Worried about someone's mental health

This page explains what you can do if you are worried about someone’s mental health. It explains how to get them help and support.

Overview

  • Changes in behaviour may mean your relative is developing a mental illness. These changes might be sudden. Or they may develop over time.
  • You can try to help your relative by encouraging them to get help from a doctor like a GP.
  • They may not want to see a doctor. You can try to ask for help yourself.
  • You can try to contact the GP or local mental health services.
  • It is important to look after your own mental health.

We have used the word ‘relative’ in this page, to refer to the person who is unwell. But we understand they may be a friend, relative or someone else.

What are the signs?

What are the signs that my relative might need help?

We all go through stressful events from to time that can change our normal behaviour. Short-term changes to behaviour are common. We may feel more stressed, angry or sad. These feelings are not always a sign of mental illness.

But changes in behaviour can be a sign that your relative is developing a mental illness. You may notice that they start to behave differently. You may see a change over a short time or over a number of months.

Below are some common changes to look out for. Your relative may:

  • be anxious,
  • be irritable,
  • try to start arguments,
  • have mood swings,
  • self-harm,
  • sleep too much or too little,
  • not want to be around other people,
  • be less able to cope with work or studies,
  • have concentration problems
  • have memory problems
  • eat more or less, or
  • have suicidal thoughts.

The changes in your relative’s behaviour may be easier to spot if your relative develops psychosis. Psychosis is a medical term. It means that your relative may hear or see things that aren’t there. It can also include unusual beliefs that you and other people don’t share. If your relative has psychosis they might:

  • focus on odd ideas or beliefs,
  • be suspicious and paranoid. Such as thinking people are talking about them,
  • believe that friends or family members want to harm them,
  • think that the TV is talking to them,
  • believe they are on a special mission or have special powers,
  • not talk to anyone or not want to leave their room for days,
  • have problems concentrating or remembering things, or
  • stop eating, washing or dressing properly.

You can find more information about ‘Psychosis’ by clicking here.

Encouragement to get help

How can I encourage my relative to get help?

If your relative is over the age of 18, they can’t be forced to have treatment they don’t want. They can only be forced to have treatment if they are detained under the Mental Health Act 1983.

You can try to help your relative by encouraging them to get help from their GP. A GP can give treatment for some symptoms of mental health conditions. Or they can refer your relative to a psychiatrist.

Your relative might not want to visit their GP. They may:

  • not think they are unwell,
  • not realise a GP can help,
  • understand they need help but feel too embarrassed or frightened to talk to a doctor.

Here are some thoughts, which may help you.

  • Imagine how you would feel in your relative’s situation. They might feel sensitive, anxious, frightened or confused.
  • Remember they may feel you are ‘getting at them’. Be calm, patient and sympathetic.
  • Try to bring up the subject when you are both relaxed and have time to talk.
  • Be aware that if your relative has delusions or hallucinations, for them these things are really happening.

There are some things you could tell your relative.

  • Stress, anxiety or other symptoms seem to be making it hard for them to cope as well as usual, and a doctor could help.
  • You can go with them to a doctor’s appointment to support them.
  • Many mental health problems can be treated. They might be worried they will have to go to hospital. This is unlikely if they get treatment.
  • GP notes are confidential. This means the doctor can’t share information with anyone else unless they agree to it. The GP may have to share information with others if they feel someone is at risk of harming themselves.

You can find more information about:

  • Responding to unusual thoughts and behaviours by clicking here.
  • Persuading someone to speak to their doctor by clicking here.
  • GP’s - what to expect from your doctor by clicking here.
  • Supporting someone with a mental illness by clicking here.
  • Mental Health Act by clicking here.

Refusing help

My relative won’t get help. What can I do?

Your relative may not want to see a doctor. You can try to ask for help yourself.

GP

You can share your concerns with your relative’s GP if you know who they are. Explain your concerns clearly. Keep to the facts and give examples. There are some examples below.

  • My daughter has left college because she believes all the staff are talking about her. She has stopped talking to all her friends. She won’t turn her phone on because she thinks that people can watch her through her phone.
  • My son does not come out of his room except to get food when we are all asleep. He hasn’t washed for over 2 weeks. He avoids all of us. If he walks into the kitchen and someone is there he runs back into his bedroom. He keeps his door locked and won’t talk to us.
  • My wife has started self-harming and takes a lot of time off work at the moment. She has started buying many packets of tablets and storing them. I found them and she got really angry with me for throwing them away. She gets so angry and starts smashing up the house. Every time I leave the house to go to work she starts crying and doesn’t want me to go.

