This fact sheet will give some information about where to turn when you or a loved one are in mental health crisis. This is when you feel that you are at breaking point and require urgent care. You may feel frightened, desperate and unable to cope any longer, and you may be at risk of being hurt by someone else, hurting yourself or (less commonly) hurting others. Crisis situations can occur for people who have already been diagnosed with a mental health problem, or it may be their first episode.
Whatever the situation, it is important to ask for help. The sort of help you need might include someone to talk to for support or advice, medical help or a safe place to go to.
A printable PDF version of this factsheet can be found here.
For people needing help in a mental health crisis for the first time
Central and North West London (CNWL) NHS Foundation Trust
Single Point of Access Service
Tel: 0800 0234 650 | Email: email@example.com
The Single Point of Access service is the first point contact to access mental health services and is open 24 hours a day, 365 days per year. People can refer themselves or enquire on behalf of a family member or friend. Further details are provided below.
For people already using CNWL services
If you are already using CNWL services, your first point of contact should be the person you usually see, such as your Care Co-ordinator or named Lead Professional. If it is outside their office hours or you do not have their contact details, you can ring the CNWL Single Point of Access Service on 0800 0234 650. You should be provided with a crisis card with details of who to call in an emergency by the person you usually see.
For people needing to see someone immediately
If you are feeling suicidal and need help immediately, you can ask the CNWL Single Point of Access Service to refer you to the CNWL Home Treatment Rapid Response Team for a home visit. Alternatively, you can call 999 or visit the A&E at Northwick Park Hospital, particularly if you have harmed yourself in some way or feel you might.
If you want to talk to someone at any time
National Freephone Number: 116 123 (24 hours a day, 365 days a year)
If you are feeling distressed, desperate or suicidal and want to talk to someone in confidence, you can call the Samaritans. You can also email firstname.lastname@example.org if you do not need to talk urgently – they aim to respond to emails within 24 hours.
Tel: 020 8427 7777 (24 hours a day, 365 days a year)
You can also visit them in person between 10am and 9pm Sunday to Friday, 10am to 6pm Saturday, at 44 Station Road, Harrow, HA1 2SQ (almost opposite Harrow Civic Centre). There are disabled toilets and wheelchair access for visitors.
The Single Point of Access Service
The Single Point of Access (SPA) provides a first point of contact for people in Harrow, Brent, Hillingdon, Kensington & Chelsea and Westminster wishing to access adult community mental health services run by CNWL NHS Foundation Trust.
The Single Point of Access can be contacted for routine enquiries or emergency support 24 hours a day, 7 days a week, and 365 days per year. The SPA team consists of qualified clinicians who are knowledgeable about different services and options. The team provides advice and guidance and can book appointments for new clients to see the community mental health teams in Harrow.
People can contact the service themselves, or make enquiries on behalf of a family member or friend. The team will also take referrals from GPs, statutory services such as the police and London Ambulance service, and non-statutory services such as housing associations, as well as other professionals.
TypeTalk and other interpreting services
If you are deaf or have a hearing impairment, you can use TypeTalk to access SPA on 18001 0800 0234 650. If you would like to talk to the service in another language, SPA can organise a telephone interpreting service when you call.
Home Treatment Rapid Response Teams (HTRRT)
Home Treatment Rapid Response Teams are offered by CNWL and help avoid admission to a mental health in-patient ward by supporting people in acute mental crisis in their homes. The teams have doctors, nurses, social workers, occupational therapists and support workers who are available to support patients, carers and their families. The teams also help people who have been discharged from hospital as they make the transition back into the community, as well as providing a 24-hour service that can rapidly respond to urgent/emergency situations. Referrals should be made through the Single Point of Access (details above).
Help from your GP
If you, or a friend or relative are experiencing mental health problems for the first time and need emergency treatment or advice during office hours, then you can contact your general practitioner (GP). Your GP is your family doctor, the doctor you would normally see if you are ill or concerned about any aspect of your health. They will be able to refer you to the most appropriate mental health service in your area. If you don’t have a GP, use the NHS Choices service search to locate the nearest one to you: www.nhs.uk/Service-Search/GP/LocationSearch/4
Accident & Emergency (A&E)
The A&E department at Northwick Park Hospital in Watford Road provides 24hr treatment for urgent physical and mental health problems. In a medical emergency, for example if you or someone you know has been injured or taken an overdose, go to A&E as quickly as possible or phone 999 for an ambulance. A specialist team for mental health assessment called Liaison Psychiatry is available at A&E.
Calling the police
Call 999 and ask for the police if you are in a situation where you feel there is an immediate risk to life, limb or property. Be aware that this could lead to the police charging someone with a criminal offence.
