CW: though I'm trying my best to keep this safe and not too detailed, so as to not harm people, this post will be discussing some heavy mental health issues - so be aware and skip certain sections if you're concerned they may trigger you. <3 I'll do my best to label things clearly.

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Hey there, comrades. I've recently, as mod of this sub, been running into a lot of very vulnerable people, which is to be expected. I'm sure we all experience that sometimes. I made this post, hoping to work together with everyone so that we can learn the best ways to help each other, without accidentally causing more harm. It can be a bit of a balancing act, especially with some of the most vulnerable people who are struggling the most with life and mental health issues.

Warning this post is pretty long. I wanted to be as detailed as I could so that we could all be educated. <3 I'm learning as I go, so please go easy on me if I get something wrong. <3 I also want to note that this post is not complete, so some sections may be a little more detailed than others, but it's a work in progress.

Disclaimer

We are here because we all realize how important community care is, and that it's just as important as self-care, if not more so. We know what it's like to struggle, and want to help others when they are struggling. It's important to know that we also need to take care of ourselves as well as others. Sometimes that means self-care, and sometimes that means reaching out to the community that you are also helping in.If you feel like you are beginning to take harm from helping someone, or taking on too much as an individual in the community and it's beginning to negatively impact your own mental health, please take a break, reach out for support from others, do whatever you need to do, but remember you are just as important as the people you're trying to help. And putting yourself in a bad state through pushing yourself past your own boundaries and limits is harmful to you, and you won't be able to help anyone in the community any better either. And know this community is here for ALL of us, even those of us who are spending much of our time helping others within it. Always feel free to reach out if you need help. <3

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Section 1: Delusions, Psychosis

To start, a really big one, IMO, is how best to handle helping people through delusions (delusions of persecution, of reference, of grandeur), psychotic episodes, etc.. I feel like depersonalization and derealization, when taken to the extreme, may be handled in similar ways, but please correct me if I'm wrong on that.I found this article super helpful. From the article, some important info on what delusions are:

• "A delusion is an extremely unusual belief one maintains despite overwhelming evidence to the contrary."
• "Numerous mental disorders precipitate delusions, but the most common ones are schizophrenia, schizoaffective disorder, and bipolar mania."
• "Typical delusions include persecutory delusions (“The government implanted a chip in my head to track me”), grandiose delusions (“I’m a famous rapper and I have a world tour kicking off next month”), and delusions of reference (“When LeBron James pointed at the camera after making that game-winning shot he was giving me a secret sign”)."
• "When someone afflicted with an untreated mental illness experiences a delusion, they’re by-and-large incapable of recognizing they’re experiencing a delusion. ..... Attacking someone with a clinical delusion almost always causes them to put up their defenses and retreat further into their beliefs."
• "If you encounter someone experiencing a clinical delusion, feeding into their delusion will only give them more reason to think their beliefs are justified."
• "Probing for more information is valuable for several reasons. Most importantly, it forces the individual to articulate how they came to reach their conclusions, which opens the door to the possibility that they’ll recognize the failings of their own logic. Often times when someone arrives at a delusion they do so without analyzing all relevant data—they make one giant leap from Point A to Point B and miss several important steps along the way."

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So how do we handle trying to help someone experiencing these things?

• Do NOT attack them
• Do NOT try to convince them they're delusional - it likely will not work, and will cause them to put their defenses up
• Do NOT dismiss it as inconsequential - disconnections from reality can be dangerous for the person experiencing them, and possibly for others - consider the delusions at hand and handle it on a case by case basis
• Do NOT play along with their delusions
• DO calmly ask objective questions about their delusions, and do your best not to judge - "Next, calmly ask the individual pertinent questions in a nonjudgmental manner so as to better understand why they believe what they do. How did they arrive at their belief? How long have they held their belief? What do they plan to do in response to it? When asking questions, don’t play the part of a detective in the interrogation room, but don’t be the individual’s yes-man, either. Think of yourself as a reporter gathering quotes for a news story. No matter how bizarre their answers, don’t react one way or the other; just listen."

Edit3 I want to add a note here, inspired by /u/tronaldodumpo, that sometimes people may struggle with delusional thoughts, but may still be grounded enough to be aware that those thoughts are not rational. It can still be absolutely terrifying to experience, so we may get people like that here. For me, when I'm in such states, connection with others, not feeling so alone, and distraction to help pull my brain away from spiraling further can be helpful. This will likely not work on people so deep in their delusional state that they are unaware of their irrational thinking! I will have to do a bit more research on the subject, so that I can add to this later. If anyone else knows whether that is a good method to help, and has some useful links, drop them in the comments!! Thanks!!

