Mental Health
For immediate danger, call 999 or go to A&E. For an urgent mental health crisis in England, call 111 and choose the mental health option; NHS England says this provides 24/7 access to crisis mental health support.
Understanding mental health
Mental health affects thoughts, emotions, behaviour, relationships, learning, work, sleep, confidence and physical health. Mental health difficulties are common and can affect children, young people, parents, carers and adults at any age.
NHS mental health services can support people with anxiety, depression, trauma, OCD, eating disorders, self-harm, suicidal thoughts, psychosis, bipolar disorder, personality disorder symptoms, and severe or complex mental illness.
Common conditions
Anxiety can include constant worry, panic attacks, health anxiety, social anxiety, phobias, school avoidance, sleep problems, stomach symptoms, racing thoughts and avoidance.
Depression can include low mood, loss of interest, tiredness, hopelessness, sleep or appetite changes, poor concentration, guilt, withdrawal, self-harm thoughts or suicidal thoughts.
PTSD can happen after trauma. Symptoms may include flashbacks, nightmares, avoidance, feeling unsafe, anger, numbness, guilt, panic and being constantly on alert.
OCD involves unwanted intrusive thoughts, images or fears, and compulsions such as checking, washing, reassurance-seeking, counting, repeating or mental rituals.
Bipolar disorder involves episodes of depression and episodes of mania or hypomania, such as very high energy, reduced sleep, impulsive behaviour, risky decisions or feeling unusually powerful.
Personality disorders describe long-term patterns of emotional distress, relationship difficulties, identity problems, impulsivity, fear of abandonment, self-harm or intense mood changes. People should still be treated with dignity, respect and evidence-based support.
Eating disorders can include anorexia, bulimia, binge eating disorder, ARFID and other serious eating problems. Warning signs include rapid weight change, food restriction, bingeing, purging, fear of weight gain, excessive exercise, secrecy, fainting, missed periods, digestive problems or obsessive food rules.
Self-harm means hurting yourself as a way of coping with distress. It should always be taken seriously, even if the person says they do not want to die.
Suicidal thoughts are a medical and safeguarding concern. If there is immediate risk, call 999.
Crisis services
Use crisis help when someone:
- may harm themselves or someone else
- has taken an overdose
- has attempted suicide
- is hearing voices telling them to harm themselves or others
- is extremely distressed, unsafe, confused or unable to cope
- has severe self-neglect
- is experiencing mania, psychosis or severe agitation
- cannot be kept safe at home
For urgent but not life-threatening mental health help, call 111 and choose the mental health option. NHS 111 online can also guide people who need medical help now.
Talking therapies
NHS Talking Therapies supports adults in England with anxiety disorders and depression. It can include CBT, guided self-help, counselling, group therapy, online therapy, video, phone or face-to-face support. Many areas allow self-referral without seeing a GP first.
CAMHS / children and young people
Children and Young People’s Mental Health Services support young people with low mood, anxiety, eating disorders, self-harm, trauma, bullying, grief, behaviour difficulties, unusual experiences, and other mental health needs.
Parents and carers can ask for help through:
- GP
- school or college
- school nurse
- health visitor
- NHS 111 in crisis
- CAMHS / CYPMHS
- local authority early help
- safeguarding team if there is risk of harm
Schools and colleges are expected to promote mental health and wellbeing using a whole-school approach, including leadership, staff training, curriculum, student voice and identifying need.
Adult mental health services
Adult services may include:
- GP mental health support
- NHS Talking Therapies
- community mental health teams
- crisis resolution and home treatment teams
- psychiatric assessment
- medication reviews
- perinatal mental health services
- eating disorder services
- drug and alcohol services
- social care support
- supported housing or employment support
- inpatient care where needed
Legal rights
Patients have rights under the NHS Constitution, including access to NHS services, dignity and respect, involvement in decisions, informed consent, confidentiality, access to records, and the right to complain.
Mental health care may also involve:
- Mental Health Act 1983: assessment, detention and treatment in hospital in specific circumstances.
- Mental Capacity Act 2005: decision-making support when someone may lack capacity.
- Equality Act 2010: protection from disability discrimination and a duty to make reasonable adjustments.
- Children Act 1989/2004: safeguarding and welfare duties for children.
- Human Rights Act 1998: rights to life, liberty, family life, dignity and protection from inhuman or degrading treatment.
Accessible support
You can request:
- interpreter
- BSL support
- Easy Read information
- large print, Braille or audio
- quiet waiting area
- longer appointment
- advocate or supporter
- trauma-informed care
- reasonable adjustments for autism, ADHD, learning disability, anxiety, sensory needs or communication needs
- parent/carer involvement where appropriate
- written care plan and crisis plan
Evidence standards and accountability
Keep clear records of:
- symptoms and risks
- self-harm or suicidal thoughts
- crisis contacts
- GP and CAMHS referrals
- waiting times
- school attendance and behaviour changes
- medication and side effects
- safeguarding concerns
- letters, emails and care plans
- names, dates and decisions
Ask services for:
- written assessment outcome
- risk assessment
- care plan
- crisis plan
- referral confirmation
- medication plan
- discharge plan
- review date
If care is unsafe or delayed, raise it with the service manager, GP, CAMHS duty team, crisis line, PALS, the NHS trust complaints team, or the Parliamentary and Health Service Ombudsman.
Practical advice
Ask these questions:
- What is the working diagnosis?
- What risks have been identified?
- What treatment is being offered?
- What should we do if things get worse?
- Who is the named professional?
- Is there a crisis plan?
- Is this referral urgent?
- What are the waiting times?
- What support is available while waiting?
- What reasonable adjustments can be recorded?
Official NHS and GOV.UK links
- NHS mental health services: https://www.nhs.uk/nhs-services/mental-health-services/
- Urgent mental health help: https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/
- NHS 111 online: https://111.nhs.uk/
- NHS Talking Therapies: https://www.nhs.uk/tests-and-treatments/talking-therapies/
- NHS England Talking Therapies: https://www.england.nhs.uk/mental-health/adults/nhs-talking-therapies/
- Children and young people’s mental health services: https://www.nhs.uk/mental-health/children-and-young-adults/mental-health-support/mental-health-services/
- GOV.UK school mental health guidance: https://www.gov.uk/guidance/promoting-and-supporting-mental-health-and-wellbeing-in-schools-and-colleges
- NHS complaints: https://www.nhs.uk/contact-us/how-to-complain-to-the-nhs/
- NHS Constitution: https://www.gov.uk/government/publications/the-nhs-constitution-for-england
Best rule: take risk seriously, ask for help early, keep records, request reasonable adjustments in writing, and use 111/999 immediately if safety is at risk.