Mental health and emotional support: the complete guide

We know these are hard days for many families. Maybe you lie awake listening for a knock. Maybe your child stopped wanting to go to school. Maybe you lost someone and the world kept moving as if nothing happened. Whatever brought you here, hear this first: what you feel makes sense, and there is help you can reach today, whatever your immigration status.

Do Not Lose Hope is not a crisis line, a clinic or a counselor. We cannot answer calls or messages for help. This guide is general information, not medical or legal advice. It points you to people who are trained to listen and to care.

On this page

• Why do I feel this way, and what helps today?
• How do I know if it is more than stress?
• Where can I get counseling without papers or insurance?
• Will a counselor share my information with immigration?
• How do I help my child when they are scared?
• What if my teen is struggling?
• What do I do in a crisis?
• What do I do if someone I love talks about suicide?
• How do I live with grief and loss?
• Where do faith and community fit in?
• What changed in 2025 and 2026?
• Who can help for free in the Bay Area?
• Questions people ask
• Printables

Why do I feel this way, and what helps today?

You feel this way because your body is doing its job. Stress is your body and mind reacting to something hard. When the hard thing does not stop, the stress does not stop either. That is why fear about immigration, money, work or family can leave you worn out every single day.

The National Institute of Mental Health (NIMH) explains it simply. Stress is the response to an outside cause. A stressor can happen once, or it can happen over and over for a long time. Anxiety is the body's reaction to stress, and it can show up even when there is no danger in front of you right now. Stress is a normal part of life, and some stress even helps you solve problems. But stress that goes on for a long time can affect your sleep and your immune, digestive and heart systems.

Signs your body is carrying stress

The CDC lists signs like these:

• Trouble sleeping, or nightmares
• Headaches, body pains, stomach problems or skin rashes
• Changes in appetite or energy
• Feeling worried, angry, sad or numb
• Trouble focusing or making decisions
• Using more alcohol, tobacco or drugs

If you see yourself in this list, you are not weak. You are carrying a lot.

What helps today

These steps come from the CDC and NIMH. None of them fixes the cause. All of them can lower the weight a little, and a little matters.

1. Take a break from the news and social media. Check once for what you need, then put the phone down. Endless videos of raids feed fear without giving you a next step.
2. Breathe slowly. Take deep breaths, stretch, or try a short meditation.
3. Ground yourself. Name 5 things you see, 4 you can touch, 3 you hear, 2 you smell and 1 you taste. This pulls your mind back to the room you are in. More ideas are in Simple grounding exercises to calm fear and stress.
4. Protect your sleep. Adults need 7 or more hours. Go to bed and wake up at the same time. Turn screens off 30 minutes before bed. Skip caffeine in the afternoon and alcohol close to bedtime.
5. Move and eat. A walk, regular meals, and less alcohol help your body handle stress.
6. Write it down. A journal can get worries out of your head and onto paper.
7. Talk to someone. Call a friend or family member. Connect with your community or a faith based group.
8. Make a plan for what you fear. Fear shrinks when you know what you will do. A family preparedness plan is one of the most calming things a family can make. See Make a family preparedness plan.

Free tools you can use tonight:

• UCLA Mindful offers free guided meditations, from 3 to 19 minutes, in English, Spanish and many other languages.
• The VA's free PTSD Coach app is for anyone dealing with symptoms after trauma, and for family too. It is not a replacement for care.
• Soluna (ages 13 to 25) and BrightLife Kids (parents of children 0 to 12) are free state apps with coaching by chat, video or phone, in English and Spanish. The state says they are open regardless of insurance or immigration status.

When to talk to someone

NIMH says to reach out when you are struggling to cope, when symptoms will not go away, when they get in the way of everyday life, or when they make you avoid things you need to do. You do not have to wait for a crisis. Read more in Why you feel overwhelmed all the time, and what helps.

Mistake to avoid: waiting until you "really need it." Counseling works best before things fall apart.

How do I know if it is more than stress?

Look at how long it lasts and how much it gets in the way. Everyone feels sad or worried sometimes, and these feelings usually pass. When they stay most days and start to take over your life, it may be depression or an anxiety disorder. Both are real illnesses, both can affect anyone, and both can get better with care.

