AIBU to tell someone not to phone 999

[Fermatslittletheorem]

Sorry to post my rant here but I am wound up! (I get wound up easily and have drafted many an AIBU in my head but never actually posted)

I am on a mental health facebook group and someone posted saying that they were in crisis but had lost the number for their local crisis team, did anyone know it.

Someone else commented on their post saying to phone 999. I then commented saying not to phone 999 unless there was risk of life or limb. I also suggested they phoned 111 who were lovely and would arrange for the local crisis team to phone them back. Or that they could find the number for the crisis team on the local trust website (admittedly I could have done this for them myself - and actually did after I had posted the comment). I have done both these things in the past.

Another person, an admin, deleted my comments and had a go at me for telling people not to phone crisis lines. That it was "absolutely unacceptable". I tried to explain but she ignored me.

To my mind, if she had phoned 999 (not actually a crisis line but the emergency services although that may be semantics), she would have spoken to a 999 responder who would have been lovely but probably not a specialist mental health professional. They would have (I assume) sent an ambulance, costing what, £400? (not saying this person doesn't deserve money spent on their mental health needs, but £400 could either fund a "free" ride to hospital or maybe 10 hours of therapy which would actually help someone in this situation). They would be transported to A&E where they would probably sit in an uncomfortable noisy waiting room (not a nice place to be at the best of times, but especially when you are in crisis) and eventually get to speak to psych liaison or crisis team who would maybe admit to the psych ward.

Alternatively she could phone 111 (who answer extremely quickly and also triage for ambulances) who would get her in touch with the crisis team, or find the crisis team number herself. She would be speaking to trained, specialist mental health professionals much sooner than through emergency services, who could either help her resolve the crisis over the phone, or visit her at home, or arrange for her to be admitted to the psych ward much more quickly.

I'm not getting at the original poster - she was only asking if anyone knew the number - but at the person who was angry with me and deleted my comments. And I am not commenting about how good (or not) crisis teams can be.

AIBU? Again, sorry for posting my little rant and trying to justify myself when the person in question refused to discuss with me. I am tired and generally irritable anyway! Please feel free to disagree with me.

Hmmm it depends, being close to someone who did require an ambulance for a mental health crisis; they were in no position to be posting on facebook. There are also a lot of numbers online for local authority crisis teams, or even local mental health units who will be more help than 999. So you weren’t necessarily being unreasonable in this case, but as others may be reading for whom an ambulance response would be appropriate it could be dangerous.

@Puggles123 you are right, I didn't think about other people maybe being affected by it - and like you say, this person was well enough to be posting on facebook about it. Although I didn't say not to phone 999 for mental health crisis full stop, I said not to UNLESS it was immediate threat. But yes, someone could misinterpret and think not to phone unless it was a medical emergency. Maybe it's good my comment was deleted in case people misunderstood what I was saying. Having said that, I would also say not to phone an ambulance for a physical complaint that was not an emergency, but don't think this would be seen as unreasonable (in fact the NHS actively promotes this), and people would presumably not be liable to misinterpret this and think I was saying not to phone an ambulance if they were, say, having a heart attack.

Thank you for taking the time to comment.

I believe that the 999 call would result in triaging before automatically sending an ambulance due to the limited number of resources. They might then signpost people in crisis to the right place or have a mental health professional speak to them over the phone. A 999 call does not result in an ambulance every time (unless there is a threat to life).

People panic, the don't know what to do, they are frightened and want help. That can be for physical or mental health distress. I wouldn't criticise anyone genuinely unwell or scared for ringing the emergency services.

I have a family member who normally requires both police and ambulance when in a crises so it really does depend on context of the crises. But then that person wouldn't be coherent enough to post on facebook. To be fair they wouldn't be coherent enough to dial 999 either.

As @DeadBod says, a 999 call would not necessarily result in an ambulance. In my local area 999 ambulance and 111 calls are both handled in the same control room so they can triage from one to the other if required.

I agree with you that 111 is the better option in this case but I wonder if the admins were afraid of repercussions if someone was told not to phone 999 and then ended up seriously harming themselves or worse.

You were right OP - people panic and don’t see the logic sometimes.

Out of curiosity, I just Googled "east sussex mental health crisis" to see who I could call if I needed help (as I'm in East Sussex) and this is the page I found:-
www.sussexpartnership.nhs.uk/urgent-help-crisis
So I think good advice would be to tell someone in crisis to Google "(their area) mental health crisis" and reading the page to see what would be the most appropriate.

As you can see, the very first question and answer are:- Is your situation life threatening or have you seriously harmed yourself? You can go to any hospital A&E department and ask for help. If you need an ambulance, call 999.

But then there are all the other options if the first question isn't applicable.

