Mental Health Emergencies

Our approach to mental health emergencies

London Psychiatry Clinic is not an emergency service, and we can’t respond if someone’s life is at risk. In that case, call 999 or go to A&E. It’s the fastest way to get help.

If you or someone close to you is struggling but not in immediate danger, we can usually arrange an urgent appointment with one of our psychiatrists at short notice. Our psychiatrists have extensive experience helping people through mental health crises.

Nobody should feel guilty, embarrassed or ashamed about asking for help. Whatever you’re going through, we’ll treat you with dignity and respect, in a safe, confidential and supportive setting.

Worried about someone else?

You may notice warning signs before they do. You can book an appointment with one of our psychiatrists to talk through your concerns about a relative or someone close to you. Everything you share is confidential, and you don’t need to give us the other person’s details. We’ll help you understand what might be happening and how best to support them.

What is a mental health crisis?

A mental health crisis is when someone’s mental or emotional state gets worse quickly and they feel unable to cope or stay safe. It can happen at any time of day or night. Sometimes there’s a clear trigger, such as an argument or a loss, and sometimes it seems to come out of nowhere.

A crisis might look like an emotional breakdown, a period of feeling suicidal, or a sudden change in how someone thinks or behaves. If you notice warning signs, reaching out early to a trusted friend, family member or professional can sometimes stop things getting worse. You don’t need a diagnosis or the “right words” to ask for help.

Signs of a mental health crisis

Get help straight away (999 or A&E) if you or someone else:

• has taken an overdose of medication or drugs
• has seriously harmed themselves
• is thinking about suicide and may act on those thoughts, or has made plans
• feels they might seriously harm someone else
• is behaving in a way that puts themselves or others in immediate danger

If you’re not sure, check the NHS page on when to call 999.

Other signs that you may need urgent mental health support

• feeling you can’t cope or can’t go on
• having thoughts of suicide, even brief ones
• harming yourself
• feeling you’ve lost control
• intense distress that won’t ease
• intrusive, repetitive thoughts that cause you distress
• very upsetting flashbacks
• hearing voices or seeing things that others don’t
• feeling very paranoid, confused or frightened about what’s happening around you
• feeling you can’t trust anyone
• reckless or impulsive behaviour, such as spending large amounts of money, gambling or taking serious risks with your health or safety
• feeling that your use of alcohol, drugs or another behaviour has reached a crisis point

Thoughts of suicide or self-harm are always worth taking seriously. If you’re not in immediate danger, call NHS 111 option 2, or Samaritans on 116 123.

See more information about how to get urgent help for mental health through the NHS.

Physical symptoms

Intense anxiety or panic can cause a racing heart, sweating, shaking, dizziness and a sense that something terrible is about to happen. These feelings are frightening but usually pass. However, always call 999 for chest pain, difficulty breathing, fainting, or after an overdose, as these can be signs of a physical medical emergency.

How to get help

In the UK

• Emergency: call 999 or go to your nearest A&E
• Urgent mental health support (England and Wales): call NHS 111 and choose option 2
• Scotland: call NHS 24 on 111 and choose the mental health option
• Northern Ireland: call Lifeline on 0808 808 8000
• To talk to someone, any time: Samaritans, free on 116 123
• If you’d rather text: text SHOUT to 85258 (free, 24/7)

Outside the UK

• Europe: call 112
• USA and Canada: call 911
• Elsewhere: search online for the local emergency number, or go to the nearest hospital emergency department.

How London Psychiatry Clinic can help

Call us on 020 3488 8555 to speak to our team. Our lines are open 9am to 5:30pm Monday to Friday.

Urgent appointments

If seeing one of our psychiatrists would help, we’ll arrange an urgent appointment. After the assessment, your psychiatrist will talk you through the options. These may include treatment with us, support from local NHS crisis services, or admission to hospital if needed.

Over the phone

Depending on your situation, our team can:

• give advice on next steps
• arrange an urgent appointment
• arrange follow-up calls to check how you’re doing
• with your agreement, involve a family member or someone you trust
• help connect you with NHS services, such as your local crisis team

Longer-term support

Once the immediate crisis has passed, we can offer a full assessment and diagnosis, and a personalised treatment plan. This may combine psychological therapy, medication, stress-reduction techniques and lifestyle support (nutrition, exercise and sleep).

Hospital admission

If your psychiatrist thinks you may need inpatient care, they’ll discuss this with you. Some of our psychiatrists have admitting rights at Nightingale Hospital in Marylebone, and admission can generally be arranged within 24-48 hours, depending on bed availability. If you’d prefer a different hospital, such as the Cardinal Clinic or a Priory hospital, we can help you contact them. 

Depending on the circumstances, a psychiatrist outside London Psychiatry Clinic may take over your care while you’re in hospital. We’re happy to work alongside them and any other professionals involved.

Private admission isn’t covered by the NHS, so you’ll need to check your health insurance or be prepared to self-fund.

