What to do if someone is experiencing hallucinations?

I was walking around the shopping centre a few days ago and saw someone who seemed to be experiencing hallucinations as she was walking around alone and seemed rather frustrated pointing and speaking to the air.

A part of me felt bad as I did not know what to do to help soothe her and in the end I just ignored and walked past her.

However, I would like to know what else can be done if let’s say it happens to someone close to me or if I ever come across such a situation again ?

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Dear @Otterworldly,

Thank you for reaching out and sharing your concern about how to respond when encountering someone who might be experiencing hallucinations. It’s evident that you genuinely care about the well-being of others and want to approach such situations with empathy and understanding. It’s truly commendable that you want to be supportive and make a positive difference in such situations.

Hallucinations and delusions are experiences that can occur in various mental health conditions, most commonly in disorders like schizophrenia, schizoaffective disorder, and sometimes in severe episodes of bipolar disorder or major depressive disorder. Here’s a bit more information regarding these experiences:

Hallucinations: Hallucinations involve perceiving things that aren’t present in reality. These sensory experiences can involve seeing, hearing, feeling, smelling, or tasting things that others don’t. For instance, someone might hear voices or see objects that others cannot perceive. These experiences can be distressing and sometimes frightening.

Delusions: Delusions are strongly held beliefs that are not based in reality. They might involve beliefs that seem bizarre or impossible to others, such as believing one has special powers, is being controlled by external forces, or has a unique mission. Delusions can significantly impact a person’s thinking and behavior.

Here are some steps to consider if you encounter someone who appears to be experiencing hallucinations or delusions:

  1. Stay Calm and Non-Judgmental : Approach the situation with a calm and non-judgmental demeanor. Remember that the person’s experiences are very real to them, even if they might seem unusual to others. While you should not pretend that you also experience the hallucination, you should also avoid trying to convince the person that the hallucination does not exist. You may instead ask questions like, “Are you hearing voices other than mine? What are they telling you?”. The immediate goal of your response should be to help the person focus on reality rather than the hallucination. Gently instruct the person to look at you, rather than whatever else they are seeing.

  2. Ensure Safety: If the person’s behavior seems risky (e.g., wandering into traffic), prioritise their safety and gently guide them away from potential harm. Reassure the person gently that you want to help them, and explain who you are, what you are doing and why. Helping the person to understand what is going on can reduce their stress and confusion (the contrary may result in an increase in hallucinations).

  3. Respect Personal Space: Approach the person at a respectful distance, avoiding any sudden movements that might startle them. Avoid touching the person without their permission. If delusions are present, it is important to keep yourself safe from potentially violent reactions, until you know the content and context of the delusions.

  4. Use Gentle and Reassuring Language: Speak softly and reassuringly. Use simple and clear language to communicate. At times, whispering and laughing may be misunderstood by the person, especially if they are experiencing paranoid delusions, so you would want to be mindful of this as well.

  5. Listen, Validate and Avoid Arguing : If the person is comfortable sharing their experiences, listen actively and validate their feelings without confirming or denying the reality of their hallucinations or delusions. Generally, it’s not productive to argue with someone about the validity of their experiences. Instead, focus on their emotions and well-being. For example, if they have a strong belief that their water has been poisoned, connect with the emotion underlying the delusion or hallucination – you could say something like “It must be really frightening to believe that all your water has been poisoned”.

  6. Offer Assistance : If the person is open to it, ask if they need any assistance or support. Be prepared to respect their wishes if they decline. If possible, you could ask the person if they would like you to guide them to a quiet and less stimulating environment where they may feel more at ease, for example.

  7. Emergency Help: If the person’s safety is at risk, and they’re unable to communicate or respond, consider calling emergency services for professional intervention.

Remember that while your intention to help is admirable, it’s important to prioritise your safety and comfort as well. If you’re unsure how to proceed or if the situation escalates, seeking assistance from mental health professionals or authorities is a responsible course of action.

Educating yourself further about mental health conditions, such as schizophrenia and related disorders, can also provide you with valuable insights and strategies for supporting individuals who might be experiencing hallucinations or delusions. You could read more on psychosis here.

Thank you for your compassion and willingness to support others. Your efforts to approach these situations with empathy can make a positive difference in someone’s day.

If you have any further questions, our community is always happy to help. Please feel free to let us know.