It might help to give evidence of changes in your relative’s behavior. For example, your relative may have sent you an email, letter or text that seems odd or distressing. Keeping a diary of behaviour might help.

You should tell the GP if there is a history of mental illness in the family.

The GP might invite you to make an appointment to discuss your letter. Or you could try to make an appointment yourself. A GP may contact your relative to invite them for a checkup or they may agree to visit your relative at home. Although this is unlikely to happen without your relative’s consent.

The GP might need to share the information you give with your relative. You might worry that this will affect your relationship or trust. You could ask that any information you share is used as sensitively as possible. You could explain that this is needed to protect your relationship.

You might find that a GP won’t speak to you if you try to give information about your relative. If this happens, you could write down your concerns in a letter or email. This might make it harder for them to ignore.

NHS urgent mental health helplines

These helplines are available in most areas of England. They are available 24 hours a day. Most of them are available 7 days a week. You can call them for advice and support for yourself or your relative. They can help you to speak to a mental health professional. And they can assess what is happening and help you to decide on the best course of care.

To find your local helpline go to: www.nhs.uk/service-search/mentalhealth/find-an-urgent-mental-health-helpline

The helpline can make a referral to the appropriate mental health team. A referral means the healthcare professional passes your relative’s details to a team or service so they can make an appointment to see them. They can make referrals to services such as the community mental health team (CMHT), early intervention team and crisis team.

We have given more information on these teams below.

Community mental health team

A community mental health team (CMHT) is part of the NHS. The team is made up of health professionals like psychiatrists, psychologists and community psychiatric nurses (CPNs).

They can assess your relative’s mental health to decide on the best treatment and support for them.

How can my relative get a referral?
A GP, or the NHS urgent mental health helpline, will usually refer your relative to the CMHT for help. Your relative may be also be referred by social services.

Some CMHT’s will accept self-referrals. You can check this on the local mental health trust website. Or we could check this for you. You can contact us on 0300 5000 927.

You can write to the CMHT to explain your concerns. Even if your relative is not supported by them. But the CMHT may say they can’t get involved. It should be easier for you to share your concerns with the CMHT if your relative is already supported by them.

Early Intervention Team

Early intervention teams (EIT) are like the CMHT, but they focus on treatment and support for people who are experiencing psychosis for the first time.

How can my relative get a referral?
The National Institute for Health and Care Excellence (NICE) recommends that everyone experiencing psychosis for the first time should be referred to an EIT. It might help to point this out to your relative’s doctor. EIT’s should support people of all ages.

EIT’s usually accept self-referrals or referrals from friends and family. You can check this on the local mental health trust website, or we could check this for you. You can contact us on 0300 5000 927.

If you can’t refer your relative to the EIT, you can still write to them to explain your concerns. The EIT may say they can’t get involved. But they may be able to offer you some advice on how to deal with the situation.

Crisis team

The crisis team is another team within the NHS. They are sometimes called crisis resolution teams or home treatment teams. They can support people who are having a mental health crisis in the community.

Most areas will already have a crisis team in place. They may not be able to get to your relative straight away if they are very busy.

They offer short-term intensive support to people in a crisis. For example, they may be able to visit your relative at home to help them. This aims to reduce the number of people who have to go to hospital.

Your relative will usually need a referral from a health professional to get help from a crisis team. GP’s, or the NHS urgent mental health helpline, can make this referral. But sometimes they will accept selfreferrals or referrals from relatives or friends. You can check on your local mental health trust website or we could check this for you. You can contact us on 0300 5000 927.

How do I get help in an emergency?

Your relative might need help quickly if it is an emergency, or they are very unwell. You could contact professionals such as:

  • your relative’s GP,
  • you relatives local NHS urgent mental health helpline,
  • NHS 111 if your relative doesn’t have a GP,
  • your relative’s community mental health team,
  • your relative’s crisis team,
  • your relative’s early intervention team, or
  • take your relative to accident and emergency at the local hospital.

In a life-threatening situation call 999 and ask for an ambulance. You may also need to ask for the police.

You can find more information about:

  • Confidentiality and information sharing by clicking here.
  • Community mental health teams by clicking here.
  • Early intervention teams by clicking here.
  • Crisis teams by clicking here.
  • Psychosis by clicking here.
  • Getting help in a crisis by clicking here.

