Crisis – what to do in a crisis

Dealing with a mental health crisis

If you experience mental health problems, it can be frightening and you may feel alone.

If this is a new experience, you may not know what is happening.

If a person’s mental or emotional state gets worse quickly, this can be referred to as a mental health crisis or a mental health emergency.

A mental health crisis often means that you no longer feel able to cope or be in control of your situation. You may feel many things (although this may be different for individuals) including emotional distress or anxiety, that you can’t cope with day-to-day life or work, you might think about suicide or self-harm, or you might experience hallucinations and hear voices.

A crisis can also be the result of an underlying medical condition, such as confusion or delusions caused by an infection, overdose, illicit drugs or intoxication with alcohol. Confusion may also be associated with dementia.

You might be in crisis if:

• you are thinking of hurting yourself or suicide seems the only option
• you are experiencing extreme distress that seems overwhelming, which may relate to current/past trauma
• you are experiencing psychotic episodes (loss of sense of reality, hallucinations, hearing voices) and / or other behaviour that seems out of control or irrational and that is likely to endanger the person or others.

In a crisis situation, there are several different avenues that you can take. It is important however to get help quickly. Whether you experience a sudden deterioration of an existing mental health problem, or are experiencing problems for the first time, you’ll need immediate expert assessment to identify the best course of action and stop you getting worse.

People already receiving treatment / help for mental ill health

If you are already receiving treatment and support for your mental health from a community mental health team, the first point of contact should be with the team and your care coordinator / named worker.

If you have previously had similar symptoms then you might find it useful to think about what helped you cope before.

Your care plan and / or a crisis and recovery plan will identify what you (and others) can do to help along with details of who to contact in an emergency and outside of the teams operational hours.

It’s best to seek help from professionals that know you well as they can help support you better.

If there is an immediate risk

If you, or someone you know, are in immediate danger of serious harm (for example, if someone has taken an overdose, you need immediate help and are worried about your safety being close to acting on suicidal thoughts) go to your nearest accident and emergency department or call 999 for an ambulance immediately.

Give as much information as possible to the 999 operator and be as clear as you can when giving your address and telephone number.

If there is a risk of physical violence, or if you are at risk of self-harm or of causing harm to someone else, it may be necessary to contact the police directly by calling 999.

Our crisis and home treatment teams (see leaflet L289 – Crisis and intensive home treatment team) work closely with the acute hospitals / accident and emergency departments to make sure that you can be treated for a mental health illness where needed.

Call 999 if you, or someone you know, are seriously ill or injured and their life is at risk whether that is a medical emergency or a mental health emergency.

If you aren’t already under the care of mental health services or if you experience a mental health crisis out of hours

Phone your GP surgery and ask for an emergency appointment. If you phone and the surgery is closed there should be a recorded message giving you an emergency contact number to call.

Injuries or other physical health problems

If you or someone you know has injured themselves or is experiencing another physical health problem which your GP or urgent care service cannot address, then please go to the accident and emergency department.

Call NHS 111 if you urgently need medical help or advice, but it’s not a life threatening situation. NHS 111 is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones.

Telephone. 111

Text phone. 18001 111

If you need someone to talk to

If you want to call someone about how you feel or how to deal with someone else’s behaviour, you could contact one of the following helplines for immediate assistance.

These helplines have specially trained volunteers who’ll listen to you, understand what you’re going through and help you through the immediate crisis.

You can also text SHOUT to 85258.

Recovery College Online

The recovery college online, www.recoverycollegeonline.co.uk, provides a range of online mental health educational courses and resources. The content of the site has been developed by people with experience of mental illness.