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

In the first instance please contact your local CMHT (see table below) or Early Intervention if you are concerned someone is experiencing a first episode psychosis.

Team

Address

Opening Times

Telephone Number

Duty Line (for urgent queries)

Ramsgate House

Ramsgate House, Ramsgate Street, Lower Broughton, Salford, Greater Manchester, M7 2YL

Monday to Friday, 9am to 5pm

0161 358 0732

07760 960548

Prescott House

Prescott Street, Little Hulton, Salford, Greater Manchester, M28 0ZA

Monday to Friday, 9am to 5pm

0161 357 1202

07776 962024

Cromwell House

32 Cromwell Road, Eccles, Salford, Greater Manchester, M30 0GT

Monday to Friday, 9am to 5pm

0161 357 1280

 07901 107938

Salford EIT

The Broadwalk Centre, Belvedere Road (access via Whitebeam Close), Salford, M6 5EJ

Monday to Friday, 9am to 5pm

0161 358 2500

07917 233404

The CMHT service will ask you if you are requesting to make an emergency, urgent or routine referral.

  • A routine referral will receive an assessment appointment within 21 days.
  • An urgent referral will receive an assessment appointment within 5 days.
  • If you request an emergency referral the CMHT service will pass you straight to the Duty Worker, who will discuss the referral with you and agree an urgent assessment time with you, this can be a same day assessment.

Outcomes you can expect:

  • 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
  • Following the duty assessment a referral may be made to acute care services (Home based treatment team / inpatient services)
  • 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 (9am to 5pm Monday to Friday)

  • You can contact either the Care Co ordinator if known or request to speak with the duty worker via the CMHT please see table above.

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 MHLT.

Alternatives if the client cannot wait for this 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) who will aim to assess within 1 hour.

The team can be contacted on 0161 206 4847.

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.

If you identify your client requires an assessment under the Mental Health Act we would advise urgent referral to the CMHT in the first instance where possible. However, if deemed more urgent you can liaise with our GMMH Approved Mental Health Practitioner (AMHP) Hub. In hours, the AMHP can be contacted on 0161 358 0653 / 357 1280. Out of hours and at weekends Salford EDT can be contacted via 0161 794 8888.

In the near future we will be offering a urgent listening lounge in Salford, more details will follow in due course.