Signs of depression

NIMH says a doctor looks for symptoms most of the day, nearly every day, for at least 2 weeks. One of them must be a low mood or losing interest in things you used to enjoy. Other signs include:

• Feeling sad, anxious, empty or hopeless
• Feeling irritable, restless, guilty or worthless
• Being tired all the time
• Sleeping too much or too little
• Eating much more or much less
• Trouble thinking, remembering or deciding
• Aches, headaches, cramps or stomach problems with no clear cause that do not get better with treatment
• Pulling away from people
• Drinking or using drugs more
• Thoughts of death or suicide

Not everyone with depression has every sign.

Signs of anxiety

NIMH says an anxiety disorder is worry that does not go away, shows up in many situations and can get worse over time. For generalized anxiety, a doctor looks for worry that is hard to control on most days for at least 6 months. Signs include:

• Worrying too much about everyday things
• Feeling on edge, restless or irritable
• Trouble focusing or sleeping
• Headaches, muscle aches, stomachaches or tension
• Trembling, sweating, feeling lightheaded or out of breath

Panic attacks and chest pain

A panic attack is a sudden wave of intense fear. Your heart may pound, you may sweat, shake, struggle to breathe or feel chest pain. It can last a few minutes or up to an hour or longer. But chest pain and shortness of breath are also major signs of a heart attack. If you are not sure, call 911. Do not guess.

Do not wait for the clock

The 2 week and 6 month numbers are how doctors make a diagnosis. They are not how long you must suffer before you ask for help. If it is hard to get through the day, reach out now. Medicines and health problems such as thyroid disorders can cause the same symptoms, so a checkup matters too.

Before your visit: write down when the feelings started, how often they come, and how they affect your work, sleep and family. A doctor may ask about all of this.

The good news is real: NIMH says most people with depression benefit from treatment, and with time and treatment, depression can lift. Treatment is usually talk therapy, medicine or both. Finding what works can take some trial and error. Keep going.

See the full lists, including signs in children, in Signs of depression and anxiety in yourself or your family.

Where can I get counseling without papers or insurance?

Start with your county's 24 hour line or a community health center. You can get counseling without papers. What it costs and where you go depend on your age, your coverage and your county.

Step 1: Call your county line

• San Mateo County ACCESS Call Center: (800) 686-0101, TTY 711, 24/7. It serves county residents who have Medi-Cal and people who are uninsured. Staff speak English, Spanish and Chinese, and a phone interpreter is free. ACCESS gives information, an assessment and a referral. You can call about someone you are worried about.
• Santa Clara County Behavioral Health Services Call Center: (800) 704-0900, press 1, 24/7, including holidays. It is open to residents with Medi-Cal, Medicare or no insurance, with interpreters in all languages spoken in the county. The county says most of its therapy programs are for people enrolled in Medi-Cal, and staff can check if you qualify and help you enroll. There is a financial assistance application.
• In East Palo Alto, the county runs the East Palo Alto Community Counseling Center for youth and adults at 2415 University Avenue, Suite 301, (650) 363-4030.

Outside these two counties, find your county's line on the DHCS county mental health plan list.

San Mateo County says it serves uninsured residents, but neither county lists fees for uninsured adults, and neither says whether intake asks about immigration status. Ask both questions when you call.

Step 2: Or go to a community health center

Federally funded health centers may not deny you service because you cannot pay. They use a sliding fee based on income.

• Ravenswood Family Health Network offers counseling for children and adults. You can refer yourself or ask your doctor. Call (650) 330-7400. Main clinic: 1885 Bay Road, East Palo Alto. It also has clinics in Mountain View, Sunnyvale and Palo Alto.

Step 3: Check your Medi-Cal

• Children under 19 can get full Medi-Cal whatever their immigration status, if they meet other rules such as income. Mental and behavioral health care is covered.
• Adults who had full Medi-Cal by January 1, 2026 keep it if they renew on time. If it ends, you have three months to sign up again.
• Most adults 19 and older without papers cannot newly sign up for full Medi-Cal since January 1, 2026. Restricted scope Medi-Cal covers emergency, pregnancy and nursing home care. Routine counseling is not on its list of benefits. In a psychiatric emergency, DHCS tells county mental health plans to cover psychiatric hospital care (BHIN 23-046). Ask your county line what counseling it can offer you.
• From January 1, 2027, members the state lists with "unsatisfactory immigration status" (undocumented, DACA and other PRUCOL statuses, and green card holders in the five year wait) move to Fee for Service Medi-Cal. The state says specialty mental health and substance use treatment will continue through county behavioral health plans.
• From July 1, 2027, most adults 19 to 59 in that group will pay a premium of $30 to $50 a month, with the exact amount set by the governor in May 2027. Not paying changes coverage to restricted scope. More: Medi-Cal changes in 2027.

