Dealing with a mental health crisis or emergency
Everybody will have a different experience of a mental health crisis or emergency, but in general, this happens when you feel you cannot cope or be in control of your behaviour. You may feel very upset and distressed, or feel numb, like there is too much stress in your life at the moment and you cannot cope with your normal day-to-day activities, or that you need to use drugs or alcohol in order to cope. It may feel that no one will understand what is happening for you, or cannot help – these are normal feelings in a crisis but it is important to remember that there is help out there. You may feel that it will never feel better and nothing will help – this can go along with feeling in crisis, but these feelings will always pass, and you can feel better. Whatever the cause, if you feel unsafe or that you cannot cope, you need to seek help and assistance immediately.
You may want to call a friend or family member to be with you so that you are not seeking help on your own. They can even call people on your behalf, but any professionals will probably want to you to tell them it is OK for them to speak on your behalf. Sometimes it can be helpful to be somewhere else, such as a friend’s or family member’s house, when you are feeling overwhelmed.
If you have had a crisis before, or are worried that you are getting to the point where you cannot cope, it can be helpful to make a plan of what to do so you are prepared. Friends and family members can be helpful here, as they may be able to see signs that you are not noticing or call for help when you feel you cannot. Agree with them what signs mean you need help, what they should do, and what kind of treatment you would want. You can do this in writing, or you may want to write out some kind of statement that gives them permission to seek help for you or discuss your difficulties.
Advance statements. This includes any written statement you make about what you would like to happen if you lose capacity to make a relevant decision. Advance statements are not legally binding, so health professionals aren’t necessarily required to follow them, but they should carry out your wishes wherever possible. Joint crisis plans and crisis cards are both types of advance statement.
- Advance decisions (also known as an ‘advance directive’ or ‘living will’). These are a type of advance statement which clearly sets out any medical treatments you do not want to receive. They are legally binding, so a health professional must comply with your advance decision (except if the type of treatment you have refused relates to your mental health problem and you are currently sectioned under the Mental Health Act).
The charity Mind offers information about how to plan for a crisis.
If you have mental health support at the moment, you may want to develop a safety plan with those who support you, detailing what you will do if you feel you are in crisis. You could also write a joint crisis plan with your care coordinator.
The National Institute for Health and Care Excellence (NICE) recommends that a joint crisis plan should include:
- Information on early warning signs of a crisis.
- What support you have to help you manage your crisis at home.
- Where you’d like to go, if you need to be admitted to hospital.
- Arrangements for childcare if you’re admitted to hospital.
- Advance treatment statements, including your preferences.
- Any family members you’d like to be contacted.
- Contact details for your care team.
- Information about 24-hour access to services.
You could also include:
- Details of any medication you take.
- Psychiatric and physical diagnoses.
Types of service that can help
Listening services (telephone support)
These are helpful if you need to talk to someone right away about how you feel.
Emergency GP Services
Your GP will be able to refer you for help if you need urgent support for your mental health.
Crisis Resolution and Home Treatment Teams
These teams can provide urgent support to get you through your crisis. You will need to be referred by your GP or mental health staff in other crisis services.
If you need immediate help, especially if you feel you might act on suicidal thoughts, or you have harmed yourself and need medical attention.
These teams work at hospitals to help support the medical staff by evaluating your mental health needs and making referrals and recommendations about treatment.
Helpful if you feel you need advice on what to do next.
Day Treatment Programmes
These services can offer extra support to get you through your crisis.
These are helpful if you need more support than can be offered in your home, but are not eligible for hospital admission.
If you need ongoing intensive support and your needs are more than can be dealt with in the community.