*This is Part Two of Three, you can read Part One here!*
After recognising you need help and that you think the Crisis Team might
either be able to provide it or be able to advise you or some other way, I
think the next difficult thing is all the bits that happen when you actually
pick up the phone and call them. It can be incredibly challenging to build up
the courage and determination that it can take to ring the Crisis Team and that’s
made even harder to cope with when you’re immediately put on hold and into a
queue to be answered. Where your mental health, self-confidence, and/or
self-worth are already vulnerable, this can lead to thoughts of ‘they mustn’t
care about me to not answer straightaway’ or ‘I can’t be important if there’s
people ahead of me in the queue’ or ‘I don’t want to take up a call slot when
there’s already so many other people needing help from them.’ All of these
things – and others – can lead to a person hanging up the phone before even
reaching the call handler or member of the Team!
So, here are some tips to stay patient – no matter how awful the hold
music or audio recording is!...
1. Take
Deep Breaths
·
Before
reacting, pause and take 3–5 slow, deep breaths.
·
This
activates the parasympathetic nervous system and calms the mind.
2. Shift Your Perspective
·
Remind
yourself: "This
moment will pass." or "They're struggling, not
trying to upset me."
·
Empathy
can expand your tolerance.
3. Adjust Expectations
·
Expecting
immediate results or perfect behavior sets you up for frustration.
·
Mental
health conversations especially require slowness, space, and setbacks.
4. Use a Grounding Technique
Try one of these when you feel impatience rising:
·
5-4-3-2-1: Name 5 things
you see, 4 you hear, 3 you feel, 2 you smell, 1 you taste.
·
Body scan: Briefly check
in with your body from head to toe.
5. Remind Yourself of the Bigger
Picture
·
Ask:
“What
matters more—this moment going perfectly or the relationship and trust?”
__________________________________________________________________________________
When you’ve stayed patient and are through to someone, the next
challenge is typically having to give them details on why you’re calling. I
think that the greatest aid in coping with this, is that before you ring, you
remind yourself and prepare yourself for having to do that. So that’s it’s not
out of the blue and you don’t feel caught off-guard in terms of suddenly having
to tell someone how much you’re struggling. And it’s important to remember that
– in most cases, because Crisis Teams across the Country sometimes have
different procedures and processes – it’s important that you share as much as
you feel able to in that first call because it could help determine how quickly
you receive a callback from a Psychiatric Nurse or other type of member of the
Team.
Now, when you’ve coped and poured your heart out to the call handler,
how do you cope with the time you have to safely wait for the callback? So, as
well as the advice above to help with your levels of patience, below are some calming
activities you can do in your own home whilst you wait for your callback:
1. Use
a Grounding Tool
·
Try
the 5-4-3-2-1 grounding
technique:
5
things you can see, 4 you can touch, 3 you can hear, 2 you can smell, 1 you can
taste.
·
It
can help you feel more anchored in the present.
2. Write
It Out
·
Grab
a notebook or phone and write down:
o What you're
feeling
o What triggered
it
o What you need
right now
·
Journaling
helps offload intense emotion and can clarify what to say when the Crisis Team
calls.
3. Focus on Your Breathing
·
Try
box breathing: Inhale for 4,
hold for 4, exhale for 4, hold for 4.
·
Or
just place a hand on your chest and breathe slowly, intentionally.
4. Put
on Calming or Familiar Music
·
Listen
to songs that bring comfort or grounding.
·
Avoid
music that may intensify sadness, if possible.
5. Hold
or Touch a Comfort Object
·
Wrap
up in a blanket, hold a soft item, or cuddle a pet.
·
Sensory
comfort can soothe the nervous system.
6. Watch
Something Low-Stress
·
Pick
a gentle show or video you've seen
before or something calming (nature videos, slow TV, light comedy).
·
Familiarity
helps reduce mental load.
7. Doodle
or Colour
·
No
need to be artistic—just scribble, shade, or colour in a book.
·
The
motion and focus can be meditative and distracting.
8. Do
Light Movement
·
Gently
stretch, walk slowly around the room, or sway side to side.
·
Movement
helps release built-up stress in the body.
