Something I often notice in my work as a Clinical Psychologist is just how much effort people have already been putting into managing their difficulties, often long before they reach out for professional help. They might have spent years trying to keep themselves functioning, looking after everybody else, managing difficult feelings and finding ways to get through each day.
Sometimes, though, there’s a point where those ways of coping aren’t enough anymore. Perhaps something has happened that has made life particularly difficult, or they’ve been struggling for so long that they’re exhausted by the effort it takes just to get through an ordinary day.
For some people, this can develop into a mental health crisis. They might be experiencing overwhelming anxiety, hopelessness, thoughts about suicide or urges to harm themselves. For others, it’s less obvious. They may simply have a growing sense that something isn’t okay anymore, but struggle to understand what they need or where to turn.
One of the things I think is particularly difficult is that you might already know a great deal about your mental health. You may have learned coping strategies, attended therapy or spent years trying to understand your difficulties, yet find that when things become particularly overwhelming, that knowledge is much harder to access.
Sometimes we need another person to help us manage what’s happening, particularly when we’re struggling to think clearly or work out what to do next.
In this article, I’ll explain where you can find help during a mental health crisis, what you might expect when contacting crisis services and some ways of communicating what you need, particularly if you’ve previously struggled to access appropriate support.
Where to Get Help During a Mental Health Crisis
If you’re struggling to keep yourself safe, please don’t feel that you need to read through this article before asking for help.
For urgent mental health support in England, call NHS 111 and select the mental health option. This service is available 24 hours a day and can help you access an appropriate assessment or support. You don’t need to be suicidal or already receiving mental health treatment to contact them.
If there is an immediate threat to life, call 999. If you’ve taken an overdose, sustained a serious injury or need immediate emergency medical treatment, call 999 or attend A&E.
If you need somebody to listen, call Samaritans on 116 123. They’re available 24 hours a day, and you don’t have to be suicidal to speak to them.
If you’d rather communicate by text, text SHOUT to 85258. Shout provides free, confidential text-based mental health support, 24 hours a day.
Mental Health Support in Leicester, Leicestershire and Rutland
If you live locally, Leicestershire Partnership NHS Trust provides information about urgent mental health services and other support available in the area.
You can call NHS 111 and select the mental health option for urgent mental health help. There is also a local text service on 07480 635199, which aims to respond within four hours and isn’t suitable for emergencies.
Neighbourhood Mental Health Cafés provide additional support at various locations, with opening times depending on the service.
For people aged 11 and over in Leicester, Leicestershire and Rutland, Tellmi provides moderated digital peer support and access to further support where available. This is an option for less urgent difficulties rather than an emergency crisis service.
You can find current local information on the Leicestershire Partnership NHS Trust website.
How Do I Know Whether I’m Having a Mental Health Crisis?
I think the word crisis can sometimes make people feel that things have to be at their absolute worst before they’re entitled to ask for help. But people experience mental health crises in different ways, and you don’t have to be experiencing suicidal thoughts to need urgent support.
You might be experiencing intense anxiety, panic, overwhelming emotions or difficulty managing things that would ordinarily feel straightforward. You might be frightened by your thoughts or behaviours, or finding that the things you usually rely on to get through difficult periods aren’t helping.
Sometimes it can be less obvious to other people. You might still be going to work, looking after your family and doing everything that needs to be done, while privately feeling that you’re barely holding things together.
There isn’t a single point at which somebody suddenly becomes entitled to ask for help. If you’re concerned about your safety, frightened by what’s happening or feeling that you cannot manage things on your own, that’s a good reason to reach out. You don’t need to know exactly what kind of support you need before making contact.
What Happens When You Contact a Mental Health Crisis Service?
One of the things that can make asking for help particularly difficult is not knowing what’s going to happen once you make the call. You might be worried about being judged, not being taken seriously or losing control over what happens next.
When you contact NHS 111 for mental health support, the professional you speak to will usually want to understand what’s happening and how safe you are. They may ask about suicidal thoughts, self-harm, your current circumstances, what support you have around you and what you’ve already tried.
I think it’s important to be as open as you can about how difficult things have become, even if some of what you’re experiencing feels frightening or embarrassing to talk about. People sometimes minimise their difficulties because they’re worried about what might happen if they’re completely honest, but explaining what’s actually happening helps professionals understand what level of support may be needed.
