You are here:

A guide to mental health services in England

Dealing with a mental health crisis or 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 great emotional distress or anxiety, can’t cope with day-to-day life or work, think about suicide or self-harm, or experience hallucinations and hearing 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. Here's some info on the symptoms of dementia.

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 cause of action and stop you getting worse.

 

Where can I get help?

If you've already been given a Crisis Line number from a health professional, call it.

If you are under the care of a mental health team and have a specific care plan that states who to contact when you need urgent care, follow this plan. The charity Mind offers information about how to plan for a crisis.

The Samaritans operate a free to call service 24 hours a day, 365 days a year, if you want to talk to someone in confidence. Call them on 116 123.

You can also find local crisis support services on this site.

Contact NHS 111

You can call NHS 111 if you or someone you know requires urgent care, but it is not life-threatening. For example: 

  • if you have an existing mental health problem and your symptoms get worse
  • if you experience a mental health problem for the first time
  • if someone has self-harmed but it does not appear to be life-threatening, or is talking about wanting to self-harm
  • if a person shows signs of onset dementia
  • if a person is experiencing domestic violence or physical, sexual or emotional abuse 

Book an emergency GP appointment

Alternatively, contact your GP practice and ask for an emergency appointment. Your practice should be able to offer you an appointment in a crisis with the first available doctor.

For more information, see:

Visit A&E or call 999

A mental health emergency should be taken as seriously as a medical emergency.

Call 999 if you or someone you know experiences an acute life-threatening medical or mental health emergency.

You can go to A&E directly if you need immediate help and are worried about your safety. You may be close to acting on suicidal thoughts or have seriously harmed yourself.

Once at A&E the team will tend to your immediate physical and mental health needs. Many hospitals now have a liaison psychiatry team (or psychological medicine service) which is designed to bridge the gap between physical and mental healthcare. Learn more about this service in the glossary section.

If this service is not available, the A&E team will contact the local on-call mental health services, such as the crisis resolution and home treatment teams (CRHTs). See more details in the box below.

The team in charge of your care will assess you, decide on the best course of care, and whether you can go home or need to be admitted to hospital.

 

When to contact social services?

If you have urgent concerns about someone's social circumstances, such as children and young people, vulnerable adults or people with learning difficulties, it may be more appropriate to call social services. Local government services such as housing services and social care services often run out-of-hours duty provision. Search for your local council to find out how your social care service deals with emergencies out of office hours.

Social care services may also be involved in the assessment of people in crisis through the legislation of the Mental Health Act.

 

What are crisis resolution and home treatment services (CRHT)?

CRHTs treat people with severe mental health conditions who are currently experiencing an acute and severe psychiatric crisis that, without the involvement of the CRHT, would require hospitalisation. Psychotic episodes, severe self-harm and suicide attempts are examples of acute mental health crises.

Because of the nature of their work, CRHTs offer a 24-hour service, and cases are often referred to them through A&E departments or the police service.

CRHTs will usually review a person in their own home, but they may also see people in other community settings, such as dedicated crisis houses or a day centre. They may also see people who are in psychiatric hospitals and are ready to go on leave or be discharged. CRHTs will help them manage getting back into the community, as people can be particularly vulnerable in the time shortly after leaving hospital.

CRHTs are also involved in the planning of care for someone who has had a crisis to prevent any relapse in the future. This will usually involve working with the local community mental health team.

What are crisis houses?

Crisis houses offer safe short-term accommodation and support to people experiencing a mental health crisis. They are used when home treatment is not suitable, or as a short-term alternative to hospital admission.

Crisis homes usually have a small number of beds. They generally offer support for a particular group of people, such as people in danger of committing suicide or vulnerable people from black ethnic minority communities.

Some crisis houses accept self-referrals, but referrals are often taken from secondary mental health services.

Page last reviewed: 26/04/2016

Next review due: 26/04/2019