I or Someone I Love Is in a Mental Health Crisis

If someone has taken an overdose, is actively trying to harm themselves, or has used a weapon to harm themselves, call 999 for an ambulance. If they are violent or there is immediate danger to others, ask for police as well. Tell the call handler clearly that this is a mental health emergency — do not be afraid to use the word "suicidal" if that is the situation. Ambulance staff have the same duty of confidentiality as any other NHS clinician, and reaching A&E starts the formal mental health response.

Since 2024 every NHS region has a 24/7 mental health crisis line accessed via NHS 111, option 2. The line is staffed by mental health practitioners (not GPs or general 111 staff) and can: assess the situation, connect you to a local Crisis Resolution and Home Treatment Team (CRHT), arrange a face-to-face crisis assessment, signpost to crisis cafes, sanctuaries or peer support, and arrange medication review out-of-hours. This is faster than waiting for a GP appointment and avoids A&E in many cases.

CRHTs are NHS multi-disciplinary teams that visit you at home, often within hours, and provide intensive treatment as an alternative to hospital admission. They can prescribe and deliver medication, monitor your safety overnight by phone or visit, refer for inpatient admission if needed, and stay involved for 2-6 weeks. Access is through NHS 111 option 2, your GP, or A&E. If a CRHT visits and decides admission is needed, they coordinate it directly with the local mental health trust — you do not need to go via A&E.

All A&E departments have a mental health liaison team available 24/7. After the initial triage (medical issues like overdose treated first), you will be assessed by a psychiatric nurse or doctor, usually within 4 hours of triage. They will decide whether you need: discharge with a community follow-up, referral to the local crisis team, or admission to an acute mental health ward. A&E is not the ideal environment for a mental health crisis but is the legal pathway for many compulsory assessments. Bring a trusted person if you can — they can stay with you and advocate.

Sectioning means being detained for assessment or treatment under the Mental Health Act 1983. The most common sections are: Section 2 (28-day assessment), Section 3 (6-month treatment, renewable), Section 4 (72-hour emergency), and Section 136 (24-hour police place-of-safety). You have the right to: an Independent Mental Health Advocate (IMHA), free legal aid for a Mental Health Tribunal hearing, an appeal to the Tribunal (once per Section 2 detention; once per Section 3 detention period), and free aftercare under Section 117 once discharged (if detained under Section 3).

If you are the nearest relative (as defined by section 26 MHA — usually husband/wife/cohabitee, then child, parent, sibling in age order), you have specific rights: to be consulted before a Section 3 detention (and you can object, which prevents it unless displaced by court order), to discharge the person under Section 23 (giving 72 hours' notice — the consultant can block this but only by certifying continuing dangerousness), to request a Mental Health Act assessment if you believe the person needs detention, and to receive certain information about the patient's status. If you are a carer (not the nearest relative), you also have rights to a Carer's Assessment under the Care Act 2014.

Section 117 aftercare applies for life after Section 3 detention — free care services, jointly arranged by the NHS and council. For people not under Section 117, request a referral to your local Community Mental Health Team (CMHT) for ongoing support. Care plans should follow the Care Programme Approach (replaced in many trusts by Dialog+ from 2023). Free peer support: Mind (0300 123 3393), Rethink Mental Illness (0300 5000 927), Samaritans 24/7 (116 123), SHOUT text 85258. Plan for next time — a Wellness Recovery Action Plan (WRAP) and an advance choice document spell out your wishes if you become unable to communicate them.