For every Medi-Cal detail, see Health care for immigrant families: the complete guide.

Step 4: Other doors

• San Mateo County says legal status is not required for county funded coverage. Call 650-616-2002.
• Young people 12 to 25 can go to allcove, free or low cost, in San Mateo and Palo Alto. See What if my teen is struggling?
• Not in crisis, just need to talk? The California Peer Run Warm Line is for anyone living in California. Call or text 855-600-9276. Hours: Monday, Tuesday, Wednesday and Friday, 7 a.m. to 11 p.m., Thursday 8 a.m. to 10 p.m. Hours can change.

What to bring

• Any ID you have. Ask the clinic what it accepts
• Your Medi-Cal card or insurance card, if you have one
• Proof of income, if you will ask about a sliding fee
• A list of your medicines
• Your notes on how you have been feeling

What happens next

On the first visit, someone asks what brought you in, how you sleep and eat, and whether you feel safe. Then you make a plan together. If there is a wait list, ask what you can use while you wait, such as a group, an app or the warm line.

For a walk through every step, see Mental health care without fear.

Mistakes to avoid:

• Giving up after one "no." Ask, "Where else can I go?" and write down the answer.
• Paying a stranger online who promises "immigration friendly therapy." Use a licensed provider from the list on this page.

Will a counselor share my information with immigration?

In California, no, not for immigration enforcement except in narrow cases. Your immigration status and place of birth, when a health provider knows them, count as private medical information. A provider may not share medical information for immigration enforcement unless you allow it, or unless the law compels it, such as a California or federal court order or a search warrant signed by a judge.

What protects you

• California's medical privacy law (Civil Code 56.05 and 56.10) treats immigration status as medical information and bars sharing it for immigration enforcement except in those narrow cases.
• SB 81, in effect since September 20, 2025, requires providers that get public funding to mark the areas where patients get care as nonpublic. Immigration agents may not enter those areas without a valid judicial warrant or a court order that grants access, unless state or federal law requires it. Staff must tell management right away about any such request.
• You choose what to share. A counselor can help you without knowing your status. If a form asks, you can ask why it is needed.
• Psychotherapy notes, a counselor's private session notes, need your written OK for most uses under federal HIPAA rules.
• Drug and alcohol treatment records have extra federal protection. They cannot be used to investigate or prosecute you without your written consent or a court order.

Where privacy ends

Be real about the limits, so nothing surprises you:

• Danger. A provider may share information to prevent a serious and imminent threat to someone's health or safety. In California, a therapist must try to warn a person you seriously threaten with violence, and the police.
• Child abuse. Therapists, psychologists, social workers and counselors are mandated reporters of child abuse.
• Court orders and warrants. Valid court orders and judicial warrants can compel records.
• Subpoenas from immigration. We did not find an official answer on whether an ICE administrative subpoena or an immigration court subpoena can make a California counselor hand over records. If your records matter to an immigration case, talk to your lawyer first.

Medi-Cal records

The state says a federal court ruled on December 29, 2025 that limited Medi-Cal information, such as status, address, phone, date of birth and Medicaid ID, may be shared with ICE about people not lawfully present. The state says sensitive health records remain protected, the lawsuit is ongoing, and canceling Medi-Cal does not erase information already sent. Counseling notes are not on that list.

988 and your privacy

988 conversations are confidential, but not anonymous. 988 usually receives the number you call or text from, and counselors take notes. 988 does not receive your exact location. It says it shares identifying information outside its network only in rare cases of imminent risk, or when the law requires, such as a valid warrant or court order. The 988 privacy pages we read do not mention immigration status at all. Read Calling or texting 988: what happens and privacy.

Ask before you start: "Who can see my records? When would you have to share something? Do you need my immigration status?" A good counselor will answer plainly. Full details are in Will my therapist share my information with immigration?

How do I help my child when they are scared?

Listen first, tell the truth simply, and keep daily life steady. Children feel the fear in a home even when no one says a word. The American Academy of Pediatrics (AAP) and the National Child Traumatic Stress Network (NCTSN) give parents clear steps.

