How do you get a mh crisis team to do a home visit??

[Faraway20]

In the north west. A family member needs help quite urgently. He has had some kind of breakdown over the weekend and is now extremely paranoid that the police/doctors/authority are out to kill him and absolutey will not go to a gp voluntarily. This is all related to being wrongly arrested for a very serious crime (totally cleared of any involvement since) so if the police tried to take him to hospital it would be awful. I don't have a clue what to do. The gp just said phone 999 if he gets worse.

www.nhs.uk/using-the-nhs/nhs-services/mental-health-services/dealing-with-a-mental-health-crisis-or-emergency/

My understanding is :

You do have to go down the 999/A and E route unless he is what is called "open to secondary services" which means "already known to your local mental health trust" eg is under a psychiatrist already or has a Care Co-Ordinator. In which case he is open to the Crisis services of that trust.

Somebody may correct me on this.

Thanks, I followed the link and it suggests 111 or 999. I was hoping someone could assess him at home but perhaps not.

I found it quite difficult to get any kind of support and the only thing you can really do is report your concerns to your GP or in really extreme circumstances e.g. threat to life request an assessment. The problem being that you're seeking help for someone else, not yourself.
I found it helpful to keep a diary of incidents of concern and to encourage others to report their concerns too. There is no quick fix unfortunately.
There might be some useful info for you here;
www.mind.org.uk/information-support/guides-to-support-and-services/seeking-help-for-a-mental-health-problem/helping-someone-else-seek-help/

If he is already known to the crisis teams I think that would be the case, but tbh it sounds like he needs help and will be the best place for him atm

A secondary service such as MH is referral only, for example GP or A and E.

It is the same as getting to see any specialism you have to endure the referral process.

Mental Health, however, is the only specialism that I can think of that would really benefit from a specialised emergency service that could be tapped into or turned up at.

Sadly, it will probably never happen. Bureaucracy at its finest.

No point calling 111 they won’t be able to help much. Especially as they would want to speak to him directly. And unless he is suicidal they will tell him to go to a&e

Contact the Access Team by phone.
Or go to A&E to be seen by Psychiatric Liaison Team.

If you’re in Scotland you can try contacting your local council’s health and social care service - they are integrated with mental health teams and it’s an alternative route in. I’m not sure how fast it would be, though.

I was referred by GP urgently and had a visit the same day. Good luck.

He hasn't had any mh issues previously so isn't known to any services already. Thanks for confirming though. Its hard to know when to call 999, he's very calm and quiet but terrified.

I don't know how we would physically get him to a&e though? Two paramedics couldn't do it.

If paramedics attended and agreed he needed to go, they’d call for back up if it was required.

But sadly if he’s unknown to services, it’ll be a 999 call to get him help. There’s no other way.

Has he had contact with mental health services previously? If he has had a support worker previously and/or been sectioned or accessed their services, you can call and they (manpower dependent) can send someone round. This is to assess though whether they are able to safely recieve support from home without further intervention, often it actually results in being referred for assessment though anyway. A&E is sadly the best call, especially if be would be disturbed by police presence. I agree with a PP that MH ambulances would be of huge benefit, and fairer to the paramedics who absolutely cannot be masters of physical and mental health, and doesn't tie up resources. When my sister was sectioned, it took the police over an hour to get her in the ambulance, and that could have been out on other jobs had another resource been available. Police often assist if you call 999 or have a home visit and need to be taken elsewhere and won't go voluntarily, so in this case where that would disturb him, it might be a good idea.

Sorry, in the time it took me to write a reply I see you've answered some questions. If you call an ambulance and he won't go in voluntarily, they will call the police to assist, who will restrain if needed. Obviously the ideal given his experience would be to get him to A&E yourself, but I appreciate that's not always possible in situations such as this.

Thanks Choo. I think it will end up with 999 and police, I was just hoping for another option.

If he wont seek help himself then it has to be 999

If he's in no immediate danger, can you call his GP in the morning? They can't give you any information but you can report your concerns to them. GP may choose to refer to mental health services.

He won't seek help, he does not think he is delusional/paranoid.

The gp said he needed to make himself an appointment, or we needed to phone 999 if he deteriorated.

Thanks all.

Many ambulance services have mental health teams in the control room and are very experienced with people in mental health crisis (my DH is one). Do you think he is a danger to himself or to anyone else?

if the police attend and assess him as being a danger to himself or others they can detain him under section 136 of the Mental Health Act which means he remains under their care until it can be transferred to a mental health team. they will take him to hospital.

previous posters are correct in saying that unless he is under secondary services there is no Crisis Team available. there is always a Psychiatric Liaison team available via A&E.

i wish you and your family member all the best.

How urgent do you believe the issue is? Will it last the night/the day/a week??

Our area has a 24 hour crisis team number. Doesn't mention anywhere about referrals being needed:

'In a mental health emergency you can contact your local crisis resolution and intensive home treatment team using our central freephone telephone number below:

Service opening hours:24 hours a day, seven days a week.'

Then it gives a free phone number. There might be something similar near you OP.

The NHS have a page here:
www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline

Put his age and postcode in. It will give you the number to ring. Surely it's worth a try?