Non-NHS help

How can I ask for help outside the NHS?

Charities

You could try to get your relative help from a local charity. Your relative might find a local charity less ‘clinical’ than a GP surgery. This may make them feel more comfortable. Charity support will be different across the country. But often they can help with recovery plans, one to one support and support groups.

Some charities can provide mental health treatments such as talking therapies, but they can’t prescribe medications.

Some charities may have contact with NHS mental health services. They could let mental health services know if your relative is unwell and they need a mental health assessment.

You can search for local mental health charities at:
www.hubofhope.co.uk/. Or we could check this for you. You can contact us on 0300 5000 927.

Social services

You can ask social services to carry out a social care assessment for your relative. This is called a ‘needs assessment.’ The assessment will work out if social services can support your relative in line with The Care Act 2014. Social services have to assess someone who has high care needs.

Social care support could be support in the home. Or help to use local facilities. Social services can’t give money for any treatment that your relative may need. But, if your relative is assessed as needing social care support, they may be eligible for direct payments. A direct payment is money that the local authority (LA) can give to your relative to pay for the social care that they need.

A social worker, or other professional from the local authority, will usually assess your relative. But social services can ask other services to do assessment instead of them. They may do this if other services have more experience in your relative’s area of need. For example, they may ask a community mental health team to do an assessment.

Social services won’t assess your relative if they don’t want social services. You can find out more information about:

  • Recovery by clicking here.
  • Social care assessment by clicking here.
  • Social Care. Care support and planning by clicking here.
  • Social care. Direct payments by clicking here.

Help for non-relatives

How can I help someone who is not a friend, relative or loved one?

You might be worried about someone you don’t know very well. For example, a housemate, neighbour, tenant or colleague. It’s unlikely that you know who their GP is, or if they are getting help from mental health services.

If you feel someone is struggling with their mental health you can contact social services and tell them. Their contact details are usually on the local authority’s (LA) website. Or we could look for you. You can contact us on 0300 5000 927.

Safeguarding

You may be concerned that someone is at risk because of their mental health. If you think someone is being abused you can report this to the adult safeguarding team, in social services. There are many different types of abuse. This includes:

  • physical,
  • sexual,
  • domestic violence or abuse,
  • emotional,
  • financial,
  • organisational abuse,
  • modern slavery,
  • discriminatory abuse,
  • neglect, and
  • self-neglect.

If someone is not looking after themselves this may be neglect. You can tell the safeguarding team about this. Their contact details are usually on the LA’s website. Or we could look for you. You can contact us on 0300 5000 927.

Things to remember

What things should I remember?

  • Your relative might not want to go to their doctor. This can be difficult, as you cannot force someone to get help even if they are unwell.
  • Your relative can only be forced to have treatment if they are detained under the Mental Health Act 1983. Someone can only be detained if they are a severe risk to themselves or other people.
  • It can be useful to give doctors information on your relative’s health even if they won’t go to their GP. Your relative may decide to seek help later on.
  • Some doctors think listening to the concerns of others about a patient breaches their duty of confidentiality. This is not true. Confidentiality rules do not stop a doctor listening to your concerns.
  • A doctor or mental health team will need permission from your relative to share their personal information with you. You can still share concerns without this. But professionals won’t be able to tell you anything about your relative without their consent. They can only listen to you. This includes what they will do with your information.
  • If you share concerns about your relative with professionals, they may tell your relative. This could affect your relationship. You could ask the doctor to keep this confidential and to use the information sensitively.
  • You may not know which GP surgery your relative is registered with. If you ask a surgery if your relative is a patient there the surgery will not usually be able to tell you this. If your relative has given them permission to share information they would be able to tell you.
  • If your relative agrees to visit their GP, you may be concerned that their GP won’t listen to them properly. Or you may be concerned that your relative won’t be honest. You could write to the GP before their appointment so that the GP understands your concerns.
  • Try to get help for someone if you think that your relative has psychosis symptoms. Getting help as soon as possible can increase your relative’s chance of recovery.

You can find more information about:

  • Confidentiality and information sharing by clicking here.
  • Mental Health Act by clicking here.
  • Psychosis by clicking here.
  • Getting help in a crisis by clicking here.

Help for myself

How can I get help for myself?

It is important to look after yourself. Trying to get help for someone who is unwell can be stressful. And can affect your own mental health.

You might be able to get help for your own mental health as a carer through the following ways.