Steps

1. Ask what they know. Use open questions like "What's on your mind?" Follow their lead. Children sometimes hide worries to protect their parents.
2. Name the feeling. "It makes sense that you feel scared." Feelings are normal and can change over time.
3. Be honest, without false promises. Skip "Don't worry about it." Try an "and" sentence that pairs the truth with comfort: "I am scared too, and we have a plan to keep you safe."
4. Match their age. Young children need simple words and to know which grown ups will care for them. School age children may need help understanding words like "immigrant" and "deportation." Teens need honest answers. It is fine to say, "I don't have all the answers."
5. Turn off the scary videos. Limit violent news. If they watch, watch together and talk about it.
6. Keep routines. Meals, bedtime and school help children know what to expect. Drawing, puzzles, prayer, singing, walks and deep breathing can calm them.
7. Make the family plan together. Let children help in small ways, like choosing where important papers are kept. Make sure teens know the plan and where the documents are.

Signs your child needs more help

Watch for changes in sleep, stomachaches or headaches, new fears, acting younger (like bedwetting), trouble focusing, anger, or not wanting to go to school. Call your child's doctor if the changes worry you or if your child was close to a frightening event. The CDC notes doctors are advised to screen for anxiety from age 8 and depression from age 12.

If a parent was detained or deported

This is one of the hardest things a child can face. NCTSN says children can recover with caring, age appropriate support.

• Tell them it is not their fault. Young children often believe they caused bad things.
• Tell the truth in simple words. NCTSN says it is usually better for children to get accurate information from a caregiver, explained in very concrete terms, like who will dress them, take them to school and put them to bed (NCTSN).
• Keep them connected to the parent if you can, in person or by phone or video.
• Keep siblings together and keep the family's language, culture and traditions.
• Do not speak badly about the parent or the family.

Full guides: How to help your children when they are afraid of immigration raids and Helping your children cope when a parent is detained or deported.

Where to get care for a child

• Medi-Cal covers children under 19 whatever their status, and its behavioral health services for children and youth under 21 are confidential. Medi-Cal helpline: 1-800-541-5555.
• Your child's doctor is a good first call. In East Palo Alto, Ravenswood pediatrics is at (650) 330-7400.
• At school: Ravenswood City School District offers school based counseling, groups and check ins with trusted adults. Call the district at (650) 329-2800. Sequoia Union High School District lists counseling among its wellness supports, (650) 369-1411.
• CHC's Ravenswood Initiative offers bilingual family therapy and parent education for families in East Palo Alto and East Menlo Park, using a needs based model, at 650-702-2487.
• BrightLife Kids gives free coaching to parents of children 0 to 12. It is coaching, not therapy.

California schools may not collect information about a student's or family's immigration status, except as required by law. See Where your child can get mental health help in California.

What if my teen is struggling?

Take it seriously and start the talk this week. A struggling teen is not being dramatic and is not making it up. Get help if changes last more than two weeks, or if they get in the way of school, home or friends.

Signs to watch

• Sad, irritable or angry most days
• Losing interest in friends, sports or things they loved
• Sleeping or eating much more or less
• Spending more and more time alone
• Falling grades or trouble focusing
• Using alcohol or drugs
• Hurting themselves
• Talking about death or feeling like a burden

One sign alone does not mean depression. Several signs on most days are a red flag.

How to start the talk

• Pick a quiet moment, like a car ride or a walk. Side by side can feel easier than face to face.
• Say what you see: "You seem really down lately. I love you and I want to help."
• Listen more than you talk. Do not rush to fix it.
• If you are worried about suicide, ask directly. NIMH says asking does not put the idea in their head.

What your teen can do on their own

• Counseling without your signature. In California, a teen 12 or older may agree to outpatient counseling on their own if a professional finds them mature enough. The counselor must involve the parent unless that would be inappropriate. This law does not let a teen get psychiatric medicine without a parent's OK.
• School counselors. What a student 12 or older tells a school counselor is generally confidential and stays out of the school record without written consent. There are exceptions, such as child abuse reports and clear danger.
• allcove, for ages 12 to 25. No referral is needed, and most services do not need a parent's OK. Services are free or low cost, and you learn the cost before your visit.
  • allcove San Mateo: 2600 South El Camino Real, Suite 300, (650) 226-7030. English, Spanish and Cantonese. Not billed to insurance.
  • allcove Palo Alto: 2741 Middlefield Road, Suite 102, (650) 798-6330. English, Spanish and Vietnamese. May bill insurance.
  • Both are open Monday to Friday, 1 to 7 p.m.

This can feel scary for a parent. Think of it this way: your teen reaching out to a trained adult is a good thing.

Lines teens can use

• 988: call, text or chat, any time.
• Teen Line, run by Didi Hirsch, for young people up to 19, staffed by trained teen volunteers with adult professionals. Call (800) 852-8336, 6 to 10 p.m., or text TEEN to 839863, 6 to 9 p.m. Pacific. English only.
• The Trevor Project, for LGBTQ+ young people, 24/7: call 1-866-488-7386, or text START to 678678.
• Crisis Text Line, 24/7: text HOME to 741741, or HOLA for Spanish. Volunteers are not medical professionals.

