Maybe you have had an experience of what this looks like.  Or, maybe you haven’t?

The key word to have in mind if you see or feel unsure about someone in a mental health emergency is: SAFE.

Phrases for a mental health emergency:

ARE YOU SAFE?

ARE OTHERS SAFE AROUND YOU?

IS THE PERSON YOU ARE WORRIED ABOUT SAFE IF THEY ARE ON THEIR OWN?

If the person/you do not feel safe in public:

You may see in the street someone looking very unwell, paranoid, distressed, preoccupied or expressing worrying signs of mental disturbance.  The person may appear aggressive, you may want to cross the street away from this person?  Is the person shouting nonsense?  Is there behaviour erratic?

You may have seen it and I think it’s important that people know where they can get help.  You may see any of the above in a gym setting, walking down the road, on a bus as well as at the bus stop.  Mental health does not discriminate and people who have a mental health diagnosis or struggle with mental health difficulties need to use the gym’s and public services too (and it’s helpful to do so!)

Call 999 or 101.

  1. Say you have walked past/seen a person displaying concerning behaviour (agitation, aggression, shouting, irratic).
  2. Tell the police that you felt threatened? You crossed the street as you were concerned.
  3. Tell the police what they are wearing.
  4. Tell the police they need help as you are not sure they are safe.

Why ask for police not an ambulance?

Ideally if things are really concerning, an ambulance will take someone to A&E, however, police are trained and have powers to take people to A&E also (a safe place).  Police can restrain a difficult person in the street, ambulance staff will not.

Greatful to be in the UK.

I was in New York one New Year and as I was looking up towards Times Square from the Lower East Side with an old school friend, we could see the haze of the impending ball dropping. A guy walked towards us and in my view (being an experienced mental health professional) I thought that he was likely to have a mental health diagnosis – schizophrenia based on his behaviour that I have worked with a lot. He wanted to talk to my friend but as he did, he could hear her British accent. The guy became confrontational and my instinct was to minimize the conversation to avoid a difficult potentially dangerous situation. On the other hand, my friend was trying to be kind and placate the guy (we all manage situations differently!)

We managed to convince the guy to walk on and escaped into my friends apartment building.  While in the middle of New York, I knew if I called the police, this guy would end up in a police cell and maybe in prison for a long time. Awful. No medical insurance, no medical help for a mental illness.

In the UK however, we are incredibly lucky that our ambulance and police services are trained to understand mental health at least a bit.

Tell them that I was concerned about the mental health of this person in the street and I could not predict if they might cause harm to themselves or others in their ongoing journey. This guy could do with a medical assessment and a bit of help.

You do not feel safe –

There is a hierarchy of advice here and some people disagree with how I view the order in which to seek out help.

If you or someone in your immediate family does not feel safe and needs help immediately:

  1. Call 999.
  2. Tell 999 that you/family do not feel safe and need to go to a safe place (hospital) for a mental health assessment.
  3. Call help lines while you wait for help

Help lines

https://www.giveusashout.org

https://www.samaritans.org

https://www.kooth.com

https://www.pandasfoundation.org.uk

https://calmharm.co.uk

Calling for help does not mean hospital.

I have called 101/999 many times.  Most of the time, despite me telling the call operator that I am a mental health professional and feel that I know what I’m talking about, it can not be an easy conversation to have.  I have at times felt that my concerns are not being taken seriously.  I have in fact been told that what I am saying is ‘urgent’ is in fact not urgent.  So I do understand people’s reluctance to call for help when the person on the other end doesn’t seem to understand.

In the UK we are incredibly lucky to have the https://nhs.uk/using-the-nhs/nhs-services/mental-health-services/.

Calling for help or going to A&E does not mean you will end up staying in hospital.  Hospital staff do not want to send any one to a psychiatric unit unnecessarily.  Community mental health services exist to support people out of hospital.

Do not be afraid of what will happen when you get there as psychiatrists and mental health nurses should be kind and compassionate.  They have seen it all before.  They are experienced in understanding what is going on.  Just like the helplines can support you on your way to the hospital to talk, NHS staff want to hear how hard things are for you.