FAQ

Can I go to A&E for a mental health emergency?

Yes. A&E is there for mental health emergencies as well as physical ones. Most A&E departments can arrange an assessment by a liaison psychiatry team. If you’re worried about your safety or someone else’s, don’t hesitate to go.

How can I get help outside office hours?

If our lines are closed:

• If someone’s life is at risk: call 999 or go to A&E
• If it’s urgent but not life-threatening: call NHS 111 and choose option 2. You can call on someone else’s behalf.
• If you need to talk: call Samaritans on 116 123 or text SHOUT to 85258
• For non-urgent health concerns: contact your GP (some practices offer out-of-hours support)
• If you think you need urgent private admission: Nightingale Hospital accepts psychiatric emergency admissions 24 hours a day. Call 020 7535 7700 at any time. They may need to assess you before confirming admission, and may ask you to go to A&E first for a medical check. Admission isn’t covered by the NHS.

What should I do if my child or teenager is in crisis?

If their life is at risk, call 999 or go to A&E. For urgent support, NHS 111 option 2 is available for all ages. 

If it’s not an emergency, these helplines can offer support and advice.

• Young people under 19 can contact Childline for free: 0800 1111
• Parents can get advice from the YoungMinds Parents Helpline for free on 0808 802 5544 from Monday to Friday, 9:30am to 4pm.

Our Child and Adolescent Psychiatry team can offer urgent appointments for children and young people. You can contact us to book a consultation:

• Call us: 020 3488 8555. Our lines are open Monday to Friday (9am–5:30pm). Calling is the fastest way to reach the practice management team.
• Text or call us on WhatsApp, Monday to Friday (9am–5:30pm): 07425 919570
• Or write to us at: enquiries@londonpsychiatry.clinic 

What is a welfare check?

A welfare check is when the police visit someone to check they’re safe. Police in England and Wales now generally attend welfare calls only where there’s a real and immediate risk to someone’s life or of serious harm. For other concerns, they may direct you to health or social care services instead. This is part of a national approach called Right Care, Right Person.

How do I ask for help if I’m worried about someone?

• If you think their life is at immediate risk (for example, they may have taken an overdose or harmed themselves, or have said they’ll end their life), call 999. Explain clearly why you believe they’re in danger.
• If it’s not immediately life-threatening, call NHS 111 and choose option 2. A mental health professional can advise you and connect them with local crisis services.
• For non-emergency police matters, call 101.

If you’re told the police won’t attend but you still believe someone’s life is at risk, call 999 again and explain what has changed or why you’re worried.

What happens after a welfare check?

If the person is found safe and well, the police may let you know, and usually no further action is taken. If they need urgent medical help, the police will call an ambulance. You may be contacted and asked for more information.

What is sectioning?

Being “sectioned” means being kept in hospital under the Mental Health Act so you can be assessed or treated, even if you don’t agree. It’s only used when someone is seriously unwell and other options, such as treatment at home or voluntary (informal) admission, aren’t safe or suitable.

Sectioning isn’t decided by a single doctor. In most cases, an Approved Mental Health Professional (AMHP) makes the application, supported by recommendations from two doctors. The doctors can be NHS or private, and the hospital can be NHS or independent.

Someone can only be sectioned if they have a mental disorder serious enough to need assessment or treatment in hospital, and it’s necessary for their own health or safety or to protect other people.

Most people are first admitted under Section 2, which allows assessment for up to 28 days. There are other sections for different situations, such as Section 3 for treatment. People who are sectioned have legal rights, including the right to appeal to a tribunal and to support from an independent mental health advocate.

These rules come from the Mental Health Act 1983, which applies in England and Wales. The Mental Health Act 2025 is updating it, with changes being introduced in stages. Scotland and Northern Ireland have their own mental health laws.

What is a Mental Health Act assessment?

If there are serious concerns about someone’s mental health and safety, a Mental Health Act assessment may be arranged. Concerns can be raised by a GP, psychiatrist, crisis team or the person’s nearest relative (a specific legal role, usually a close family member). The local AMHP service or crisis team arranges the assessment.

The assessment is carried out by an AMHP (often a social worker, nurse or occupational therapist) and two doctors, at least one of whom has specialist approval under section 12 of the Act. The second is often a GP or another doctor who knows the person.

They’ll consider whether the person has a mental disorder, the risks to them or others, and whether care could safely be given another way. They’ll look at every alternative first, such as support from a home treatment team. Only if hospital is necessary and the person won’t or can’t agree to it will the AMHP make an application to detain them.

Where can I get other support?

We’re a private clinic, not a charity, so we’re unable to offer financial or practical support. These organisations may be able to help:

• Mind: information and support for anyone affected by mental health problems
• Samaritans: emotional support, 24/7, on 116 123
• Shout: free 24/7 text support. Text SHOUT to 85258.
• National Domestic Abuse Helpline: 0808 2000 247, 24/7
• Shelter: help with housing and homelessness
• Citizens Advice: advice on benefits, money, food banks and practical problems

Panic attacks

What is a panic attack?