  • Your GP.
  • Charities, such as carer’s service.
  • Join a support group.
  • Learn about your relative’s condition. This could help you to manage it. NHS offer family intervention for some mental health conditions.
  • Training for carers.
  • Carers assessment.

How do I find charities and support groups?

There are services and groups for carers across the UK. These are often run by local charities or the NHS. They can be a useful way to meet other carers and get support, information and advice.

You can find details of carers’ services in the ‘Useful Contacts’ section below. Rethink Mental Illness are linked to carers groups in some areas of the country. You can find groups by looking on the Rethink Mental Illness website. Below is the link to our website:

www.rethink.org/about-us/our-support-groups

If there isn’t a group in your area the Rethink Mental Illness participation team can help you to set up your own group.

Rethink Mental Illness Involvement Team
The involvement team can help people to set up groups throughout England

Telephone: 07484 001928
Email: groups@rethink.org

How do I ask for a carers assessment?

You can also ask your local social services team for a ‘carers assessment’. This is like a social care assessment. Someone from the local authority will assess you to see if you need support in your caring role.

You can find more information about:

  • Supporting someone with a mental illness by clicking here.
  • Responding to unusual behavior by clicking here.
  • Carers assessment and support planning by clicking here.
  • Stress by clicking here.

Further reading

Kings College
Kings college have developed a free 4-week online course to help carers support a relative with psychosis or schizophrenia. Click the link below.

Website: www.futurelearn.com/courses/caring-psychosis-schizophrenia

Useful contacts

Carers UK
They have an advice line, online support carers groups throughout the UK.

Telephone: 0808 808 7777 (Monday – Friday, 9am – 6pm)
Address: 20 Great Dover Street, London SE1 4LX
Email: through their website
Website: www.carersuk.org

Carers Trust
They give practical advice about caring for someone, they can give information about local support if you call them.

Telephone: 0300 772 9600
Address: 32–36 Loman Street, London, SE1 0EH
Email: info@carers.org
Website: www.carers.org

Samaritans
Can be contacted by telephone, letter, e-mail and mini-com. There's also a face-to-face service, available at their local branches. They are open 24 hours a day, every day of the year.

Telephone: 116 123
Email: jo@samaritans.org
Website: www.samaritans.org

Sane Line
Work with anyone affected by mental illness, including families, friends and carers. Their helpline is open between 4:30pm and 10.30pm every day of the year. They also provide a free text-based support service called Textcare and an online supportive forum community where anyone can share their experiences of mental health.

Telephone: 0300 304 7000 (4:30pm – 10:30pm every evening)
Textcare: www.sane.org.uk/what_we_do/support/textcare
Support Forum: www.sane.org.uk/what_we_do/support/supportforum
Website: www.sane.org.uk

Support Line
They offer confidential emotional support to children, young adults and adults by telephone, email and post. They work with callers to develop healthy, positive coping strategies, an inner feeling of strength and increased self-esteem to encourage healing, recovery and moving forward with life. Their opening hours vary so you need to ring them for details.

Telephone: 01708 765200
E-mail: info@supportline.org.uk
Website: www.supportline.org.uk

Silverline
Aimed at people over 55. The Silver Line operates the only confidential, free helpline for older people across the UK that’s open 24 hours a day, seven days a week, 365 days of the year. They also offer telephone friendship where we match volunteers with older people based on their interests, facilitated group calls, and help to connect people with local services in their area.

Telephone: 0800 4 70 80 90
Website: www.thesilverline.org.uk

The Mix
Aimed at people under 25. Their helpline is open between 4pm and 11pm, 7 days a week. They also run a crisis text service which is open 24 hours a day, 7 days a week.

Telephone: 0808 808 4994
E-mail: through the website.
Crisis text message service: Text THEMIX to 85258
Webchat: through the website. (4pm - 11pm, 7 days a week - chats may not be connected after 10:15pm)
Website: www.themix.org.uk

Mood Swings
Aimed at anyone affected by a mood disorder, including friends, families and carers.

Telephone: 0161 832 37 36
E-mail: info@moodswings.org.uk
Website: www.moodswings.org.uk

Shout
If you’re experiencing a personal crisis, are unable to cope and need support, text Shout to 85258. Shout can help with urgent issues such as suicidal thoughts, abuse or assault, self-harm, bullying and relationship challenges.

Text: Text Shout to 85258
Website: www.giveusashout.org/

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