Save 988 and one trusted adult's number in your teen's phone today. Under California law, public and private schools that issue student IDs for grades 7 to 12 must print 988 on them.

Read When your teen is struggling, Where a teen can talk to someone right now and, for teens worried about a friend, What to do if a friend tells you they want to die.

What do I do in a crisis?

If a life is in danger right now, call 911. If you or someone else is thinking about suicide or is in deep distress, call or text 988, or chat at 988lifeline.org. You do not need to be sure it is "bad enough." 988 is for anyone who needs to talk.

What happens when you call 988

The 988 site describes it this way. You hear a short greeting with options (press 1 for veterans, press 2 for Spanish). You may hear hold music. A trained counselor introduces themselves, asks if you are safe, listens, and shares resources. Texting and chat work in a similar way, and both are now offered in Spanish.

• Free. Using 988 is free.
• Other languages. Call 988 and ask for an interpreter in English, or say the name of your language. Interpreters cover more than 240 languages by phone, and it usually takes about 20 seconds.
• Deaf or hard of hearing. 988 offers videophone access 24/7.
• If the call does not connect, try text or chat. In a medical emergency, call 911.

Will 988 send the police?

Rarely. 988 says fewer than 2 percent of its calls involve emergency services, and more than half of those happen with the caller's agreement. 988 contacts 911 only when the risk of harm is happening now or about to happen and a safer plan cannot be worked out together. Counselors try other options first, like a safety plan, a mobile crisis team, or involving family.

Local crisis teams that are not police

• San Mateo County Crisis Line, for San Mateo County residents: (650) 579-0350, 24/7, run by StarVista (county crisis resources). You can call for yourself, family or a friend. A mobile response team of behavioral health clinicians can come in person, in plain vehicles without lights or sirens. The county's Youth S.O.S. team, run by StarVista's crisis center, responds to children and youth ages 0 to 25. The county lists no separate number for it, so call the same line (San Mateo County BHRS).
• Santa Clara County: call (800) 704-0900 and press 1, 24/7. A mobile team serves adults 18 and older; another serves children and young adults 4 to 20. From a 408, 650 or 669 number, you can also dial 988.

If you must call 911 for a mental health emergency

San Mateo County suggests these steps:

1. Say, "I'm calling about a mental health emergency, and I request a CIT officer." CIT officers have crisis training.
2. Describe what is happening, any weapons, where you are, and whether there was an attempt.
3. Share diagnoses, medicines and whether alcohol or drugs are involved.
4. Ask if responders can arrive without lights or sirens.
5. Stay on the phone.

Be ready: the county notes a person may be placed on a hospital hold of up to 72 hours.

About immigration and 911: California law bars local police and sheriffs from using their resources to ask about immigration status for immigration enforcement, with some exceptions (Gov Code 7284.6). It covers state and local law enforcement agencies only (Gov Code 7284.4), so it does not bind federal agents. If someone's life is in danger, call 911. A life comes first.

Other lines

• Poison Control: 1-800-222-1222, 24/7, free. If the person is unconscious or has trouble breathing, call 911.
• Abuse at home: National Domestic Violence Hotline, 1-800-799-7233, or text START to 88788. See Help for survivors.
• Drugs and alcohol: SAMHSA National Helpline, 1-800-662-4357, free, 24/7, English and Spanish, for treatment referrals.

Not sure which line? See Which helpline to call.

What do I do if someone I love talks about suicide?

Take it seriously, ask directly, stay with them, and connect them to 988. You do not need training to help. You need to care and to act.

The five steps

NIMH and the 988 Lifeline teach five steps:

1. Ask. "Are you thinking about killing yourself?" Studies show asking does not raise the risk. Talking about it may even ease the thoughts.
2. Be there. Listen without judging. Take what they say seriously. Listen for their own reasons to keep living, like a child, a sibling, their faith, something they want to see. Do not push your reasons on them.
3. Help keep them safe. Ask whether they have a plan, when, and whether they can reach the means. Putting time and distance between a person and a gun or pills can save a life. Lock up or remove guns, medicines and alcohol. Out of sight is not locked up.
4. Help them connect. Call or text 988 together. Reach out to a trusted family member, friend, spiritual advisor or counselor.
5. Follow up. A call or text in the days after can make a real difference.