Under Section 136 of the Mental Health Act 1983, the police also have the power to remove a ‘mentally disordered person’ from any public place if they believe that person needs immediate care or control, and to take them to a ‘place of safety’ for up to 72 hours, usually a police station or the Mental Health Unit. This is also known as being ‘sectioned’. A mental health assessment should follow as soon as possible.
If you are arrested, always consider asking for legal representation. If you are detained in a police station, the police should help you get in touch with a duty solicitor or a legal service of your choice. You may also get help and advice from an advocacy service – see our advocacy factsheet to find out more. If you are sectioned it is important to be aware of your legal rights, which are explained by Mind on the following webpage:
Emergency Duty Social Worker Team
020 8424 0999 (5pm to 9am every day)
An emergency duty social worker is on duty at all times out of hours to meet urgent needs that cannot wait until the next working day. When you call an operator will pass details over to the duty social worker, who will return your call as soon as possible and always within an hour. The social worker may give you advice and guidance on how to deal with the problem, refer the matter to the specialist service the next working day or arrange any immediate help necessary.
Duty Social Workers deal mainly with urgent difficulties with children and young people, child protection matters, older people who are at risk or who need immediate help, concerns about a person with a physical or sensory disability, urgent support for someone with mental ill-health or severe learning difficulties, Mental Health Act Assessments, vulnerable people in Police custody and homelessness.
Residential Crisis Services
You may feel that you need to be admitted to a residential service to help you deal with your crisis. Below are some local services that you or a mental health professional can refer you to. You can also ask to be admitted to hospital.
Rethink Recovery House Harrow (formerly known as The Harrow Assessment Unit)
Tel: 020 8861 3717 | Fax: 020 8861 1939 | Email: email@example.com
Recovery House offers residential support for up to six people, aged 18-65, with serious mental health problems. It works with the "recovery model" of mental health and promotes user involvement, self-management, choice and hope.
In addition to the six places mentioned above, there is a place reserved for someone in crisis expecting to stay for two to four weeks. If you wish to be referred, ask your keyworker or any member of the community mental health services you have contact with (e.g. consultant psychiatrist, community psychiatric nurse, social worker, etc.).
The Maytree, 72 Moray Rd, Finsbury Park, London, N4 3LG
Tel: 020 7263 7070 | Fax: 020 7272 6863 | Email: firstname.lastname@example.org
Maytree is “A Sanctuary for the Suicidal”. They offer a free 4-night/5-day one-off stay to adults over the age of 18 from across the UK. Their aim is to provide a safe, confidential, non-medical environment for guests. The service runs 24 hours a day, 365 days a year. You can self-refer or someone else can refer you; all contact is confidential and there is no pressure to take things further. If, after assessment, they cannot meet your needs, they will aim to refer you to someone else who can.
Being Prepared For a Crisis
In a crisis situation it can sometimes be difficult to know what to do and who best to contact. If you are worried about what might happen to you in a mental health crisis or you have already experienced a crisis and are concerned about going through something similar again, it may be useful to take steps to prepare yourself. From past experience you may already know what course of action is most helpful to you.
To plan in advance of a crisis you might consider the following:
- Who you would want to contact or be contacted on your behalf
- Where you might feel safest at a time of crisis
- What kind of treatment you might find helpful, and any treatment that you would not want to receive e.g. due to allergies or adverse reactions to medications
You may have difficulty expressing your needs and wishes during a crisis. Having information like this written down in advance may help you get the support you need.
Crisis Care Planning
If you currently have a care plan, it may be useful to include action to take and support you might need in the event of a mental health crisis. Even if you do not have a care plan written up in conjunction with mental health professionals, you may find it helpful to set out a crisis care plan for yourself.
An advance directive is a formal written statement of your consent or refusal to treatment, prepared in advance. For an advance directive to be legally enforceable certain rules must be followed including:
- You must be over 18 and ‘mentally capable’ at the time of writing the directive
- It should be signed by someone, preferably your doctor or other professional involved in your care, as witness that you are competent at the time
- The directive should state clearly and without doubt what your wishes are regarding treatment and in what circumstances you want them followed
- It should include your name, address, signature and the date it was written
The professionals involved in your health care should understand your wishes. A copy of the directive should be kept in your medical notes so that it can be followed in the case of a mental health crisis. Although your wishes should always be considered, an advance directive can be overruled in some circumstances, including if you are detained under some sections of the Mental Health Act 1983.
Links for further information
National Mind – Information and support about crisis services
National Mind – Information and support about suicidal feelings
Samaritans – 'I am worried about a friend. What can I do?'
Rethink – 'Getting help in a Crisis' (Advice for Carers)
Rethink – information on the Mental Health Act 1983
Last updated 27/07/16