Overview

• A mental health crisis can mean different things to different people.
• It means when someone’s mental health is very bad they usually need urgent help from professional services.
• You and your loved one may notice early warning signs that their mental health is getting worse. Try to get help at the earliest stage possible.
• You or your loved one can call your local NHS urgent mental health helpline to access urgent support.
• Different NHS services can help your loved one in a crisis, such as the community mental health team (CMHT) or crisis team. Services can vary depending on the area that your loved one lives in.
• Your loved one might need to be detained in hospital under the Mental Health Act. This will only happen as a last resort if they’re a risk to themselves or others because of their mental illness.

About

What do we mean by a ‘mental health crisis’?

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

• thinking about suicide or acting on suicidal thoughts,
• experiencing mania,
• having an episode of psychosis, or
• doing something that could put yourself or other people at risk.

Psychosis is a term used to describe when people lose some contact with reality. Common symptoms are hearing voices or having strong beliefs that aren’t shared by most people. Experiencing psychosis by itself might not be a mental health crisis. But it might be if someone is acting on their delusions or a risk to themselves or others.

You may know better than most when your loved one is having a mental health crisis. Both you and your loved one might notice early warning signs that their mental health is getting worse. It’s good to try and get help at the earliest stage possible.

Friends, family and carers can help in a crisis. But often, it’s important to try and get help from professional services.

There are lots of different reasons why people can have a mental health crisis. It can be sometimes linked with issues with things like physical health, housing, money, work, volunteering or education, relationships or social contact.

See our webpage on Psychosis for more information.

Getting help

How do I get help from NHS mental health services?

NHS mental health services can help people with mental health problems and conditions by offering care and treatment. If your loved one is already with mental health services, they may already know about some of their difficulties.

The services below won’t usually support or treat your loved one unless they agree to it. This can cause problems if your loved one doesn’t realise they’re unwell or they don’t want professional help. If this happens, you might have to try other options for getting professional help. Please see the next section for more details.

Mental health services include:

NHS urgent mental health helplines

These local helplines are usually available 24 hours a day 7 days a week. You can call them for advice and support for yourself or your loved one.

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.

NHS crisis teams

Crisis teams are sometimes called crisis resolution teams or home treatment teams. They support people who are having a mental health crisis in the community.

The teams are available to contact 24 hours a day, 7 days a week. But they may not be able to get to your loved one straight away if they’re very busy.

The team should make a care plan. This helps to make sure your loved one 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’re in touch with other services to get long-term support.

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

Your loved one might be able to self-refer to their local crisis team. But they might need to be referred by a medical or social care professional. If this is the case your loved one can speak to their:

• local NHS urgent mental health helpline,
• GP,
• point of contact at their NHS mental health team, if they’re with one, or
• social worker.

Also, they might be referred to the crisis team by NHS staff if:

• an ambulance is called, or
• they visit the accident and emergency department (A&E) at hospital.

You can find details of your loved one’s local team by searching online. You can search ‘NHS mental health crisis team X’, where X is your loved one’s local area. You can also call NHS 111, the local NHS urgent mental health helpline or ask your loved one’s GP.

NHS Accident and emergency (A&E) departments

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

Staff at A&E can assess your loved one and may arrange for a mental health professional to see them. They will decide on the best next steps, which can include:

• outpatient help and support from mental health professionals at the hospital,
• help from an NHS crisis team in the community, and
• going into a mental health ward in hospital.

You can search for your loved one’s local A&E here:
www.nhs.uk/Service-Search/other-services/Accident%20and%20emergency%20services/LocationSearch/428

NHS emergency services (999)

If your loved one 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 paramedics need more support police might come with them.

NHS early intervention in psychosis teams

Early intervention in psychosis teams (EIT) can support your loved one if they experience psychosis for the first time.

Psychosis is a term used to describe when people lose some contact with reality. Common symptoms are hearing voices or having strong beliefs that aren’t shared by most people. Experiencing psychosis by itself might not be a mental health crisis. But it might be if someone is acting on their delusions or a risk to themselves or others.