Do not

• Do not leave them alone if they say they will act.
• Do not promise to keep it a secret.
• For your own safety, we suggest you do not try to take a weapon from someone yourself. Step away and call 911.

Call 911 now if

NIMH says to call 911 in a life threatening situation (NIMH). We suggest calling right away if:

• They are already hurt or took something
• They have a weapon or pills in hand and say they will use them
• They will not stay safe and you cannot stay with them
• They are unconscious or struggling to breathe

Warning signs to know

The 988 Lifeline and NIMH list signs like: talking about wanting to die or being a burden, looking for a way to do it, feeling hopeless or trapped, unbearable pain, drinking or using more, pulling away, sleeping too much or too little, rage, and saying goodbye or giving things away. Signs matter most when they are new, getting worse, or come after a painful loss or change.

Home safety in California

• A person who may be at risk can hand a gun to an adult 18 or older for temporary safekeeping to prevent suicide, without going through a dealer (Penal Code 27882).
• Family and household members can ask a court for a gun violence restraining order, including when the danger is to the person themselves. There is no filing fee.
• Take unused medicines to a pharmacy or police take back site. The DEA website finds year round locations.

Make a safety plan

The 988 Lifeline describes a written plan: your warning signs, things that calm you, people and places that help, people to call, professionals and crisis lines, and steps to make your space safe. NIMH says a written safety plan can lower the risk of acting on suicidal thoughts. Use our printable safety plan.

Take care of yourself too. 988 notes that supporting someone can bring up hard feelings. You can call 988 for yourself.

More help: What to do right now, How to talk with someone you love about suicide and Warning signs.

How do I live with grief and loss?

Let yourself grieve, lean on people, and get help if the pain does not ease with time. Grief is the normal response to losing someone you love. There is no right or wrong way to mourn, and no rule for how you should feel.

What grief can feel like

The National Institute on Aging and MedlinePlus describe grief as both emotional and physical:

• Shock, numbness, fear, sadness or despair
• Anger, even at the person who died
• Guilt, including guilt for still being alive
• Crying easily
• Trouble sleeping, little interest in food, trouble focusing or deciding
• Body aches or getting sick more often

All of this is normal. Over time, for most people, the sharpest pain eases. You will still miss them. There will be good days and bad days. Laughing again does not mean you loved them less.

What helps

1. Do not ignore your grief. Let it be there.
2. Talk about them. Many families find comfort in sharing memories and saying the person's name.
3. Accept help. Say yes to the meal, the ride, the visit.
4. Care for your body. Sleep, eat, move, and go easy on alcohol.
5. Eat with others. Grief can take away the wish to cook or eat alone.
6. Lean on your faith community if you have one. Many grieving people find comfort in prayer, scripture and being with others who share their beliefs.
7. See your doctor. Grief is hard on your health.
8. Wait on big decisions like moving or quitting a job, if you can.
9. Ask about grief counseling or a support group. Hospitals, hospices, faith groups and funeral homes often know of groups. Hospice teams may offer bereavement support even if hospice did not care for your loved one.

When grief needs more help

The National Institute on Aging calls it complicated grief when mourning is so long or so painful that you cannot carry on with daily life. The American Psychiatric Association calls a lasting form "prolonged grief disorder." For adults, doctors consider it only when the loss was at least a year ago. For children and teens, at least 6 months. Signs include intense longing, feeling part of you died, deep loneliness, and feeling life has no meaning without them.

You do not need to wait a year to ask for help. If sadness makes it hard to get through each day, reach out now. If grief comes with thoughts of dying or wanting to join the person who died, call or text 988.

Children and grief

The American Academy of Child and Adolescent Psychiatry says children grieve differently. Young children may think death can be undone. Many children act younger for a while, get angry, or blame themselves. Do not force a scared child to go to a funeral. Find another way to remember, like lighting a candle, saying a prayer, making a scrapbook or telling stories.

Get professional help if, over time, a child:

• Loses interest in daily life for a long period
• Cannot sleep, stops eating, or is afraid to be alone for a long time
• Acts much younger for a long time
• Keeps saying they want to join the person who died
• Pulls away from friends, or grades drop sharply, or refuses school

Loss without a death

Many families in our community grieve someone who is still alive: a parent who was deported, a spouse in detention, a home and country left behind. We believe that loss is real, even when no one sends flowers. The same steps can help: name it, talk about it, keep routines, and ask for support. For children separated from a parent, see Helping your children cope when a parent is detained or deported.