A panic attack is a sudden rush of intense fear and physical symptoms. It’s the body’s alarm system, the “fight, flight or freeze” response, being set off when there’s no real danger. Panic attacks can be triggered by a stressful situation or can seem to come from nowhere. They’re common and treatable. When someone has repeated, unexpected panic attacks, this may be panic disorder.

What does a panic attack feel like?

• overwhelming dread or fear, sometimes a feeling that you’re about to die
• a racing or pounding heart
• tightness in the chest
• sweating
• trembling or shaking
• shortness of breath, or feeling like you’re choking
• tingling in your hands, feet or lips
• feeling detached from yourself or your surroundings

What should I do if I think I’m having a panic attack?

If you have chest pain, trouble breathing or symptoms you’ve never had before, or you’re not sure what’s happening, call 999. Heart problems and panic attacks can feel alike, and only a medical assessment can tell them apart. Don’t try to rule out a heart problem yourself.

If you’ve had panic attacks before and recognise the symptoms, these steps may help:

1. Move somewhere quiet if you can.
2. Breathe slowly and deeply, making each breath out longer than the breath in.
3. Focus on your surroundings, for example by naming things you can see and hear, to help ground yourself.

Most panic attacks pass within 5 to 20 minutes. Although they feel frightening, the panic attack itself isn’t dangerous. If you’re having panic attacks, speak to your GP or a mental health professional. It can also help to keep a note of when they happen, to spot any patterns.

What’s the difference between a panic attack and an anxiety attack?

“Anxiety attack” isn’t a medical term, but people often use it to describe anxiety that builds more gradually, usually in response to a particular worry or stressful situation. A panic attack tends to come on suddenly, peaks quickly, and is often more intense, with strong physical symptoms.

What triggers a panic attack?

Triggers vary from person to person. For one person it might be crowds; for another, being alone or a particular worry. Some panic attacks have no obvious trigger at all.

What is a mental breakdown?

“Mental breakdown” or “nervous breakdown” isn’t a medical diagnosis. It’s a common way of describing a period of severe emotional distress when someone can’t function in their daily life as usual. It’s often linked to conditions such as severe anxiety, depression or burnout. If you feel you’re reaching that point, it’s a good time to seek help.

What is mania?

Mania is a period of unusually high mood, energy or irritability, lasting days or longer. It’s most often associated with bipolar disorder. People experiencing mania often don’t realise anything is wrong, even if those around them are worried, and this can make it hard to help them.

Signs of mania can include:

• much more energy than usual
• needing far less sleep without feeling tired
• restlessness
• feeling unusually confident or important
• being easily distracted
• talking a lot or very quickly
• racing thoughts or lots of new ideas
• starting many projects at once
• increased sex drive
• behaving in ways that are out of character or overfamiliar
• taking risks, such as overspending, gambling or risky sex

Mania is often followed by a period of depression. Getting help early can reduce the harm from a manic episode and the risk of a severe low afterwards.

Hypomania is a milder form of mania that lasts for a shorter time. Episodes of hypomania with depression are a defining feature of bipolar II disorder.

If someone with mania is putting themselves or others at risk, call 999. Otherwise, contact their care team or NHS 111 option 2.

Psychosis

What is psychosis?

Psychosis is when someone loses touch with reality. It can involve:

• hallucinations: seeing, hearing, feeling, smelling or tasting things that aren’t there
• delusions: strongly held beliefs that aren’t true, such as believing they’re being watched or followed

Psychosis can be caused by:

• mental health conditions such as schizophrenia, bipolar disorder or severe depression
• drug or alcohol use, or withdrawal
• some physical health conditions
• extreme stress or trauma
• in some cases, the period after giving birth (postpartum psychosis, which needs urgent help)

What are the warning signs of psychosis?

Psychosis often develops gradually. Early signs can include:

• hearing, seeing or sensing things others don’t
• holding beliefs that others can’t talk them out of
• feeling suspicious or mistrustful of people they previously trusted
• withdrawing from friends and family
• seeming emotionally flat
• neglecting self-care or hygiene
• finding it hard to concentrate, with an unexplained drop in performance at work or school

Am I experiencing psychosis?

Psychosis can make it hard to tell what’s real, so it’s not always easy to recognise in yourself. Only a mental health professional can assess it properly. If you or someone close to you is noticing these changes, seek help early.

Someone I know has psychosis. Should I be afraid?

Psychosis is often misrepresented in films and the media. In reality, people experiencing psychosis are more likely to harm themselves, or be harmed by others, than to harm anyone else. Psychosis is distressing and frightening for the person going through it, and it’s not a personal failing. Your support, and helping them get professional care, can make a real difference.