Getting help in a crisis

If your relative has a mental illness, you may find that there are times when their mental illness gets worse. This section gives you information on who to contact if you feel that the situation has reached crisis point and they need urgent help.

Overview

  • A mental health crisis can mean different things. It generally means when someone’s health worsens to the point where they need urgent help from professional services.
  • You and your relative may notice early warning signs that their mental health is getting worse. If possible, try to get help early.
  • Different services can help your relative in a crisis, such as the Community Mental Health Team (CMHT) or crisis team. Services vary depending on the area that your relative is in.
  • In some circumstances, the Mental Health Act might be needed. The ‘nearest relative’ can ask social services to think about assessing your relative under the Mental Health Act.

About

What do we mean by crisis?

Having a mental health crisis can mean different things to different people, but can include:

  • thinking about suicide or acting on suicidal thoughts
  • having an episode of psychosis. This is when you might experience or believe things that other people don’t, or
  • doing something that could put yourself or other people at risk.

You may know better than most when your relative is having a mental health crisis. Both you and your relative might notice early warning signs that their mental health is getting worse. It is good to try and get help at this stage to try and prevent a crisis.

Friends, family and carers can help in a crisis. But in some cases, it is important to try and get help from professional services.

Getting help

How do I get help from mental health services?

Mental health services can help people with mental health problems by offering care and treatment. If your relative is already in touch with mental health services, these services may already know about some of their problems.

Mental health services include:

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/mental-health/find-an-urgent-mental-health-helpline

Crisis teams

Crisis teams are part of mental health services. 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.

The NHS Long Term Plan says that there should be a crisis team in every area by 2021. This should be available 24 hours a day, seven days a week.

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.

The team should make a care plan. This helps to make sure your relative has the right treatment and support. They may:

  • offer medication,
  • arrange regular visits or phone calls to check they are okay, and
  • make sure they are in touch with other services to get long-term support.

This is to try and stop your relative needing to go into hospital. But they might still need to go to hospital if they are very unwell.

Services differ depending on area. For instance, some crisis teams are called crisis resolution and home treatment (CRHT) teams. Not all crisis teams work the same way. For example, the amount of support they offer could vary.

Some crisis teams can only support your relative through a referral from a health care provider. Like a GP, community mental health team (CMHT) or Accident & Emergency (A&E).

Accident and emergency (A&E)

You can take your relative to the accident and emergency (A&E) or casualty department of the local hospital. You can also do this if they need help for physical injuries such as self-harm, injury or overdose.

A&E can assess your relative and may arrange for a mental health professional to see them. They can do a more in-depth assessment. Your relative could get admitted to a mental health ward in hospital. Or referred to the crisis team or community mental health team (CMHT).

A&E departments often have long waiting times. And the waiting areas can be stressful.

Emergency services (999)

If your relative is at risk of harming themselves or others, you can contact the emergency services on 999. They may contact mental health services such as the crisis team. If an ambulance is called but the staff may be at risk, then the police might come with them.

NHS 111

You can call NHS 111 when you need medical help but it’s not a 999 emergency. Call 111 if:

  • you are not able to speak to your relatives local NHS urgent mental health helpline,
  • you need help urgently for your relatives mental health, but it's not an emergency, or
  • you're not sure what to do.

Community mental health teams (CMHTs)

Community mental health teams (CMHTs) support people who have complex or serious mental health problems in the community. They are usually only available during office hours on weekdays.

If your relative is already under the care of the CMHT they should have a care plan. The care plan should include ways in which your relative can manage their mental health, including what to do in a crisis. If you don’t already have a copy of your relative’s care plan, it might help to ask them for one. This could help if they go into crisis again in the future.

A CMHT is only able to help in a crisis if they are already treating your relative. For example, your relative may have regular meeting with a CPN or psychiatrist.

If you know that your relative is being treated by a CMHT but don’t know their contact details you can speak to the NHS urgent mental health helpline. If there is no helpline in your area then you can contact NHS 111.