Grief help in our area

• Kara, grief support in Palo Alto, serves children, teens, families and adults, with peer groups and services in Spanish. Call 650-321-5272. Office: 457 Kingsley Avenue, Palo Alto. Office hours Monday to Thursday, 9 a.m. to 4 p.m., Friday 9 a.m. to 1 p.m. Kara's site describes grief after a death, so ask whether they serve a loss like yours, and ask about cost.
• Your county line (above) can refer you to counseling.
• Your faith community may hold grief groups or simply sit with you. That matters.

Where do faith and community fit in?

Right beside you, and right beside professional care. For many families, faith and community are where strength comes from. You do not have to choose between prayer and a counselor. You can have both.

What the research and health agencies say

• The CDC lists things that protect people from suicide. They include support from family and friends, feeling connected to school and community, a strong sense of cultural identity, reasons for living, and cultural, religious or moral beliefs against suicide.
• The CDC also suggests connecting with community or faith based organizations as a way to cope with stress.
• NIMH lists a spiritual advisor among the trusted people who can help someone reach support.
• The National Institute on Aging says many grieving people find comfort in their faith community, prayer and scripture.
• The AAP lists prayer among the calming activities that help children.

For people of faith

• Your pain is not a lack of faith. Depression and anxiety are illnesses. Seeking care is not giving up on God.
• Ask your pastor or faith leader to walk with you to the first appointment, or to sit with you while you call 988.
• Keep going to worship if you feel safe. If fear keeps you home, ask about online services, home visits or a ride with a friend. Staying home and alone can deepen sadness.

For pastors, faith leaders and helpers

People often come to you first. That trust is a gift. Our suggestions:

• Listen first. Avoid sermons or blame.
• Ask directly if you are worried about suicide. Faith does not make the question wrong.
• Pray with them if they want to, and connect them to care too. Call 988 together or help them call the county line.
• Know your limits. You are one caring adult in their life, not the only one.
• Follow up in the days after.
• Take care of yourself. Helping others carry pain is heavy.

See How to talk with someone you love about suicide, which has a section for faith leaders.

For neighbors and friends

You do not have to be a counselor to help. A call, a visit, a shared meal, a ride to church or a clinic, or help finding a counselor can all make a person feel less alone. Connection is protection.

What changed in 2025 and 2026?

Here is what we confirmed on official pages. Some of it is hard news. Some of it is good. All of it helps you plan.

• January 20, 2025: the Department of Homeland Security rescinded its earlier policy that limited enforcement near "protected areas" such as hospitals and churches. ICE says decisions are now made case by case. California's own privacy and clinic laws still apply (below).
• September 20, 2025: California's SB 81 took effect. Clinics and hospitals that get public funding must keep patient care areas nonpublic. Immigration agents need a valid judicial warrant or court order to enter them, unless the law requires access.
• October 16, 2025: a federal rule took effect to route 988 texts to a nearby crisis center using general location, not your exact location. Nationwide carriers have until April 16, 2027. Calls were already routed this way under an earlier rule.
• December 29, 2025: a federal court allowed limited Medi-Cal information about people not lawfully present to be shared with ICE. The state says sensitive health records stay protected and the lawsuit continues.
• January 1, 2026: most undocumented adults 19 and older can no longer newly sign up for full Medi-Cal. People already enrolled keep it if they renew on time. Children under 19 are not affected.
• February 16, 2026: new federal rules for drug and alcohol treatment records took full effect. They keep these records from being used to investigate or prosecute patients without consent or a court order.
• September 18, 2026: a new federal public charge rule took effect. If you or a family member may apply for a green card, see Public charge and benefits: the complete guide before you change any benefits.
• 988 today: 988 text and chat are now offered in Spanish. 988 is for everyone, including LGBTQ+ young people.
• Coming January 1, 2027: Medi-Cal members with "unsatisfactory immigration status" (undocumented, DACA and other PRUCOL, green card holders in the five year wait) move to Fee for Service. Specialty mental health and substance use care stays with county behavioral health plans.
• Coming July 1, 2027: most adults 19 to 59 in that group will pay a premium of $30 to $50 a month, with the exact amount set by the governor in May 2027.

What did not change: 988 is still free and confidential. County lines still serve people with no insurance. Health centers still may not turn you away because you cannot pay. Teens 12 and older can still agree to counseling on their own. Your immigration status is still private medical information under California law.

Who can help for free in the Bay Area?

Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

Outside the Bay Area, 988, Teen Line, The Trevor Project, Crisis Text Line and the California Peer Run Warm Line still work for you. For counseling, find your county's line on the DHCS county list.