The way my local Crisis Team now functions is that you ring 111, press
option 2, and then a call handler takes your basic details – which includes why
you’re ringing and whether you’re home alone or have any thoughts of hurting or
killing yourself, and then someone from the Triage Team ring back, and they
decide whether you need an assessment with the Crisis Team. This last occasion on
their caseload was actually the first time I’d gone through that system because
not only is it a recent change, but it’s also a service I haven’t needed for a
long time. So, previous to this, you’d have a call handler and then straight to
the Crisis Team. One thing that isn’t clear to me – because I’m not going to
act like I understand the whole system! – with this being the first time for
me, is whether the Triage Team saying you need a Crisis Team assessment always means
they’ll come out to see you, or whether they can then review things themselves
too and change that decision.
So, I asked Chat GPT what an assessment
with an NHS Crisis Team is like, it came up with an actually accurate and effective
response, but I don’t want to seem like I’m taking credit for it! I wanted to
be transparent and honest, but I honestly felt like it was such a brilliant
response that fitted in well with the rest of the blog post. So, the following section
was completely created by AI:
1. How It Starts
·
The
assessment might happen:
o Over the phone
o At your home
o In A&E or a hospital
o In a crisis hub or mental health unit
You’ll
usually be seen by a mental
health nurse, social worker, psychiatrist, or a
combination of professionals.
2. They’ll Ask You About:
Your Mental Health
·
What
symptoms you're experiencing (e.g., low mood, anxiety, hallucinations, suicidal
thoughts)
·
How
long you've been feeling this way
·
What
has triggered or worsened your current state
Your Thoughts and Feelings
·
Whether
you're having suicidal
thoughts or urges to self-harm
·
If
you feel at risk of harming yourself or others
·
Any
thoughts that don’t
feel like your own (e.g., paranoia, intrusive thoughts)
Safety &
Support
·
Whether
you have support at home (friends,
family, carers)
·
If
you’re currently safe
to be left alone
·
Any
risk factors (alcohol,
drugs, recent losses, past trauma)
Your History
·
Any
previous mental health
issues
or diagnoses
·
Medications
you’re on or have taken
·
Past
involvement with mental health services
3. They’ll Assess:
·
How
immediate and serious your situation is
·
Whether
you’re at risk of harming
yourself or others
·
If
you need urgent treatment,
admission,
or community support
This is often called a risk assessment.
4. They’ll
Work With You on a Plan
They may suggest:
·
Home
Treatment Team
support (daily or frequent visits at home)
·
Crisis
care plan
(what to do if things get worse)
·
Referral
to community mental
health teams
·
Hospital
admission
(voluntary or sectioned, if necessary)
·
Medication
review or therapy signposting
What You Can Do to Prepare
·
Be
as honest as you can, even if it
feels hard or shameful.
·
Write
things down
beforehand (symptoms, questions, medications).
·
Have
someone with you
if you feel safer that way.
·
Don’t
worry if you cry, go quiet, or can’t explain everything perfectly—they're trained for that.
Example Questions They Might Ask:
·
“What
brought you to crisis point today?”
·
“Have
you had any thoughts of ending your life?”
·
“Are
you able to keep yourself safe tonight?”
·
“Do
you have anyone supporting you at the moment?”
·
“What
has helped you cope in the past?”
Important
Notes:
·
You won’t be judged—they’re
trained to deal with distressing or complex thoughts.
·
You
can refuse treatment unless you’re
at high risk and detained under the Mental Health Act.
·
If
you don’t understand something, ask them to explain in plain language.
__________________________________________________________________________________
One big difficulty to come from the end of the call back/triage/assessment,
is that – even if it’s subconsciously – you’ll likely have gone into it with an
expectation as to what the end result will look like. Or what you hope it will
look like.
There was one time, a few years into my mental health journey, that I
thought I knew how everything worked and was confident I could trick the system
in a way that meant I could be honest about how unsafe I was but not end up
being sectioned. That ended up being a completely a wrong judgement and from that
instance, I learnt not to try to second-guess mental health professionals – particularly
and especially, the Crisis Team!
I think that the biggest challenge with having expectations in mental
health, is that part of the reason or you requiring the support of the Crisis
Team, could be related to difficult thoughts and if you aren’t thinking ‘properly’
then how can you expect your assumptions and judgments to be accurate?