Depending on your circumstances, you may be offered advice, referred for further assessment or helped to access a specialist mental health service.
What Does a Mental Health Crisis Team Do?
Something that can be reassuring to understand is that mental health crisis services aren’t simply there to decide whether somebody needs to go into hospital.
The NHS has specialist services known as Crisis Resolution and Home Treatment Teams, which assess and support people experiencing severe mental health difficulties. Where appropriate, they can provide intensive support in the community, sometimes helping somebody remain safely at home rather than needing hospital admission.
Depending on your needs and local arrangements, this might involve regular contact with professionals, home visits, medication review, involving people you trust or developing a plan for managing the immediate situation.
Not everybody who contacts NHS 111 will be referred to a specialist crisis team. These services have eligibility thresholds, and an assessment will consider the severity and urgency of your difficulties, your safety and what support is available.
Sometimes hospital admission is necessary, but community-based crisis treatment is an established part of NHS mental health care, and admission isn’t automatically the next step when somebody is struggling.
Will I Be Sectioned If I Tell Somebody I’m Feeling Suicidal?
This is something that understandably frightens people, particularly if they’ve previously had experiences of mental health services that left them feeling powerless.
Having suicidal thoughts does not automatically mean you’ll be sectioned under the Mental Health Act.
Compulsory detention is a significant intervention involving specific legal criteria and a formal assessment process. Professionals consider the nature and degree of the mental health difficulties, whether hospital detention is necessary and the person’s health, safety or the protection of others. It isn’t determined by a single risk score or a fixed period of time before somebody might come to harm.
Depending on the circumstances, there may be appropriate alternatives involving community services or other support.
If you’re frightened about what might happen, you can explain those concerns to the professional you’re speaking to and ask what they’re considering, what alternatives may be available and how you can be involved in decisions about your care.
You can read more about the Mental Health Act and your rights on the NHS website.
What If Asking for Help Hasn’t Gone Well Before?
I think one of the difficult things about reaching out during a mental health crisis is that you’re often hoping somebody will really understand what’s happening for you, particularly when you’ve already spent so long trying to manage things yourself. And sometimes that isn’t the experience you have. You might find yourself being offered suggestions you’ve already tried, feeling that the complexity of what you’re experiencing hasn’t been understood, or being passed between services without getting the help you need.
For some people, this isn’t an isolated experience. They may have repeatedly tried to access support and been left feeling dismissed or misunderstood. I can understand why that might make it incredibly difficult to reach out again, particularly when you’re already feeling vulnerable. We also know that, for people who have experienced trauma, feeling powerless or unheard can sometimes reactivate earlier experiences and make an already difficult situation even more distressing. Although mental health services are increasingly encouraged to work in trauma-informed ways, people’s experiences of care can still vary considerably.
I think it can be helpful to recognise that the first professional you speak to may be concentrating on assessing your immediate safety and working out what support is available, rather than fully understanding everything that’s brought you to this point. You might find somebody who is particularly supportive and understanding, or the conversation might help you access another service or professional who can offer more appropriate support. Sometimes the immediate goal is to have somebody help you work out how to stay safe and manage the next few hours, rather than having to figure everything out on your own.
Of course, I can’t promise that reaching out again will lead to the support you need, particularly if services have repeatedly failed to respond appropriately in the past. But it does create another opportunity to find somebody who can help, whether that’s through practical support, a further assessment or being connected with somebody who can work with you more closely over time.
What Can I Say If I Don’t Feel Heard?
I think this is particularly important because advocating for yourself can be incredibly difficult when you’re feeling at your most vulnerable. You may have spent a long time trying to manage your distress independently, and being offered another breathing exercise or a suggestion you’ve already tried can feel quite defeating when you’ve finally found the courage to ask for help.
If you’re struggling to get across what you need, it may help to have a few phrases written down beforehand.
You could say:
- “I’ve already tried a number of coping strategies, and they’re not helping enough at the moment. I need some additional support.”
- “I’m finding it difficult to explain how serious things feel because I’m so overwhelmed. I’m worried about how I’m going to manage over the next few hours.”