Crisis, any time

• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. 24/7, free. Spanish: press 2 or text AYUDA.
• San Mateo County Crisis Line (StarVista), for San Mateo County residents: (650) 579-0350, 24/7, with a mobile team.
• Santa Clara County crisis: (800) 704-0900, press 1, 24/7, with mobile teams for adults and for ages 4 to 20.

Counseling and referrals

• San Mateo County ACCESS Call Center: (800) 686-0101, TTY 711, 24/7.
• East Palo Alto Community Counseling Center (San Mateo County), youth and adult: 2415 University Avenue, Suite 301, (650) 363-4030.
• Santa Clara County Behavioral Health Services: (800) 704-0900.
• Ravenswood Family Health Network counseling: 1885 Bay Road, East Palo Alto, (650) 330-7400.
• CHC Ravenswood Initiative, family therapy and parent education for East Palo Alto and East Menlo Park: 1765 East Bayshore Road, 650-702-2487.

Youth

• allcove San Mateo: (650) 226-7030. allcove Palo Alto: (650) 798-6330. Ages 12 to 25.
• Teen Line: (800) 852-8336, or text TEEN to 839863. Up to age 19.
• The Trevor Project: 1-866-488-7386, or text START to 678678.
• Crisis Text Line: text HOME or HOLA to 741741.
• Soluna (13 to 25) and BrightLife Kids (parents of 0 to 12): free state apps.

Someone to talk to

• California Peer Run Warm Line: call or text 855-600-9276.
• 211 Bay Area: dial 211, for food, housing, counseling and other local help. Not an emergency service. See 211.

Grief

• Kara, Palo Alto: 650-321-5272.

Legal questions about privacy or your case

• See Free legal help in the Bay Area.

Questions people ask

Do I have to tell a counselor my immigration status? Usually no. A counselor can help you without knowing it. If a form asks, ask why. In California, a provider that learns your status must treat it as private medical information. See Will my therapist share my information with immigration?

Will calling 988 get me in trouble with immigration? 988's privacy pages do not mention immigration status. It shares identifying information only in rare cases of imminent risk or when the law requires. Fewer than 2 percent of calls involve emergency services. See Calling or texting 988.

Can I call 988 for someone else? Yes. You can contact 988 any time you are worried about a friend or family member.

I don't speak English well. Can I still get help? Yes. 988 has Spanish by pressing 2 or texting AYUDA, and phone interpreters in more than 240 languages. San Mateo ACCESS has Spanish and Chinese speaking staff and free interpreters. Santa Clara's line offers interpreters in all county languages.

I have no insurance and no papers. Can I really get counseling? Yes. Call your county line, or go to a community health center like Ravenswood, which may not turn you away because you cannot pay.

Can my teen see a counselor without me? In California, a teen 12 or older may agree to outpatient counseling on their own if mature enough. The counselor will usually involve you unless that would be inappropriate. Medicine still needs your OK.

Will using Medi-Cal for counseling hurt a green card case? Public charge rules changed on September 18, 2026. Talk to an immigration lawyer before you drop or avoid any benefit. See Public charge and benefits.

Can immigration agents walk into my clinic? Under SB 81, clinics with public funding must keep care areas nonpublic, and agents need a valid judicial warrant or court order to enter them, unless the law requires access. See Can ICE arrest me at a courthouse, hospital or church?

Is it normal to still cry a year after someone died? Yes. Grief comes in waves, especially around birthdays and holidays. If it keeps you from daily life, ask for help.

My child wets the bed again since the raids. Is that normal? Acting younger is a common stress reaction in children. Keep routines, offer comfort, and call your child's doctor if it worries you.

Is praying enough? Prayer can bring real comfort and strength. Depression and anxiety are also illnesses that respond to care. Many people of faith use both.

I'm a pastor. Someone told me they want to die. What now? Stay with them, ask directly, and call or text 988 together. If they are in danger right now, call 911. See How to talk with someone you love about suicide.

Are there free apps that actually help? Yes. Soluna (13 to 25) and BrightLife Kids (parents of 0 to 12) are free from the state, in English and Spanish. UCLA Mindful has free guided meditations in many languages.

Printables

You were not made to carry this alone. Whatever you are facing tonight, there is a next step, and there are people ready to take it with you. Make one call. Say one honest thing to someone who loves you. Rest if you can. Hope is not pretending things are fine. Hope is taking the next step anyway. We are holding hope with you.