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

Could I get care in hospital?

Why might I need to go to hospital?

When we’re experiencing a mental health crisis, sometimes being in hospital is the best way to keep ourselves safe and make sure we get the level of treatment we need.

A doctor might recommend that you be admitted to hospital if:

  • you need to be admitted for a short period for further assessment
  • there’s a risk to your safety, for example if you are severely self-harming or at risk of acting on suicidal thoughts
  • there’s a risk of harm to other people
  • there isn’t a safe way to treat you at home
  • you need more intensive support than can be given to you at home

[The crisis team] admitted me to a hospital 20ish miles away [from where I live]. After three weeks in there I was sent home, and they visited every few days for two weeks until I got a CPN (community psychiatric nurse).

How does treatment work in hospital?

Hospital wards should:

  • offer appropriate care
  • offer treatment and activities
  • be safe and secure
  • use the minimum amount of restriction necessary to keep you and others safe

The care team should begin your care by creating a care plan for you – a written record that outlines your care and treatment. You have a right to be involved in creating your care plan, so the team should consult you about what goes in it.

Your care plan will name one person who will act as your care coordinator – this will be one of the mental health professionals involved in your care. Your care coordinator should then work with you to create a care plan for when you leave hospital.

Is hospital treatment right for me?

Your experience of being treated in hospital can depend on:

  • the hospital you go to
  • what kind of treatment you receive
  • your personal feelings about being in hospital

Some people feel much safer and more secure in hospital than at home, but others find it very difficult.

Potential advantages

Potential disadvantages

  • your mental health problem is being properly recognised by mental health professionals, and you're likely to have access to a range of talking treatments and medication that could help you feel better
  • there are trained staff are around to protect you when you feel like you want to hurt yourself or others, and the environment is designed to minimise your opportunity to act on these kinds of feelings
  • you might feel like you're getting a break from the problems you have at home
  • it can provide structure in your day and make sure you have people around you
  • you can't always decide what you do, so there might be times when you get very bored or have to do activities you don't enjoy
  • you don't have all your own comforting things around you, such as your familiar bed from home
  • you won't be able to have your family or friends near you whenever you like
  • you can't always leave when you want to
  • nearly all hospitals have single-sex sleeping accommodation, but some may have mixed facilities during the day, which you might find difficult

If you're making a decision about going into hospital, or are currently staying in hospital, you might want to think about these things to help you evaluate the quality of the service:

  • ward size and occupancy rates – how many in-patients are there at any one time, and how many staff are available to look after you?
  • ward environment – does the ward feel like a safe and therapeutic space to be in?
  • access to therapy – what kinds of different therapies are you offered, and how frequently are they provided?
  • patient involvement – do staff involve you in decisions about your treatment and communicate with you in a way that makes you feel informed and empowered?
  • cultural sensitivity and respect – do staff show equal respect for all patients regardless of your ethnicity, religion, gender, sexuality, age etc.? At the same time, do they recognise and show sensitivity for any factors in your social or cultural background which might be impacting on your mental health?

Hospital wards aren't all the same, and unfortunately, not everyone's experience of hospital treatment is positive. If you have a really bad experience with your hospital treatment and want to complain, see our pages on complaining about health and social care.

In psychiatric units, [I find] the most successful ones are those that organise activities for the patients, get us involved in our care, and take time out to actually listen to us, to our needs, and even just be someone to listen to us when we’re feeling down.

How do I get admitted to hospital?

If you think that a stay in hospital would help you, then you can ask your GP, psychiatrist or other mental health professional to refer you. If you choose to go into hospital, you are considered a voluntary patient (or informal patient). This means that:

  • you should have the right to to come and go from the hospital (within reason)
  • you may discharge yourself if you decide to go home

However, unfortunately in many areas there is a shortage of beds available so it might not always be possible for you to be treated in hospital, even if that's what you want.

About locked wards

Locked wards are a kind of hospital ward where you can't come and go freely. This is to keep you, and other people, safe.

  • The doors may be physically locked, or you might need to get permission to leave the ward.
  • Some wards might only be locked at certain times, but others may be locked all the time.
  • Some locked wards have access to a secure outdoor space like a garden or courtyard.

On most psychiatric wards there will be a mixture of voluntary patients and others who are sectioned (detained under the Mental Health Act). Health services have an equal duty to keep all these patients safe. Because of this many psychiatric wards are locked, so if you are in hospital by choice you might feel like your freedom is more restricted than you would like.

Could ever I be forced to go to hospital?

If a group of mental health professionals agree that hospital treatment would be in your best interests to keep you or others safe, then they could detain you in hospital under the Mental Health Act (sometimes called being sectioned) – even if you don't want to be there.

This is a very serious process, and there are lots of rules and restrictions about when you could be sectioned. See our pages on sectioning for information about the circumstances in which you can be sectioned, and about your legal rights.

What happens when I leave hospital?

There are some differences in what happens when you leave hospital depending on whether you are a voluntary patient or have been detained under the Mental Health Act.


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


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