How to get an NHS psychiatry referral during a mental health crisis?

"Suicidal ideation".

I hate to say it but keyword to add would be "active"

I've been in the unfortunate position of being in mental health crisis many times and have had to ring the crisis team. Not one time did they actually come out. Mainly cos I wasn't actively at that point acting on it. And tbh even then if you say you are, they just tell you to go to a+e.

I'm sorry you're in this situation OP 😔

I was once told by the crisis team that they could only offer help if I successfully completed suicide. They didnt seem to grasp that at that point I'd no longer be alive until I pointed it out to them.

It seems to change from area to area, but the crisis team here generally won't see you unless you have a plan to complete suicide within the next 24 hours.

Going via the GP will sometimes get you on a waiting list, if the mental health team accepts the referral.

I'm sorry you're in this position. The stare of mental health services is absolutely woeful.

So I'm not sure if this will help, but from my 20+ years of being in and out of CMHT services, a lot tend to prioritise who gets to see someone (especially a psychiatrist) based on clinical need.

Does he see his GP regularly? They would ideally be the ones to refer him, and when they do, if they can stress how much of a negative effect it's currently having on his life (he's in crisis, can't work/function/may be a danger to self) etc they may be more likely to escalate/triage it.

If nothing else please strongly ask for a mental health assessment, which should be carried out by a psychiatrist. Who will then decide whether to take them on under the community mental health team (CMHT).

Has he ever had contact with them before?

I would contact that team, the person should still have a crisis number/duty number.

GP request referral as they have deteriorated they are unable are unable to function, self neglect and at risk of physical health decline.

I would also ring 111 option 2 and advise of the above they are also capable of actioning a referral. Make sure you explain they are know to services and have a long history of severe entrench OCD.

Some people have said say they are suicidal- This is just wrong, unless you are in need of immediate life saving intervention it’s deceitful and clogs the system. Otherwise they will be assessed not in need of crisis home intervention team then discharged possible back to GP. If they are by all means report this.

Lots of people feel suicidal but are not in crisis.

I would emphasis the following:-

1. long severe history
2. recent life events have acted as triggers to worsening state
3. self neglect - this is just as risky explain what they are NOT doing and if they haven health conditions that may worsen as a result, have they missed medical appointments, how are they getting food, can they maintain home clean and safe?
4. recent changes to meds - may need a review as secondary care meds maybe prescribed which GPs do not have access to.
5. risk of non compliance due to withdrawal and lack of functioning

please don’t get hung up on them seeing an actual psychiatrist especially in the first instance - a CPN and clinical psychologist can do lots and every team has a weekly MDT to review referrals - just get them open again.

you always have the option to do an online social care referral if they are extremely isolated and struggling to function, getting a support worker or even better mental health support worker (rare)

Hope this helps but as someone else said it does vary from area to area