The National Institute for Health and Care Excellence (NICE) recommends that EIT teams should be open to people of all ages.

EIT teams usually accept self-referrals from the person experiencing psychosis or their friends or relatives. But you can check on your loved ones local EIT website or by contacting them.

You can find details of your loved one’s local team by searching online. You can search ‘NHS early intervention in psychosis team X’, where X is your loved one’s local area. You can also call NHS 111, the local NHS urgent mental health helpline or ask your loved one’s GP.

If your loved one’s EIT can't provide urgent support, you can call their local NHS urgent mental health helpline. EIT teams aim to see patients within 2 weeks of the referral.

See our webpage on Psychosis for more information.

NHS 111

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

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

NHS community mental health teams (CMHTs)

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

If your loved one is already under the care of the CMHT they should have a care plan. The plan should include ways in which they can manage their mental health, including what to do in a crisis.

If you don’t already have a copy of your loved one’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 loved one. For example, your loved one may have regular meetings with a community psychiatric nurse (CPN) or psychiatrist.

You might know that your loved one is being treated by a CMHT but don’t know their contact details. If you can’t get them, you can speak to your loved one’s local NHS urgent mental health helpline.

GP practices

Your loved one can visit their GP practice to discuss their options for help and treatment.

GP practices usually keep some appointments free for urgent issues. They might be seen by a GP or a mental health professional, like a community psychiatric nurse (CPN). They can refer them to the local crisis team if necessary.

GPs are experienced in dealing with mental health problems, so your loved one should try to be open about how they’ve been feeling.

Your loved one might be offered medication, access to talking therapies or more specialist support and treatment.

You can go with your loved one to the appointment in they want you too. You can speak to the GP or the mental health professional on behalf of your loved one if they agree to this.

Your loved one might be able to get an appointment on the weekend or in the evening. Outside of normal surgery hours you can still phone the GP surgery, but you will usually be directed to an out-of-hours service or to NHS 111.

Out-of-hours services vary across the country. You could be:

• given another phone number to call, or
• directed to another service, such as a walk-in centre in large towns and cities.

For more information see our webpages on the following:

• GPs and your mental health
• Talking therapies
• NHS mental health teams
• Confidentiality and information sharing - For carers, friends and relatives

Other services

Other services are provided in some areas by the NHS and other providers, such as charities. These local services can include:

• crisis houses that provide short-term accommodation for people experiencing a mental health crisis,
• crisis cafés that provide a safe, welcoming place where people can go if they are feeling emotionally distressed or are in a mental health crisis, and
• crisis helplines that provide emotional and sometimes practical support, and
• emotional support lines where you can talk to skilled listeners about how you’re feeling.

Rethink Mental Illness provide some of these services in some areas. You can click the ‘Help in your area’ link on our website to search:
www.rethink.org

You can search online for local crisis services and your local NHS urgent mental health helpline should know about them too:
www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline.

You can find details of emotional support lines in the Useful contacts section at the bottom of this page.

The Mental Health Act

What is the Mental Health Act?

The Mental Health Act 1983 says when someone with a mental disorder can be detained and treated in hospital against their wishes. Which is sometimes known as being ‘sectioned’ or being ‘detained under the Mental Health Act.’

A mental disorder can include mental illness and things like dementia, autism and learning disabilities.

Your relative will only be detained under the Mental Health Act as a last resort if they’re very unwell. It will only happens if they’re at risk of harm to themselves or others because of their mental disorder. It’s sometimes used in crisis situations.

You might think that your loved one needs to be assessed to see if they should be detained in hospital.

Should I try to get my loved one assessed under the Mental Health Act?

You might decide that you want to try and get your loved one assessed under the Mental Health Act if:

• they’re very unwell,
• they won’t agree to get support or treatment, or they don't realise that they're unwell,
• you think they might be a serious risk to themselves or other people, and
• there are no other alternatives.

