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One morning when I got on the Stockholm metro there was a guy, bombed out of his mind, he had tossed his jacket in the middle of the floor, and was messing about with bottle caps with water and syringes.
No one made a sound (this is normal in the Stockholm rush hour), and I reached out through the SL app chat feature to inform the security center about the situation
I told them that a poor guy on the train clearly needed help, didn't speculate, but informed them about what I could see, told them what train it concerned and where on the train the guy was and gave a description of him.
Two stops later two security guards boarded the train and quickly lead him out, no screaming or disruption at all.
I don't know what happened to the guy after that, but I was careful to stay neutral yet concerned for the guy's health, and I hope he finally got the help he needed if not wanted at the time and is doing much better now.