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Section 2: Suicidal ideation, Discussion, etc.

If you are concerned about someone on here expressing suicidal thoughts or plans, or maybe you suspect they could be suicidal based on their behaviors, it can help to start by asking direct questions.

• How are you coping with what's been happening in your life?
• Do you ever feel like just giving up?
• Are you thinking about dying?
• Are you thinking about hurting yourself?
• Are you thinking about suicide?
• Have you ever thought about suicide before, or tried to harm yourself before?
• Have you thought about how or when you'd do it?
• Do you have access to weapons or things that can be used as weapons to harm yourself?

"Asking about suicidal thoughts or feelings won't push someone into doing something self-destructive. In fact, offering an opportunity to talk about feelings may reduce the risk of acting on suicidal feelings." [1]

• "Respect their feelings. When someone expresses suicidal thoughts or feelings, the most compassionate response you can have is to validate their feelings, says Stuber. That can be as simple as saying "I care about you" or "I'm sorry you're in so much pain." Don't, however, try to talk them out of their feelings or insist you understand their suffering. Their emotions may not seem logical or reflect how you think they should experience pain, but that doesn't matter to a suicidal person." [2]
• "Phrases or responses to avoid, says Stuber, include the following: You have so much to live for. ; Things could be worse. ;How could you think of suicide? Your life is not that bad. ; I don’t know why you would feel this way. ; It’ll get better soon." [2]

Here are some links and resources for those who are feeling suicidal or are in crisis:

• US National Suicide Prevention Lifeline 1-800-273-8255
• US Suicide Prevention Lifeline Chat https://suicidepreventionlifeline.org/chat/
• Crisis Text Line US: Text HOME to 741741; Canada: Text HOME to 686868; UK Text HOME to 85258 (https://www.crisistextline.org/international)
• List of International Suicide Hotlines: https://ibpf.org/resource/list-international-suicide-hotlines
• Resources for LGBTQIA persons: https://www.thetrevorproject.org/#sm.0009113oe13rdcq9qy427tj7ldus4

Sources: https://www.mayoclinic.org/diseases-conditions/suicide/in-depth/suicide/art-20044707 [1]https://mashable.com/2016/06/21/help-suicidal-friend/ [2]

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Section 3: General Mental Health, Mental Illness Information

\*this section is still a definite WIP***

Mental Health is defined as the general well-being of an individual, and ability to cope with life's stresses and ability to function in day-to-day life.

Mental Illness is impaired functioning and/or distress, characterized by a shift or difference in mood, thinking, or behavior.

Many people experience mental health problems at least once in their life.

This PDF offers some very good, very comprehensive information about mental health and mental illness. There's a lot of good links to other resources near the bottom of the PDF.

Here is a good link for general information on mental illnesses and disorders.

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Anxiety Disorders: characterized by the reaction to objects, people or situations with fear and dread.

• Generalized Anxiety Disorder Characterized by severe, ongoing anxiety that interferes with daily activities. (There's some good general information on it here. For information on how to help someone dealing with anxiety, this page is very useful.)
• Panic Disorder Characterized by sudden episodes of intense fear or anxiety and physical symptoms, based on a perceived threat rather than imminent danger. [Panic attacks.] (Some more specific information Here and here about panic disorder and panic attacks.)
• Phobias A phobia is a type of anxiety disorder, defined by a persistent and excessive fear of an object or situation. The phobia typically results in a rapid onset of fear and is present for more than six months. (Lots of good information on what phobias are, vs normal fears, and how to deal with them both clinically and on your own, here.)
• Obsessive Compulsive Disorder an anxiety disorder in which time people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions. (This page has some good info on the disorder. /u/Automate_Dogs also made a comment in this thread that discusses their experience and perspective on it here. The IOCDF has some very good information as well - here is a good bit of info about OCD. )

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Section 4: Addiction, Harm Reduction and Safe Consumption

(a lot of this was written up by redditor /u/Milkshaketurtle79 THANK YOU <3 most of the information I am aware of is very US centric, so I apologize to those outside of the US - if anyone reading has relevant information for other countries, please feel free to leave a comment and I can add the info to the post.)