- “I don’t necessarily need somebody to solve everything right now. I need some help making a plan so that I’m not dealing with this alone.”
- “When I’m feeling this distressed, I can’t access the strategies that usually help me. I need some support until I’m able to think more clearly.”
- “I’m concerned that I haven’t managed to explain how much I’m struggling. Could we go through what support is available?”
- “I don’t feel that this plan is enough to keep me safe. Could I speak to somebody else or have a further assessment?”
You don’t have to use those exact words. The important thing is to communicate what’s happening, what you’ve already tried and what you’re finding difficult to manage.
You could also ask somebody you trust to sit alongside you, help you make the call or explain your concerns with you.
If you don’t feel you’ve received appropriate support, you can ask what other options are available or request a further assessment. If you’re still concerned about your immediate safety, seek urgent help again rather than waiting until another day. Where there is an immediate threat to life, call 999.
Why Can Coping Strategies Become Difficult to Access When We’re Overwhelmed?
Something I often talk about in therapy is how our ability to think clearly, reflect and access coping strategies can be very dependent on our emotional state. When we’re feeling relatively settled, we might have a good understanding of what’s happening and what would help, but when we’re particularly distressed, that knowledge can become much harder to access.
From an Internal Family Systems (IFS) perspective, we might understand this in terms of different parts of ourselves responding to what’s happening. For example, one part might be desperately trying to keep everything together, while another feels completely exhausted and unable to carry on. We might have parts that want support and connection, alongside others that feel ashamed of needing help or believe we should be able to manage everything ourselves. When these responses become particularly intense, it can be difficult to access the capacities we have for perspective, compassion and clearer thinking.
This is where having somebody alongside us can be so helpful, particularly somebody who can recognise the complexity of what we’re experiencing without expecting us to immediately find a solution. Sometimes having another person help us make sense of things, offer some perspective or hold on to a little hope when we’re struggling to find it ourselves can help us feel more settled and reconnect with the resources we already have.
I’ve explored this in more detail in my article about coping strategies and working with your nervous system, including why particular techniques may not be helpful in every situation and why understanding what’s happening underneath can be important.
What If I’m Having Suicidal Thoughts or Urges to Self-Harm?
Thoughts about suicide and urges to self-harm can arise for different reasons, and they don’t necessarily mean the same thing for everybody.
Some people describe feeling so overwhelmed by emotional pain that they desperately want it to stop. Others may feel trapped, hopeless, ashamed or convinced that nothing is going to change.
Self-harm can sometimes serve a different purpose, perhaps providing temporary relief, interrupting emotional numbness or expressing feelings that are difficult to put into words. It doesn’t always involve an intention to die, although self-harm and suicidal thoughts can overlap, and both deserve to be taken seriously.
As a psychologist, I’m interested in understanding what somebody is experiencing and what may have contributed to these thoughts or behaviours. But that understanding needs to sit alongside appropriate consideration of their immediate safety.
If you’re concerned that you might act on suicidal thoughts or urges to harm yourself, please seek urgent mental health support through NHS 111. If you’ve taken an overdose or sustained a serious injury, seek emergency medical care.
Once the immediate situation is safer, there may be opportunities to explore what was happening beforehand, what you were feeling and what you hoped might change. Understanding these experiences can help somebody develop safer ways of responding, rather than simply expecting them to stop a behaviour without understanding why it has become so compelling.
Developing a Personalised Safety Plan
If you’ve experienced suicidal thoughts, self-harm urges or repeated periods when you’ve struggled to keep yourself safe, it may be helpful to develop a personalised safety plan.
This can involve identifying your own warning signs, recognising situations or experiences that tend to make things worse, considering what has helped previously and identifying people or services you can contact when you need additional support.
It can also include practical steps to reduce immediate risks and make it easier to ask for help when you’re overwhelmed.
Ideally, a safety plan is something you develop collaboratively with an appropriate professional who can help you think through your particular circumstances. It can be useful to involve somebody you trust, where appropriate, so they understand how best to support you.
The Staying Safe website provides information and resources about developing safety plans.
A safety plan can be an important part of managing difficulties, but it doesn’t replace urgent professional support when you’re unable to keep yourself safe.