Most people would only try to get their loved one assessed under the Mental Health Act as a last resort. You may decide that this is the only option to get your loved one help.

You might find that talking to your loved one about their options first can be helpful. You could explain that it's better for them to agree to get help than to be forced to get it.

By agreeing to get help:

• your loved one will have more control over their care and treatment, and
• there is a better chance that they will be able to remain in the community.

There is no extra treatment available to your loved one if they’re detained, compared to in the community. So, it’s best for them to agree to get help in the community if possible.

Your loved one won’t usually be detained under the Mental Health Act if they are willing to get treatment.

Going through a Mental Health Act assessment might be stressful for you and your loved one. But it might be the best thing to get your loved one the help they need.

The outcome of the assessment might not be that your loved one is detained in hospital. It might lead to treatment and support in the community instead. Mental health professionals will try and keep your loved one in the community if they can and will only detain them as a last resort.

A Mental Health Act assessment can take some days to arrange. If your loved one is an immediate danger to themselves, or others, then please see the next section.

You can think about whether your loved one is a high risk to themselves or others because of their mental health. And if you should ask for Mental Health Act assessment.

What does high risk mean?

High risk can mean many things, but it could include:

• not being aware of hazards because of delusional thoughts or confusion,
• neglecting yourself to such a degree that your health and safety is at risk,
• expressing intentions to harm or kill yourself,
• refusing to eat for fear that food is contaminated, or
• threatening to harm others due to delusions or severe paranoia.

You can think about the following questions:

• How has their behaviour changed?
• When did their behaviour change?
• What are they saying or doing to make you concerned?
• Have they tried to harm themselves or others? If so, how and when did it happen?
• Have they stopped eating, drinking or washing?
• Have you got anything to indicate the changes in their behaviour such as social media posts?
• What might realistically happen if your loved one isn’t detained?
• Who is in danger of being harmed?
• What evidence do you have of this? Have they done it before?
• Are they aggressive? If so, how?

Who can ask for a Mental Health Act assessment?

You can ask for a Mental Health Act assessment for your loved one, regardless of your relationship to them.

Someone called the ‘nearest relative’ has certain rights under the Act. Mental health professionals have a duty to consider your loved one’s mental health if their nearest relative asks them to. The nearest relative isn’t the same as the next of kin. There are rules in the Mental Health Act that say who the nearest relative is.

See our webpage on Nearest relative for more information.

How do I ask for a Mental Health Act assessment?

When you speak to someone using options below you can:

• explain that you need a Mental Health Act assessment for your loved one,
• explain the reasons why you think an assessment is necessary, focussing on risk,
• tell them what has been happening, any history of mental health issues and why you are concerned,
• explain what you think might happen to your loved one if an assessment isn’t carried out, and
• tell them everything you think is relevant but being as concise as you can.

It might help you to make notes before you call.

To ask for a Mental Health Act assessment you can:

• Call your loved one’s local NHS urgent mental health helpline. You can find details at: www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline or you can call NHS 111 to ask them for details.
• If your loved one is with an in NHS mental health team, you can call them. If you don't know the name and contact details of the person your loved one normally deals with, it might be in their care plan. If you still don’t know, you can speak to anyone at the team.
• Call your loved one’s local adult social services. You can search online for their details. Ask to speak to the approved mental health professional (AMHP) team. An AMHP is usually a social worker with mental health expertise. They start the Mental Health Act assessment process.

How do professionals assess my loved one?

Professionals might agree that a Mental Health Act assessment should be carried out for your loved one. If they do, an approved mental health professional (AMHP) will start the process.

The AHMP will try and keep your loved one in the community if they can. They will only recommend detaining them in hospital as a last resort.

If the AMHP decides that detention in hospital isn’t necessary, they must give their reasons in writing to the nearest relative.

