You're not alone: The first 72 hours can shape what comes next
The hours immediately after a mental health crisis are often the most intense. In Nevada, how quickly someone receives support can influence whether a situation stabilizes or escalates.

During this time, the focus is on three essentials: reducing immediate risk, calming emotional distress and connecting people to next-step care. When these needs are addressed early, people are more likely to recover and avoid repeat crises.

Most importantly, no one has to go through a mental health crisis alone. If someone is in immediate danger, emergency services are appropriate. For emotional distress or suicidal thoughts, the 988 Suicide & Crisis Lifeline is available 24/7 by call or text, free and confidential. Early connection to trained support can help de-escalate a situation and guide next steps before it worsens.

2. Waiting makes a crisis worse - even when people think they're "overreacting"
One of the biggest reasons people don't seek help right away is uncertainty: Is this serious enough?

The answer is almost always yes. Delays in care can allow symptoms to escalate, increasing the likelihood of emergency room visits or inpatient stays — outcomes that are more disruptive and expensive.

3. Reduce risk before taking next steps/making long-term decisions
Families often feel pressure to "fix everything" quickly. But in the early days of a mental health crisis, reducing risk comes first. This phase is about providing reassurance, clarity and reducing immediate distress. Decisions about therapy, medication, or long-term treatment plans come after the crisis begins to ease, giving the brain and body time to settle.

Helpful questions to ask early include:

Who is our main point of contact right now?
What support is available today or this week?
What is the next short-term step?

4. There's no "wrong door" to get help
Many people assume that a mental health crisis automatically means a long emergency room visit. In reality, support can start in many ways and there's no wrong door. People may reach out through a primary care doctor, a virtual visit, an employee assistance program (EAP), or a crisis line such as 988. The goal across these options is the same: fast access to the right level of support, without added stress or complexity.

Asking for help during a mental health crisis is hard, and the response should lighten the load, not more overwhelming. Early intervention works best when people feel heard and taken seriously, receive clear next steps and know support will continue beyond the first conversation.

Health plans, providers and community or advocacy organizations play an important role by simplifying navigation and connecting people to care quickly and close to home. Turning this vision into reality requires investment in community-based organizations. In Nevada, the Anthem Blue Cross and Blue Shield Foundation supports efforts such as the Boys & Girls Club's Youth Mental Health Partnership to expand early access to care.

5. The first 72 hours are the beginning, not the end
We've made real progress in talking about mental health. But talking about it isn't the same as accessing care. When someone reaches out for help, they shouldn't have to navigate a complex system in the middle of a crisis. The first 72 hours should feel clear, connected and responsive.

Peer support specialists are often recommended (separately, or in addition to treatment) and helpful in many circumstances. These trained professionals often have lived experience with mental health or substance use challenges and are trained to provide emotional support, practical guidance and encouragement – helping people feel understood and less alone.

When care is easier to access, people get help sooner, stay engaged longer and are less likely to experience repeat crises. Better experiences lead to better outcomes and lower costs for everyone.

For mental health resources, visit www.anthem.com/mental-health.

Dr. Janette Leal serves as behavioral health medical director for Anthem Blue Cross and Blue Shield's Medicaid health plan in Nevada.

The Nevada Independent

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The first 72 hours of a mental health crisis: 5 things that matter most

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