Harm Reduction

Generally, for me, at least, my favorite (and from my experience, reliable) resources are dancesafe.org, psychonautwiki.com (despite its name, it has information on tons of non psychedlic drugs), and the "Drug Classroom" youtube channel.

While I've never been an addict, sticking only to psychedelics and occasionally cannabis, I still know some basic information and resources both from a friend in recovery, and having learned to do a huge amount of research due to my use of psychedelics. [AK: I also have some past personal experience with drug use, and loved ones who are and have been drug users and people with addiction, as well as experience with a local needle exchange and the good they do for my community.]

As a general rule, when using drugs, you should:

• Never share syringes. This increases the risk of infection and bloodborne illnesses like HIV and hepatitis. [AK: Many pharmacies sell syringes and needle exchanges and Harm Reduction groups hand them, and other useful items such as cottons, sterile water, cleaning pads, sterilizing pads, and tourniquets.]
• Never share your nose straws!! Small blood vessels in your nose can rupture when snorting drugs, and can pass on hep C to you or other people (it can survive outside the body for up to three weeks!). Dollar bills are not recommended for this reason. You can get personal glass straws, cut disposable plastic straws, or even a rolled up post it note can work!
• Always test your substances. It can save you or someone you care about's life. [AK: many Harm Reduction groups and needle exchanges will give out fentanyl test kits for free. USE IT ON ALL OF YOUR DRUGS, even non-opiates. Fentanyl has been found in some pretty surprising places. More resources for getting test kits for fentanyl and other substances below.]
• Cocaine, molly, fake prescription meds (like benzos and even amphetamines), ketamine, and plenty of other substances (most commonly, anything powdered) are sometimes cut or mixed with Fentanyl, which is a very dangerous and potent opiate, responsible for countless overdoses. Fentanyl has amazing potential in a medical setting, but when you don't know you're even taking it, and even if you do, it can be very unsafe. Testing for Fentanyl can save you or a loved one's life. Most mdma (I think the number was 80%) is not real, which means it can kill, though this does not usually mean it was mixed with Fentanyl). Buying it online, believe it or not, is usually far safer than buying it at a music festival, provided its from a reputable vendor. Purchasing online also comes with the greatly decreased risk of entrapment via cop.
• Start with a low dose, and always take tolerance into account. You can always take more, but you can never take less. This is especially true for someone who used a substance with a lower OD threshold regularly, stopped, and then "relapsed". That is, their tolerance will not be what it used to be, and what may have felt like a low to normal amount before you stopped may now be enough for an overdose.
• While some substances are extremely unlikely if not impossible to cause a death via overdose (Marijuana, LSD/shrooms/dmt, supplements or herbs, etc.), following these guidelines can help you avoid doing something you regret, hurting yourself, or having a "bad trip". Even though they're physically safe if they're what you think they are, fake or contaminated psychedelics (which can be physically dangerous) are out there, and run the risk of overdose or toxicity.AK: Be aware that even drugs like LSD and marijuana, which may be physically safe (in that they won't kill you) they very much can have lasting negative affects on your psyche and mental health, especially if you are genetically predisposed to things like schizophrenia or bipolar disorder (they can trigger first episodes) but even without those they can be dangerous, so use with caution and please please please use psychedelics in an environment where you feel safe and comfortable, and are with people you trust - a trip sitter is a good idea. (I seriously would not recommend music festivals and raves for psychedelic use, both from personal experience and from the experiences of loved ones - especially if you have anxiety, social anxiety, troubles with overstimulation, etc.)Also, test your drugs, even the LSD, if you can. If you can't for whatever reason, be aware of what fakes are like and how to possibly spot the differences. For examples, things called NBOMes sometimes get passed off as LSD (they are often cheaper to make and allow for higher profit potential, and sometimes the people selling it don't even realize it's not LSD either) - it is a synthetic hallucinogen somewhat like LSD, but has a fairly low overdose level, whereas LSD has no overdose possibility. If your LSD tastes bitter, that is not LSD. LSD should have little to no flavor.