GPs

You can take your relative to their GP. A GP won’t be able to offer direct help, but they may be able to contact other teams. Such as the crisis team or make a referral to the community mental health team.

GPs should now offer weekend and evening appointments. Outside of normal surgery hours you can still phone the GP surgery, but you will usually be directed to an out-of-hours service.

Out-of-hours services vary across the country. You could be another phone number to call. Or you could be directed to another service such as a walk-in centre in large towns and cities.

Some GPs will not help unless your relative asks for help themselves. This can cause problems if your relative does not realise they are unwell or does not want professional help. If this happens, then you might have to try other options for getting professional help. Please see below for more details.

You can find out more information about:

  • Crisis teams by clicking here.
  • Community Mental Health Teams (CMHTs) by clicking here.
  • Care Programme Approach (CPA) by clicking here.
  • GPs – what to expect from your doctor by clicking here.

The Mental Health Act

What is the Mental Health Act?

The Mental Health Act 1983 is the law which says when someone can be admitted, kept and treated in hospital against their wishes. It is commonly known as being ‘sectioned’ or being ‘detained under the Mental Health Act.

Detention under the Mental Health Act only happens if the person is very unwell and is putting their own safety or someone else’s at risk. It is sometimes used in crisis situations.

Should I use the Mental Health Act?

Most people would only use the Mental Health Act as a last resort. You may decide that this is the only option to get your relative help. You might find that talking to your relative about their options first might be helpful.

For example, they might agree that they need to go into hospital. This is known as being a ‘voluntary’ patient. This means that they would not be detained under the Mental Health Act. Although an assessment would still need to be carried out.

Using the Mental Health Act could have a negative effect on your future relationship with your relative. It can be a stressful experience for everyone involved. But, under certain circumstances it may be the best thing to do to get your relative the help they need.

A Mental Health Act assessment can take some days to arrange. If your relative is an immediate danger to themselves, or other people, then please see the next section for more information.

Who can ask for a Mental Health Act assessment?

Anyone can ask for a Mental Health Act assessment. However, the ‘nearest relative’ has certain rights under the act. The nearest relative is not the same as the next of kin. There are rules in the Mental Health Act that say who the nearest relative is.

The nearest relative can ask for an assessment to decide if their relative should be detained under the Mental Health Act. They can use this right more than once if they need to.

An approved mental health professional (AMHP) and 2 doctors must agree that your relative needs to be admitted to hospital. If the AMHP decides that admission to hospital is not necessary, they must give their reasons in writing to the nearest relative.

Sometimes the team carrying out the assessment will ask the police to attend to make sure everyone is safe.

How do I use the Mental Health Act?

You might feel that your relative needs to be taken to hospital under the Mental Health Act. If so, you can:

  • Call the local adult social services or the Community Mental Health Team.
  • Ask to speak to an approved mental health professional (AMHP). An AMHP will arrange the assessment if they are concerned about your relative. In many areas you might have to speak to a general call handler, so be clear about what you are asking for.
  • Ask for a Mental Health Act assessment.
  • Explain the reasons why you think an assessment is necessary. Focus on risk. Tell them about what has been happening, any history of mental health issues and why you are concerned. It might help you to make notes before you call.

You can find out more information about:

  • Nearest Relative by clicking here.
  • The Mental Health Act by clicking here.

Helping yourself

How do I get help for myself?

Caring for someone with a mental illness can be difficult. There will be times when you will need support for yourself, especially if your relative is going through a crisis or emergency.

You may find carer support groups helpful. You can go to them to meet others for support and to share information and suggestions. Many people consider other carers the real experts who can offer tips and ideas on how to deal with situations.

You could also ask your local council’s social services department for a ‘carer’s assessment’. You would then be assessed to see if you need services for yourself to help you with your caring responsibilities.