How Can I Help Someone Experiencing a Mental Health Crisis?
If you’re concerned that somebody close to you is experiencing a mental health crisis, it can be difficult to know what to say or how best to help, particularly if they’re struggling to explain what’s happening or are reluctant to contact services.
Sometimes the most helpful thing you can do is listen without immediately trying to solve the problem, ask directly about their safety if you’re concerned about suicide, and offer to help them access appropriate support. Asking somebody about suicidal thoughts does not put the idea into their head, and it may give them an opportunity to talk about something they’ve been frightened or ashamed to share.
You might offer to sit alongside them while they contact NHS 111, help them explain what has been happening or write down the things they’re finding difficult to communicate. It can also be helpful to ask what they would find supportive rather than assuming you know what they need.
If they’re unwilling or unable to seek help and you’re worried about their safety, you can contact NHS 111 for advice about the situation. Professionals may be limited in what they can disclose about somebody else’s care, but you can still explain your concerns. If there is an immediate threat to life, call 999.
It’s also worth recognising how difficult and exhausting it can be to support somebody you care about during a crisis. You may need support and guidance yourself, particularly if the situation has been going on for some time.
Can Psychological Therapy Help After a Mental Health Crisis?
Once the immediate situation has been addressed, it may be helpful to explore whether there are underlying difficulties that continue to contribute to periods of distress.
Sometimes somebody has spent years managing anxiety, shame, low self-worth or difficulties in relationships without fully understanding how these experiences may be connected to earlier events, longstanding patterns of coping or circumstances in their current life.
I think it’s important to recognise that therapy doesn’t always need to begin with intensive trauma processing or exploring the most painful experiences in detail. For some people, the initial work may involve developing a better understanding of what happens when they become overwhelmed, strengthening their sense of safety, identifying what support they need and helping them manage difficult emotional experiences.
Some services recommend greater stability before beginning particular forms of trauma-focused treatment, and there can be good clinical reasons for this. However, carefully paced psychological therapy can sometimes be part of how somebody develops that stability, rather than something that can only begin once all their difficulties have resolved.
The most appropriate approach will depend on the individual’s circumstances, including their current safety, support and capacity to engage in therapy.
Finding a Way Forward
If you’re experiencing a mental health crisis, the most important thing initially is finding the support you need to manage the immediate situation safely. You don’t have to understand everything that’s brought you to this point or know exactly what needs to change before asking for help.
Once things feel more manageable, there may be opportunities to explore some of the difficulties underneath, including the patterns, experiences and circumstances that have contributed to how you’re feeling. That can take time, and the right support will look different for everybody, but you don’t have to work all of that out on your own.
Psychological Therapy After a Mental Health Crisis
My approach is to help you make sense of what’s happening for you, including why you might sometimes feel pulled in different directions, or find yourself responding in ways that you don’t fully understand. We can take time to explore how your experiences have shaped the way you feel about yourself, the things you’ve learned to do to cope, and what might be making life difficult for you now.
Rather than simply finding more ways to manage difficult feelings, we can work together to understand what’s underneath them and what you might need to help things feel different. There’s no one-size-fits-all approach, so the work is shaped around you, your experiences and what you’d like to change
Please note: Leicestershire Psychology Service offers planned psychological therapy rather than urgent crisis support. If you need immediate mental health help, please use the crisis services listed earlier in this article.
If you’d like to explore whether working together might be helpful, you can get in touch through my website to discuss your needs and the next steps.
Further Support and Reading
If you’re looking for additional support or information, the following organisations and resources may be helpful.
Urgent support and practical resources
- NHS 111 — urgent health advice and access to mental health support.
- Samaritans — confidential emotional support, available 24 hours a day.
- Shout — free text-based mental health support.
- Staying Safe — practical information about suicide safety planning.
- PAPYRUS — suicide prevention support, particularly for young people and those concerned about them.
- Mind and Rethink Mental Illness — information, advice and mental health support.
Understanding your difficulties
If you’d like to explore more about emotional overwhelm, trauma, coping strategies or psychological therapy, you can find further articles on the Leicestershire Psychology Service resources page.
This article provides general information and does not replace an individual clinical assessment or urgent mental health care. If there is an immediate threat to life, call 999.