When I had severe PND, I was told to call 999 or go to A&E if in crisis and unable to get through to the crisis team (I never had to, but I was reminded at every appointment that it was an option). I think YWBU I'm afraid. It's for the 999 dispatcher to make the decision.

You don't know what experience a 999 responder has, they could have extensive medical knowledge.they could easily be a trained mental health specialist. It's up to the emergency services or a medical professional to assess someone and advise what help they need. People can deteriorate very quickly, both physically and mentally when they are unwell.

I see where you’re coming from but I wouldn’t discourage anyone suffering from a mental health crisis from calling 999. Just because their suffering isn’t physical it doesn’t mean it’s not a life or death situation that needs medical aid straight away.

Last time I called the crisis team they told me to call 999 or show up at A&E they were really unhelpful so I guess it depends on how useful your crisis team actually is.

I called 111 once when having a bit of a mental health "wobble". I wasn't having a crisis, but I wanted to prepare in case it developed into one, so I asked 111 who I should call if it all started to get too much.

They immediately sent an ambulance to my house anyway, even after I insisted I didn't need one. The ambulance team were lovely and understanding and took me seriously, but I felt terribly guilty for wasting their time.

I work for a mental health charity. Calling 999 for a mental health crisis is recommended if you feel someone's life or wellbeing is at risk.

Alternatives are your GP or CMHT during their opening hours or NHS Direct at other times. Not all Crisis Teams let you self refer, ours for example don't.

Just to add, that the person having the crisis can feel their life or wellbeing is at risk and can call 999 for themselves.

Yes YABU.
And can we stop saying people in mental health crisis can't post on social media.

Thanks everyone for your comments.

I was wrong in that I thought 999 would pretty much always send an ambulance out (as they have several times sent me an ambulance when others have rang for me, even though I have clearly not needed one). But I stand corrected, thank you.

Insomniac, my other suggestion to this person was to google to find their trust website, which has the information on what to do in a crisis like the number of the crisis team. I have in fact done this myself (my CPN keeps giving me the number and I always lose it!)

Brokengirl, I am not sure who said people in mental health crisis can't post on social media? I tried to help the girl who posted by giving two suggestions on what she could do to get in touch with the crisis team, which is what she asked for in her post. At no point did I say she shouldn't have posted, or refused to help her.

When DH is in crisis he is often told to go to A&E because that is the only place he can see a psych nurse as an emergency. The crisis team used to come out to him but that rarely happens now.

If someone's life is at risk I would not discourage them from calling 999.

999 isn't just for risk of life or limb. I think giving out that advice can often be dangerous. I am not surprised the admin deleted your comments, of course they have to be very careful.

when our son's suicide plans came suddenly to light a few weeks ago (his friends raised the alarm at school) we were told we MUST get him to A&E immediately for an emergency assessment. And yeah, we sat in a noisy waiting room for 5 hours with him alternately sobbing and having a screaming meltdown, it was hellish. But then he was kept in overnight on suicide watch, I stayed with him and he was assessed in the morning and his CAMHS referral fast tracked.

He had parents on hand to get him to A&E. Had he been a few years older, maybe, stuck in a flat on his own with no car and nobody on hand, I bloody hope he would feel able to call 999 in a similar situation, and I hope that if he posted online for advice, there wouldn't be some busybody telling him it would be a waste of an ambulance and he should call 111 to be fobbed off for several hours instead before being told he needed to go to A&E.

This hysteria about not using the emergency services unless there are actual bones sticking out is DANGEROUS. It needs to stop.

Without knowing the full details behind the crisis, it's pretty hard to tell whether the issue warranted a call to 999.

I would've thought that the 999 staff would direct the call to appropriate channels anyway, so not sure what the problem is.

Maybe the comment about the person being well enough to post on f.b. Is open to different interpretation, it is irrelevant if they post on social media, it isn't an indication of their health or wellbeing. Some people don't call 999 when they should, others do when perhaps they didn't need to but that's not the decision for anyone else to take. When you're unwell you don't care about the cost of sending an ambulance, you have enough to worry about.

I don't know. There's a lot of people now days that say "oh don't call 999 it's not life or death" or "don't go A&E they won't be able to do anything" I've had this said to me when my daughter split her lip and broke her tooth, was gushing blood and I decided to go against the advice of that lady, I did ring 111 who promptly told me to go to A&E. And good job I did, as my daughter started to throw up and was concussed, she also needed an X-ray to check she hadn't inhaled the tooth.

I suppose what I'm saying is, if I'd of listened to that lady telling me not to go A&E, I'd of taken her home, she'd of thrown up at home and then I might have rang 999 panicked because of how drowsy she became.

Sometimes it is better to just say nothing at all and let the person decide for themselves. I'm sure the person posting had good intentions and I'm sure the person who it was meant for would have made an informed decision.