Helping a Service User in Crisis

Mental Health Crisis pathway guidance for the General Practitioner

Often a General Practitioner can manage a mental health crisis within the primary care setting. However, there are times where joint-working with secondary care mental health services is indicated. This can be when a client is:

• Thinking about suicide or acting on suicidal thoughts
• Having an episode of psychosis
• Doing something that could put themselves or other people at risk
• Relapsing from an existing mental health condition

Contact our Gateway service and request to make a referral to the Community Mental Health Team (CMHT).

Gateway Service Telephone Number for all referrals: 0161 271 0260 (24/7 line, outside the 9-5 Monday to Friday this call will be taken by the Home Based Treatment Team).

The gateway service will ask you if you are requesting to make a routine or urgent referral. A routine referral will receive an assessment appointment within 21 days. If you request an urgent referral the gateway service will pass you straight to the Triage Worker, who will discuss the referral with you and agree an urgent assessment time with you. We aim to provide this service within 24 hours and no later than 5 days.

Outcomes you can expect:

• Referral accepted for assessment of care and treatment needs to the Home Based Treatment Team. If a referral is not accepted, the client will be signposted and discharged back to primary care with an advised plan
• Accepted and assessed for assessment of care and treatment needs under CMHT. This may include an out-patient appointment (OPA) with an advanced practitioner, assignment of a Care Co ordinator, on call psychiatrist appointment
• If a referral is not accepted, the client will be signposted and discharged back to primary care with an advised plan. The GP will receive a written response back including the named clinician who made the decision, together with their contact details, reason for why the referrals was not deemed suitable, and advice about GP management of patient.

 

If client is already known to mental health services and receiving their care

In hours (9-5 Monday to Friday)

• You can contact either the Care Co ordinator if known or request to speak with the duty worker via the CMHT, click here for contact details.

Out of hours

• If outside normal working hours the client can contact the GMMH NHS Foundation Trust Helpline on 0800 953 0285 who will ensure their contact and concerns are reported to the relevant CMHT. The information will be passed to the CMHT the very next working day. They can also provide telephone support and advice during the crisis time. The Helpline provide a service 24/7, 7 days per week, 365 days of the year to people and their carers who are in mental health crisis, feel distressed or unsafe or worried about their mental health. They can also advise the client the next course of action to take.
• Advise the client to attend their local Emergency Department where they can be seen by the LMHT.

 

Alternatives if the client cannot wait for the Urgent assessment

Arrange for your client to attend the Emergency Department. If you feel the client can attend themselves with support this should be considered. If the risk to the client is more imminent call 999 and arrange an ambulance escort to the local ED department. You can also do this if they need help for physical injuries such as self-harm, injury or overdose.

The client will be referred to the Mental Health Liaison Team (MHLT; formerly known as RAID) who will aim to assess within 1 hour.

Outcomes you can expect:

• Referral directly into local HBTT for a period of treatment.
• Referral for a Mental Health Act assessment
• Referral for an in-patient bed if indicated
• Signposting and discharged back to primary care with an advised safety plan which is also given to the client.
• Referral to the relevant CMHT.
• A detailed discharge letter incorporating their advice and plan of care.

 

Assessments under the MHA

If you identify your client requires an assessment under the Mental Health Act we would advise you make an urgent referral to the CMHT in the first instance where possible. However, if deemed more urgent arrange for your client to attend the Emergency Department.

If you have completed a medical recommendation for s2/s3 you can liaise with our Manchester Approved Mental Health Professional (AMHP) Hub. In hours, the AMHP can be contacted on 0161 2710140. Out of hours and at weekends please contact Manchester City Council Contact Centre who can be contacted via 0161 2345001.