• If you're using a substance with a lower overdose threshold (such as opiates or certain stimulants), of one that can make you unaware of or uncaring of your actions (dissociatives, alcohol, and deliriants, mostly), bring a sitter with you, a sober one if you think the substance would prevent you from noticing or helping the other person if something bad happened.
• AK: If you are an opiate user, you should try to get a hold of narcan/nalaxone, if possible. Many needle exchanges across the US give narcan and training for it for free, and a lot of pharmacies will sell it as well. Check with your local Harm Reduction groups. Even if you aren't using opiates, if you're not able to test your drugs, it would be wise to carry narcan. The group Never Use Alone (see next bullet) has a form for free narcan to ship to you in the US here: https://www.facebook.com/freenarcanresourcesnationwide/posts/2323459014446777?__tn__=K-R"The NaloxoFind app allows anyone to identify and locate available naloxone within a two mile radius and to communicate directly with those carrying this life-saving drug. This free app also allows first responders and good Samaritans to register as naloxone carriers, making them reachable by NaloxoFind App users in emergency situations." (via: Never Use Alone): https://www.altrixmedical.com/naloxofind?fbclid=IwAR3GJ15zuIeZzBBiGSMZ3rvMWAjFwPLZQ1lCIjxuT8bOKMHoZ77NHkx8I0Y
• AK: If you must use alone, for whatever reason, you can call a group called Never Use Alone, who will stay on the line with you in case of an accidental overdose. 1-800-484-3731 They are a Harm Reduction group; no judgement, only care for your life. Check out their facebook page here for more information: https://www.facebook.com/Neverusealone/ If you don't want to, or can't, call them, you are welcome to message them on their facebook page and an operator will ask for your location and stay on with you while you use.
• Know of The Good Samaritan Law. In most US states, it basically says that if you call 911 or for help in the event of something bad happening, you may be exonerated of certain crimes, mainly the use of drugs, and in some places accidental injury. Check your local laws for details. I know we don't like cops, but do the right thing. Generally for an event like this, unless someone is being violent, they will send an ambulance, not police.
• If you use substances via injection, you should always use clean needles, or at the very least sterilize them. Don't share them. I've never used syringes, so I can't verify the validity of any links to buy them, though they seem available to order online. This, however, is a guide on how to sterilize them. In some countries, there may be a needle exchange program.
• If you're just having anxiety, or even if you're lonely, r/tripsit is a super wholesome subreddit where you talk to people while you're on something and they help you. I've used it before, and they're a nice bunch, not judgemental at all.
• Despite a lot of common misconceptions, you cannot overdose simply from touching fentanyl. You can touch it with your bare hands without harm.
• AK: Check out the Harm Reduction Coalition - a national (US) advocacy group for drug users and people with addiction: https://www.facebook.com/HarmReductionCoalition/ and https://harmreduction.org/
• AK: If you inject your drugs, here is some useful information about safety with injecting. Be careful not to hit arteries and nerves, if the shot hurts, pull out. For most drugs, if they are IV, you also want to try to avoid "missing" the shot (not getting it into the vein and instead getting it into the muscle or skin.) This can (but not always) lead to abscesses. Rotate your shots!!! Try not to use the same site repeatedly - that can quickly wear out the vein and create a build up of scar tissue, or cause the vein to collapse. This page offers some good information about safe injecting, including more detailed explanations of what you see here, and some information about safe sites to hit, and which ones to avoid: https://harmreduction.org/issues/drugs-drug-users/drug-information/safer-injection-materials/Here is some more really detailed information about safe injection, with diagrams and pictures to go along, which also includes information about alternatives to injecting: http://www.drugs.ie/resourcesfiles/guides/mqi_safer_injecting_guide.pdf
• One more important thing I forgot! It's commonly taught that people often die of dehydration on mdma, but the substance also increases water RETENTION, increasing the dilution of sodium levels. This means it becomes much easier to drink too much water, while dehydration still happens all the time, and believe it or not, you can die from overhydration.
• https://www.erowid.org/ is another good resource for education, use, harm reduction and trip reporting (thank you /u/John-Luck-Pickerd!)