You can read more about:

  • Worried about someone’s mental health by clicking here.
  • Carers assessments by clicking here.
  • Dealing with unusual thoughts and behaviours by clicking here.
  • Supporting someone with a mental illness by clicking here.
  • Suicidal thoughts – how to support someone by clicking here.

Problems

What if my relative, or others, are in immediate danger?

If your relative, or others are in immediate danger, then you can call the emergency services by dialling 999. You may need the ambulance, police or both.

An immediate serious risk might mean things like:

  • your relative is threatening to kill themselves now and they sound serious about it, or
  • your relative is threatening to harm other people now.

Explain to the emergency services that your relative has mental health issues.

The police have powers under sections 135 and 136 of the Mental Health Act to take your relative to a place of safety. A place of safety may be your relative’s home, or the hospital. They can keep your relative in a place of safety for up to 24 hours while they wait for a mental health assessment.

The assessment will decide if your relative needs to be detained under the Mental Health Act or not.

You can find out more information about:

  • Section 135 of The Mental Health Act by clicking here
  • Section 136 of The Mental Health Act by clicking here

What if I have problems getting help?

Getting help can sometimes be difficult. It is important to keep trying if you had problems the first time. You may find that you need to try different services before getting the right support for your relative. This can especially be the case if they don’t want to get help.

Can I share my concerns with health professionals?

You can speak to your relative’s GP or community mental health team (CMHT) about your concerns. You could also put your concerns in writing.

Try to include clear and specific examples of the concerns you have. For example, you could tell them about thoughts or behaviour that you are worried about. If there is any risk to the person themselves or to other people, then make this clear.

Will health professionals tell my relative what I have said?

If you share concerns about your relative, professionals may tell your relative that you did this. This can affect relationships and trust. When sharing your concerns verbally or in writing, try asking for any information you share to be kept confidential and used as sensitively as possible. You could explain that this is necessary to protect your relationship.

Sometimes, you may have information that professional services do not have. For example, if your relative will not share how they are feeling with mental health services. If this is the case, you could highlight that there is a risk that your relative would stop talking to you if the information you share is not used as sensitively as possible.

I’m still having problems getting help. What can I do?

If you are still finding it difficult to get help, or you are not happy with the help you have got, you can make a formal complaint. All GP surgeries, hospitals and mental health services have a complaints procedure.

You can find out more about:

  • Complaints by clicking here
  • Confidentiality and information sharing for carers, friends and relatives by clicking here

Useful contacts

The Samaritans
This is a listening service for anyone in distress.

Telephone: 116 123 (24 hours a day, 7 days a week).
Address: Chris, Freepost RSRB-KKBY-CYJK, PO Box 9090, Stirling, FK8 2SA
Email: jo@samaritans.org
Website: www.samaritans.org

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/

Papyrus
A charity dedicated to the prevention of suicide in young people under 35. Papyrus also supports friends and family worried about someone under the age of 35.

Telephone: 0800 068 41 41 (Monday to Friday 9am - 10pm. Weekends and bank holidays 2pm - 10pm)
Text: 07860 039967
Address: Lineva House, 28-32 Milner Street, Warrington, Cheshire, WA5 1AD
Emailpat@papyrus-uk.org
Website: www.papyrus-uk.org/

Sane Line
Work with anyone affected by mental illness, including families, friends and carers. 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) During Covid: 07984 967 708. Leave a message with your first name and number and you will be called back.
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
We offer confidential emotional support to children, young adults and adults by telephone, email and post. We 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
Email: info@supportline.org.uk
Website: www.supportline.org.uk

C.A.L.M. (Campaign Against Living Miserably)
Aimed specifically at men. Their helpline is open between 5pm and midnight every day of the year.

Telephone: 0800 58 58 58
Webchat: through the website
Website: www.thecalmzone.net

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. We 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
Email: 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
Email: info@moodswings.org.uk
Website: www.moodswings.org.uk

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