If the AMHP thinks your loved one should be detained in hospital, they will arrange for 2 doctors to also assess them. The 2 doctors must both agree that your loved one needs to be admitted to hospital. ,

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

For more information see our webpages on the following:

• The Mental Health Act, and
• Nearest relative

Immediate risk

What if my loved one, or others, are in immediate danger?

If your loved one, or others, are in immediate danger, you should call the emergency services on 999. You may need the ambulance, police or both.

Immediate danger might mean things like:

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

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

The police have powers under sections 135 and 136 of the Mental Health Act to take your loved one to a place of safety.

A place of safety may be your loved one’s home, or the hospital. , They can keep your loved one in a place of safety for up to 36 hours while they wait for a mental health assessment.

The assessment will decide if your loved one needs to be detained under the Mental Health Act.

For more information see our webpages on the following:

• Section 135 of the Mental Health Act – Being taken to a place of safety from a private place, and
• Section 136 of the Mental Health Act – Emergency police powers to take you from a public place to a place of safety

Problems

What if I have problems getting help?

Getting help can sometimes be difficult. It’s 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 loved one. 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 loved one’s GP, mental health team or social worker 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 things your loved one has said or behaviours they’ve displayed. Tell them if you think there’s a risk to your loved one or to other people.

Will health professionals tell my loved one what I have said?

If you share concerns about your loved one, professionals may tell them that you did this. For example, if it has influenced their assessment or treatment plan for your loved one.

When sharing your concerns 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 with your loved one.

Sometimes, you may have information that professional services don’t have. For example, if your loved one won’t share how they are feeling with mental health services. You could say that there is a risk that your loved one would stop talking to you if the information you share isn’t used sensitively.

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

You can complain if:

• you’re finding it difficult to get help for your loved one, or
• you aren’t happy with the help they’re receiving.

All GP surgeries, hospitals and mental health services have a complaints procedure.

For more information see our webpages on the following:

• Complaining about the NHS and social services
• Confidentiality and information sharing - For carers, friends and relatives

Helping yourself

How can 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 loved one 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’re entitled to services for yourself to help you with your caring responsibilities.

For more information see our webpages on the following:

• Worried about someone’s mental health
• Carers assessments – Under the Care Act 2014
• Responding to unusual behaviour
• Supporting someone with a mental illness
• Suicidal thoughts – how to support someone

Useful contacts

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

Phone: 116 123 (24 hours a day, 7 days a week)
Address: Freepost SAMARITANS LETTERS
Email: jo@samaritans.org
Website: www.samaritans.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.

Phone: 0800 068 41 41
Text: 07860 039967
Address: Bankside 2, Crosfield Street, Warrington, Cheshire WA1 1UP
Email: pat@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.

Phone: 0300 304 7000
Textcare: www.sane.org.uk/how-we-help/emotional-support/textcare
Support Forum: www.sane.org.uk/how-we-help/sane-community
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.

Phone: 01708 765200
Email: info@supportline.org.uk
Website: www.supportline.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

C.A.L.M. (Campaign Against Living Miserably)
Their helpline and webchat are open 365 days a year, offering practical suggestions for all of life’s problems - whether that’s anxiety, relationship concerns, health worries, money worries or suicidal thoughts. Their staff listen, talk and help people struggling with life to make a plan, so they can begin to look to the future.

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

Silverline
Aimed at people over 55. The Silver Line operates a confidential, free helpline for older people across the UK. They also offer telephone friendship where they match volunteers with older people based on their interests, facilitated group calls, and help to connect people with local services in their area.

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

The Mix
Aimed at people under 25. They have a helpline and a crisis text service.

Phone: 0808 808 4994
Email: through the website.
Crisis text message service: Text THEMIX to 85258
Webchat: through the website.
Website: www.themix.org.uk

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

Phone: 0161 832 37 36
Email: info@moodswings.org.uk
Website: www.moodswings.org.uk

© Rethink Mental Illness 2022

Last updated July 2022
Next update July 2025

Version number 9

You can access a fully referenced version of this information by downloading the PDF factsheet by using the link at the top of this page.

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