Crisis services

A guide explaining what mental health crisis services are available, how they can help and when to access them. Also provides guidance on how you can plan for a crisis.

Your stories

In crisis: my experience

In time for the release of the CQC's Mental Health Act report,Claire blogs about her experience of crisis care

Claire
Posted on 28/01/2014

How going to A&E helped me

Caroline blogs about how a visit to A&E helped her to realise she needed help.

Caroline
Posted on 27/11/2013

What can I do in an emergency?

For all serious medical emergencies (including mental health emergencies), your options for getting face-to-face medical help quickly are:

Remember: If you don't feel you need to go to A&E, but you need medical help or advice fast and can't wait for an emergency GP appointment, you can call NHS 111 (in England) or NHS Direct (in Wales).

Accident & Emergency (A&E)

A&E departments are where the most serious and urgent medical emergencies are treated. If you're experiencing a mental health emergency, it's absolutely vital to take it as seriously as you would if you had a physical health emergency.

When should I use this service?

When you feel unable to keep yourself safe and you need immediate help – especially if you think you are at risk of acting on suicidal thoughts, or you have seriously harmed yourself and need medical attention.

How can it help me?

If your A&E has a psychiatric liaison team, they can:

  • make an initial assessment of your mental health needs (sometimes called a psychiatric evaluation)
  • keep you safe for the short-term
  • prescribe medication to you help cope with some symptoms you may be experiencing right now
  • put you in contact with other crisis services, such as your local crisis resolution and home treatment (CRHT) team, if appropriate

If there is no psychiatric liaison team, the A&E staff can call a local on-call mental health service to assess you, such as the CRHT team, though they may take a while to arrive.

Based on this assessment the care team will decide whether you can go home (sometimes being supported by the local CRHT team), or if you need to be admitted to hospital.

Most of the guys at my local crisis team are brilliant. Even when they've already seen me in A&E three times that week it still feels as important.

How can I access this service?

You can:

  • Take yourself directly there (if it's too far to walk you could take public transport, call a taxi, or ask a friend to give you a lift).
  • Call 999 if you need an ambulance.

Remember: A&E can be a difficult place to be in. If you can, ask a friend or family member to go along with you for some extra support. You might have to wait a while before a doctor can see you, so it can be helpful to have someone waiting with you.

I did take myself to the crisis team at A&E and got some help, [although I was] left to sit on my own for 2 hours. [After waiting] I was put in touch with the right people – they came to see me while I was there and I had a psych evaluation.

Emergency GP appointments

Your local GP surgery should be able to offer you an appointment to see a doctor quickly in an emergency.

When should I use this service?

When you need urgent support for your mental health, but you feel able to keep yourself safe for a short while until your appointment.

How can it help me?

An emergency doctor at your regular GP practice can:

  • access your medical notes, so you shouldn't need to explain your medical history from scratch
  • make referrals if you both decide that you need more support right now to help you deal with the crisis you're going through – for example to a CRHT team or potentially for hospital admission
  • provide information and advice, for example about any other local services which you could access yourself
  • prescribe or adjust medication, which might help you cope with some symptoms you're experiencing.

An emergency appointment is likely to be with the next available doctor, so depending on the size of your GP practice, you might not be able to see your regular GP in an emergency. But it's a good idea to make a follow-up appointment with your regular GP for as soon as possible after seeing an emergency GP, so they can:

  • help you put into practice self-management techniques that have worked for you in the past
  • plan to see you more regularly while you're feeling in crisis, so they can adjust your treatment if anything changes

Also, if your regular GP is someone you have a good relationship with, you might find it very reassuring in a crisis to have an appointment to see them as well.

If it wasn't for my GP insisting on continuing to see me once a month and actually saying that she enjoys seeing me, I would not still be here.

Even if you don't feel in crisis, but you feel your mental health is deteriorating, it's a good idea to talk to your GP as soon as you can; they may be able to help you find support and treatment before it becomes a more serious problem.

(See our pages on seeking help for a mental health problem for more information about how to talk to your GP, and how to get the most out of a GP appointment.)

How can I access this service?

You should contact your surgery directly. All surgeries operate their own booking systems with their own rules.

If you need to speak to a GP after the surgery closes, most surgeries should be able to direct you to an out-of-hours services (either via their answering machine message or on their website), although this might be run by a different service.


This information was published in September 2015. We will revise it in 2018.


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