Links to test kits:

• Fentanyl Contamination Kit. Used to test drugs for Fentanyl.
• Marquis Reagent Test Kit. It's not exhaustive, but it's mainly used to verify substances like mdma, amphetamines, and cocaine.
• Erlich Reagent Test Kit. Verifies LSD, which rules out the possibility of it being a fake, dangerous counterfeit known as 25-I-NBOME.

Addiction:

If you or a loved one is struggling with alcohol or narcotic addiction, this is some general advice:

• Be careful about who you associate with when in recovery. Unfortunately, there are many people who see recovering addicts as potential targets for sexual abuse, cult recruitment, scams, and even for dealers looking to find new customers.
• While AA/NA/12 steps can help some people, it has a low success rate. SMART Recovery is something I've seen many people swear by.
• Don't feel embarassed to tell people you trust if you think they'll support you. Using sites like meetup.com can also help you to find addiction support groups that aren't official.
• Some people swear that kratom has helped them through opiate withdrawals. Kratom is an herb that affects produces opiate like effects at higher doses, such as pain relief and anxiety reduction, while acting as a mild stimulant on lower doses. The FDA has railed against it, but other studies say it's fine. I'm not going to say it's totally safe, but it is undoubtably much safer than opiates such as heroin and oxycodone.
• AK: If you are able, and it is something you're comfortable with, Medication Assisted Treatment (MAT) can be very useful and helpful, especially in the case of opiate addiction. Many people are prescribed suboxone, subutex, generic versions of those, etc. Suboxone includes both bupenorphine, a partial opioid agonist, and naloxone, an opioid blocker (also used in the drug kits to reverse opiate overdoses). Subutex only has bupenorphine. Methadone is also a possible aid in kicking opiate addiction, though it's generally considered less safe than suboxone and subutex. This site will help you find a bupenorphine doctor near you: https://www.samhsa.gov/medication-assisted-treatment/practitioner-program-data/treatment-practitioner-locator
• AK: In some places, like Canada, a small, but growing number, of doctors are able and willing to prescribe medical grade heroin to people with addiction to heroin, and who are resistant to other forms of MAT (like bupenorphine and methadone), as it allows addicts to function better in daily life. https://www.pri.org/stories/2018-09-27/canada-some-doctors-are-prescribing-heroin-treat-heroin-addiction
• AK: Many people see success in kicking addiction through things like therapy, group drug and alcohol sessions, and sometimes even rehab. (Note: rehab is not likely to fix your addiction issues, especially with the more common shorter stays - but detox and rehab can help separate you from the drugs and triggers, allow you to come out of withdrawals safely, and get a head start on MAT, if you want that [some rehabs don't allow that - check into that before you sign up] and therapy. You will need to continue with treatment of your choice and avoiding triggers when you are released.)

ALSO: If you struggle with addiction, and are trying to stop using drugs, try not to listen to those who are all or nothing, die hard, abstinence only people. Everyone has different journeys, and no one way is the right way. You can kick addiction by slowly reducing consumption and being safe, many people have been successful that way. And even if you attempt to kick drugs cold turkey, don't beat yourself up if you relapse. Relapse is super common, and it doesn't mean you're back to square one. Whatever route you choose, I wish you the best of luck.And if you are someone who chooses not to quit, for the time being or forever, you still deserve respect, support, and love. Many societies reject people who struggle with addiction, or who use drugs recreationally, very aggressively. But you are not alone, and you are loved. There are people out there who support you and see you're humanity, and don't place moral judgment on your drug use. <3 <3

For now, my brain is shot, but if anyone has anything to add, or sees something that needs correcting, please just let me know. <3

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Section 5: Resources and Information for LGBTQIA People

\*this section is still a definite WIP but for now I want to add an important resource as suggested by* /u/Jamthis12****

Support, resources, and crisis hotline for trans people here.

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Section 6: General Resources and Links

Do you want to help someone who is struggling mentally and don't know how? r/SuicideWatch has a wonderful post about that here.

/r/TrollCoping also has some wonderful links and resources here, for things ranging from mental illness resources, domestic violence, substance abuse/addiction, HIV/AIDS, and more.. ^{thank you to} /u/a^{sdfjasdjkfl for these first two links!! <3}

There are some really good resources for a myriad of mental health issues and disorders here.

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WHEEWWW. That ended up pretty long, but I reallyyyy wanted to be as comprehensive as possible, and even had to trim it down a bit to be a little easier to digest in a decent amount of time.

If there's anything you guys think I should add, or any criticisms please let me know. As I learn more, myself, I will keep adding and changing things on it.

I want to help this community be the best it can be for everyone here, and I think education is absolutely crucial. I'm so happy to be a part of this.

MUCH LOVE AND GRATITUDE TO ALL OF YOU. <3

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Edit I think it could be good to add some of the struggles specific to LGBTQIA people, people of color, other marginalized groups.. I'm absolutely exhausted at this point as it's been a very crazy day for me, and this took quite a bit of time to put together, but if any of you have any information and resources about these issues, please comment with it!! I am a part of the LGBTQIA community, but I am white and cis so I don't necessarily want to speak on the issues of groups I don't belong to, at least not without the aid of those within such groups. <3 I will add things as they come about.

Edit2 Thank you to the redditor who gave this gold!!! <3