It’s typically at this point in your journey with the Crisis Team where
this party line might come up, so I thought I’d talk about it here…
There are numerous comments which are associated to typical lines that
staff from the Crisis Team come out with – things like “take a nice long bath”
or “have a hot drink.” And another of those, is when they – and a lot of other
professionals like the Police and Paramedics – say that they have a ‘duty of
care.’
To maintain a sense of fairness and equality, I decided to research the
meaning of this for those staff before I discuss what it means to myself – and other
service users…
1. Protecting You from Harm
Crisis
Team staff must take reasonable
steps to protect you if:
·
You
are at risk of harming yourself or others.
·
You
are unable to keep yourself safe due to your mental state.
·
You’re
vulnerable due to confusion, psychosis, suicidal thoughts, or severe distress.
This
might include:
·
Close
monitoring
·
Offering
urgent treatment or support
·
In
rare cases, initiating a Mental
Health Act assessment if you're at serious risk and refusing help
2. Acting in Your Best Interests
If
you’re unable to make clear decisions (due to a mental health crisis), they
have a duty to:
·
Act
in your best interest (based on the Mental Capacity Act)
·
Ensure
any action is
proportionate,
necessary, and the least restrictive option possible
They must try to involve you in decisions as much as you're able.
3. Offering Appropriate Care or
Referrals
They must:
·
Assess
your needs thoroughly
·
Provide
or arrange suitable treatment and
follow-up support
·
Escalate
to other services (like inpatient care or safeguarding teams) if needed
They can’t simply send you away without a clear
plan or proper handover if you’re still at risk.
4. Respecting Your Rights While
Ensuring Safety
·
They
can’t force treatment unless you're
under a legal order (e.g. Sectioned).
·
But
if they believe you're a
serious danger to yourself or others, they have a duty to act to keep you safe—even if that
means overriding your wishes temporarily.
5. Confidentiality—with Limits
Their duty of care includes keeping your information private, except when:
·
There’s
a serious risk to life
or safety
·
They
need to share information with other
professionals to protect you or others
In those cases, they must balance confidentiality with safety.
__________________________________________________________________________________
I actually really appreciated reading all of that because it gave me
some sort of reassurance that perhaps, a lot of the time, they do use it in a
genuine and caring way; but I think that it’s also understandable to question
their motivation behind saying it when you’ve heard it as many times as I have!
It often, seems to go in one ear and out the other! Like, no matter which
professional says it nor what the actual situation is in which it is said – I
regularly doubt the authenticity and conviction behind it. It just sometimes
feels tokenistic and as though it’s either being said as some sort of point to
me or as purely a part of their job and the expectations within that.
In around 2017, I was asked to help the Police Lead from my local mental
health NHS Trust (Cumbria, Northumberland, Tyne, and Wear NHS Foundation Trust –
CNTW) and the Mental Health Lead of my local Police force (Northumbria Police)
to co-facilitate one day of mental health training for the new recruits to the
Force. It was a role I really enjoyed because it felt like I was making a real difference
in shaping the way others would be treat by the Police if they were in a mental
health crisis and it felt good to use my negative experiences and turn them
into positive and productive advice and guidance.
There were a couple of things I used to say in every single training session;
the first was for the Officers to never lose the confidence and courage to
speak up if they witness poor treatment of someone by a more senior or
experienced Officer. Another was for them to always consider if they would
appreciate hearing their relative was treat the way they’re treating someone.
And the third, was to always use the ‘duty-of-care’ line with caution, passion,
and consideration. I explained to them that it often lost its seriousness for
people who hear it so frequently and that it can leave that person struggling
to trust a professional who uses it. As though it makes you question their honesty
and entire integrity too. Like, ‘how many people do they say that to though?’ and
‘they’re only saying that because they’ve got to!’ It leaves you doubting that
the professional actually cares or is invested in you as a person and your
individual needs and difficulties.
So, I guess it’s relevant that this bit come next because the first
decision of the Crisis Team’s that you likely may disagree with is whether they
decide to place you on caseload or not… Some people will be relieved and
reassured to be put on caseload and some may feel they don’t need help and aren’t
that poorly. Then where you aren’t put on caseload, there will be some people
who feel they need that help and support and level of care, and others who are
grateful and deem it as them being considered not ‘too poorly.’
