Psychosis in someone close to you?

Going through a psychosis in someone close to you is intense. Here are 11 good, practical tips for dealing with someone who is psychotic.

Tip 1: Be honest and open about every step you take

People with a psychosis can experience a lot of suspicion and distrust. Be as honest as possible; say whom you have contacted and what you said. Say what you are going to do and why.

For example: “I have just spoken to your psychiatrist because I am worried about you.”

Tip 2: Appoint a contact person for family and friends

Inform the people who matter and appoint a contact person for them (perhaps yourself). Let that person make the contacts, not the person in psychosis, unless they clearly wish to do so themselves.

Is it the first time their loved one has a psychosis? Refer them to PsychosisNet for information.

Tip 3: Use the emergency plan

If there is one, get out the person’s emergency plan or crisis card and go through it together.

This document describes exactly what should be done, what the person’s wishes are regarding a possible admission or medication, and other important information.

Does someone not yet have an emergency plan or crisis card, while there have been crises before? Then try to draw one up in the future, if possible together with the person, their clinician and the people closest to them.

Tip 4: If there are children, explain that mum or dad is confused and needs help

Give the child room to talk about what they have seen, heard or noticed, and tell them that you will not abandon mum or dad and will arrange help.

Make sure the child is looked after, and tell mum or dad that the child is being cared for.

Tip 5: Create as much calm as possible

The person in crisis often feels a great deal of fear and has difficulty trusting others. Try to radiate as much calm and safety as you can, both in words and without words.

Do not go to busy places with many people or a lot of noise if there is no need. Try to reduce outside stimuli as much as possible, for example by switching off the television and radio.

Tip 6: Take the lead and be clear

Do not put more questions or choices to someone than necessary. Someone with a psychosis often experiences a lot of confusion and inner unrest, so communicate clearly and unambiguously.

An example of what not to do: “Would you like coffee or tea or something else? Shall we go here or there or…?”

Tip 7: Offer room to talk and let off steam

Let the person in psychosis tell their story; do not ask too many questions, but above all listen. Go for a walk if they like that, preferably in natural surroundings.

Realise that any delusions and hallucinations are the truth for the person at that moment. Do not judge and do not try to convince someone that you are right; do say that you experience the world differently.

Tip 8: Give someone physical space as well

Prevent someone from feeling locked up or closed in, and make sure there is always a physical way out. Give someone room to move; going for a walk, for example, can help.

Tip 9: Do not argue, and take distance where needed

In a psychosis someone can shout the most hurtful and shocking things. Do not take this personally, and do not respond to the content or argue about it, certainly not at that moment.

When someone repeatedly reacts negatively to you (with aggression or delusional ideas, for example), actively take distance. This does not mean that you are abandoning him or her, but that you are creating calm.

Tip 10: Encourage the person to seek professional help voluntarily

Try to prevent the situation from escalating to the point where the emergency services have to be called. Encourage the person to go to a doctor or crisis service voluntarily. Stress that this is exactly how you want to prevent the situation from escalating and coercion from being used.

In all cases: if there is immediate danger to you or to the person, always call in help. If a crisis service or the emergency services are contacted, do not let them simply burst in, if that is possible. Try to prepare the person for their arrival; do not take him or her by surprise unnecessarily.

Tip 11: Take care of yourself too

To really be there for someone else, you also have to take care of yourself. Going through a psychosis at close quarters, certainly when it concerns someone dear to you, is an intense experience for you too. Do what you need to do to stay on your feet, even if at some point that means taking some distance from your loved one for a while (but do tell them). You too are allowed to be afraid, angry, sad, powerless and tired. You too may sometimes not know what to do. You too may ask for help and support, for yourself. Taking care of yourself is also taking care of the other person.

Are you troubled by psychosis yourself?

Looking for useful tips on what you can do when you have a psychosis yourself? See Advice on psychosis.

Family organisations

In many countries there are organisations for family members and loved ones of people who are susceptible to psychosis, where you can go for advice and support.

Prof. dr. Jim van Os, Chair Division Neuroscience, Utrecht University Medical Centre. Jim works at the interface of ‘hard’ brain science, health services research, art and subjective experiences of people with ‘lived experience’ in mental healthcare. 

Jim has been appearing on the Thomson-Reuter Web of Science list of ‘most influential scientific minds of our time’ since 2014. In 2014 he published his book ‘Beyond DSM-5‘, and in 2016 the book ‘Good Mental Health Care’. In 2026 he published 'Wat psychisch lijden is'.

Want to read more?

Blogs by Jim van Os can be read here

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