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Responding to Psychosis with Clarity and Compassion: Staying Present When Someone Is in Crisis (Part 7 of 13)

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Daniel L. Sonnenberg

Series Part 7. Responding to Psychosis with Clarity and Compassion: Staying Present When Someone Is in Crisis

Many people in the church carry hidden pain: anxiety that keeps them awake, depression that makes every day feel heavy, or trauma that flares up in quiet moments. For some, that pain becomes so overwhelming that they lose contact with reality in ways that are frightening for them and for those around them. This is what we call psychosis.

When someone is experiencing psychosis, they may:

  • Hear or see things that others do not (hallucinations)
  • Believe things that are not real (delusions)
  • Feel extremely confused or disorganized in their thinking
  • Become suspicious, fearful, or agitated
  • Act in ways that seem unpredictable or dangerous

This article is part of a series designed to help pastors, leaders, and members learn how to care well for people who are suffering—to think biblically, speak carefully, and act wisely. The aim is not to turn the church into a clinic, but to make our church a safer, wiser, and more compassionate place for people who are weary, anxious, or depressed, and for the people who love them.

The First Job Is to Stay Calm and Stay Present

When someone is experiencing psychosis, the church’s first job is not to fix everything. It is to stay calm and stay present.

Speak plainly. Listen carefully. Avoid arguing with a person about delusions or visions, since that usually increases fear rather than helping. If the person may hurt themselves or someone else, do not leave them alone and get urgent help right away.

We are not heroes in these moments. We are simply people who are willing to be there, to speak gently, and to get help.

What Not to Do When Someone Is in Psychosis

In crisis moments, it is easy to respond in ways that accidentally hurt more than help.

Do not:

  • Shame the person.
  • Minimize the seriousness of what is happening.
  • Imply that psychosis is simply a lack of faith.
  • Promise secrecy if safety is involved, because safety must come first.
  • Give simplistic spiritual explanations for symptoms that may have medical or psychiatric causes.
  • Argue with the person about whether their delusions or visions are real.

These responses can make the person feel more alone, more judged, and less safe.

When to Get Urgent Help

Call emergency services or a crisis line if the person is:

  • Hearing or seeing things that others do not.
  • Extremely confused.
  • Showing severely disorganized thinking or behavior.
  • Likely to act violently or dangerously.
  • Unable to care for basic needs.

In the United States, 988 is the Suicide & Crisis Lifeline, and it can be used when someone is in emotional or mental health crisis. If the person is in immediate danger, emergency response is appropriate, not overreaction.

The church should prioritize safety: contact emergency services or 988 when appropriate, and avoid leaving the person isolated if danger is present.

After the Crisis: Continuing to Care

Once immediate safety is addressed, the church should continue caring. That may include:

  • Follow-up contact.
  • Meals.
  • Rides to appointments.
  • Prayer.
  • Help connecting to treatment.
  • Support for family members who are also under stress.

The goal is not to “move on” quickly, but to help the person remain supported after the urgent moment passes. Crises do not end when the danger passes; they end when the person feels safe again, connected again, and supported again.

Professional Care Is Part of God’s Care

Psychosis often needs more than pastoral support. It may need medication, psychiatric care, hospitalization, or other forms of treatment. The church should not be embarrassed to encourage people to seek professional help.

Pastors and leaders should know when to refer people to mental health professionals and where to refer them when the need arises. That is not a sign that the church has failed. It is a sign that we understand our limits and want people to receive the kind of care that truly helps.

Professional care is not a failure of faith. It is part of God’s care.

A Closing Invitation

We invite our church to learn how to carry each other’s burdens, especially the heavy ones that don’t go away quickly.

As you read this, think not just about psychosis as a condition, but about the people in our church. Who is experiencing confusion, fear, or hallucinations? Who is in danger? Who needs someone to stay present, speak gently, and get help?

We invite you to:

  • Stay calm and stay present.
  • Speak plainly and listen carefully.
  • Not argue about delusions or visions.
  • Get urgent help when safety is at risk.
  • Continue to care after the crisis.
  • Connect people with professional care when needed.

When we do this, we show people that they are not alone, that their struggle is not a moral failure, and that they belong in the church.

Articles in this Series to Help the Church Care Well:

Further reading on this topic

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