Some, may read that and adopt the attitude ‘can they ever win?!’ ‘Will
they ever get it right?!’ But I think a better response to have, would be the
recognition that each person who comes into contact with the Crisis Team and
who undergoes an assessment is an individual. An individual with completely different
difficulties, challenges, symptoms, and illnesses. And therefore, they need an
individual approach to their care/the help and support they are provided. They
need to be considered and treated equally and without comparison or unreasonable
judgments. Playing devil’s advocate; I appreciate this might be challenging when
the Team have so many people to assess within so many hours and it’s
time-consuming to read the notes or records for each individual and then create
an individual care plan too. But I’d say that’s something which should be seen
as part of the job. That we – service users – should definitely be seen as
worthy, entitled, and deserving of that time and effort.
In my last blog post about jumping from the bridge (the one I linked at
the beginning of this blog post), I included a bit of a section on asserting
yourself and it included five tips to asserting yourself and six examples of
sentences of assertion. So, as relevant as that content is for this part of
this blog post, I didn’t want to repeat things so I’d like to firstly recommend
that you visit the post if you want to read those tips and see the sentences,
once again, the link is: TW
| “SHE’S ACTUALLY JUMPED! GET AMBULANCE ON LIGHTS & SIREN!” | WHAT HAPPENS
BEFORE, DURING, & AFTER YOU JUMP, LESSONS LEARNT, & LOTS OF ADVICE |
I'm NOT Disordered. So, to be a bit different, I thought I’d re-phrase this
bit as self-advocacy and include some tips etc on that and which are
specifically tailored to needing to do this with the Crisis Team…
1. Be Clear and Honest About What
You’re Experiencing
·
Describe
your symptoms, thoughts, or behaviours as clearly and truthfully as you can.
·
Even
if it's scary or embarrassing (e.g. suicidal thoughts, hallucinations, panic), they need the full picture to help you
safely.
Try
saying:
“I
don’t feel safe right now.”
“I’ve been having thoughts of hurting myself.”
“I can’t cope at home alone.”
2. Tell Them What You Need (As Best
You Can)
You’re
allowed to say what you feel would help—even if you’re unsure.
Examples:
“I need more than just a phone call—I’m not coping
between visits.”
“I think I need to be somewhere safe for a few days.”
“Can you help me access therapy, not just crisis management?”
Even if they can’t give exactly what you ask for,
this helps shape the care plan.
3. Use Notes or a Journal
·
Write
down what you want to say before the appointment or call.
·
Take
notes during the conversation if it helps you remember.
·
You
can show them a journal entry, mood log, or safety plan if talking feels too
hard.
This can also help you track patterns, which supports better care planning.
4. Ask Questions About Your Care
You have a right to understand what’s happening and why.
You can ask:
·
“What
is the plan for me after today’s visit?”
·
“Why
was I not offered a mental health bed?”
·
“What
happens if I feel worse tonight?”
·
“Can
you explain my risk assessment to me?”
5. Involve Someone You Trust (If
You Want To)
·
You
can ask for a friend, family member, carer, or advocate to speak with you or on your behalf.
·
They
can help you feel supported or remind you of what you wanted to say.
6. Say If Something Isn’t Working
You’re allowed to say:
·
“I
didn’t feel heard last time.”
·
“I
don’t feel safe being left alone with just this plan.”
·
“The
medication is making things worse.”
Being respectful but direct helps staff adjust their approach.
7. Know Your Rights
·
You
have the right to be involved in decisions
about your care.
·
You
have the right to ask for a copy
of your crisis plan.
·
You
can ask to see a different clinician or make a complaint if you’re not being
treated fairly or safely.
__________________________________________________________________________________
In light of
that last tip, here are some helpful links which provide advice and information
on your rights – whether you’re sectioned under the 1983 Mental Health Act or being
treat under the 2005 Mental Capacity Act…
·
Your
rights under the Mental Capacity Act
·
What
is the Mental Capacity Act?
·
Mental
Capacity Act: making decisions - GOV.UK
·
Mental
Capacity Act - Social care and support guide - NHS
·
Mental
Health Act (easy read) - NHS
·
What
is the Mental Health Act?
·
How we help protect your
rights under the Mental Health Act - Care Quality Commission