If someone’s life is at risk, they have taken an overdose, or you cannot keep yourself or someone else safe, call 999 or go to A&E now. For urgent mental health help when it is not an immediate emergency, call NHS 111 and select the mental health option. These are the routes set out in NHS urgent mental health guidance.
You do not need to choose a rehab provider before getting urgent help. Crisis assessment addresses what is happening now and what support or treatment is needed next. A planned private admission, a routine therapy referral, and an emergency assessment have different purposes and should not be treated as interchangeable routes.
Choose the route by current need
A mental health crisis can involve severe distress, rapidly worsening symptoms, or feeling unable to manage safely. You do not need a confirmed diagnosis to seek advice. If you already have a crisis plan or a treating team’s urgent number, use that route when appropriate, while remembering that an immediate emergency still requires emergency services.
Urgent physical symptoms matter even when drugs, alcohol, or a known mental health condition are involved. Unconsciousness, breathing difficulty, collapse, or a suspected overdose should not be attributed to “just intoxication” while waiting for someone to sleep it off. Tell emergency staff about both the physical symptoms and the mental health concern.
If you are unsure whether the situation is urgent, NHS 111 can help identify the appropriate next step. Describe what is happening rather than trying to diagnose it yourself. A sudden change from the person’s usual behavior, a recent deterioration, or an inability to manage essential needs can be important information for the assessing professional.
What to expect when calling NHS 111
NHS England confirms that people of all ages and concerned family members can use the mental health option. The service can direct callers toward appropriate support, which may include a face-to-face assessment or a community crisis service. Calling does not automatically mean admission to a hospital.
Be ready to say where the person is, how to contact them, what has changed, and whether there is an immediate safety concern. Explain if they are alone, if children or other dependents are present, and whether someone trusted can stay with them safely. Do not delay the call while gathering a perfect history.
Say if alcohol, drugs, prescribed medicines, or recent changes in medication may be relevant. Also explain whether the person has a current mental health team or has recently left hospital. These details help staff connect the urgent concern with existing care and avoid assumptions based on only one part of the situation.
If language or communication is a barrier, ask for support. NHS 111’s access information includes telephone interpretation and a British Sign Language service. Tell staff about hearing, sensory, cognitive, or other communication needs rather than struggling through an assessment in a format that does not work.
When alcohol or drugs are involved
FRANK’s emergency guidance advises calling 999 for urgent medical help after drug use or drinking and telling responders what is known about the substances taken. If possible, provide medication packaging or accurate names, but do not delay emergency assistance because the substance or amount is uncertain.
Physical dependence on alcohol can create another urgent problem when drinking stops or falls sharply. The NHS alcohol use disorder guidance warns that abrupt stopping can be harmful in dependence. Severe withdrawal, including seizures, hallucinations, or marked confusion, needs urgent medical care. A future detox booking is not a reason to wait through worsening symptoms.
When contacting a drug or alcohol service about deterioration, state whether the concern is withdrawal, overdose, a medication interruption, a change in mental state, or several of these. A routine keyworker appointment may still be useful later, but it does not replace urgent assessment when physical or mental health has become unsafe.
After immediate needs are addressed, our medical detox assessment guide explains how clinicians evaluate planned withdrawal care. The coordinated dual diagnosis guide discusses how ongoing mental health and substance use services can work together rather than leaving the person to choose which problem to mention.
Verified London crisis assessment services
Some London services offer direct crisis assessment outside a general emergency department. Their age criteria, catchments, and medical limits matter. Use NHS 111 or the relevant crisis team if uncertain which service fits. A specialist mental health setting may not be equipped to treat an overdose or another urgent physical health problem.
St Charles Hospital: CNWL Mental Health Crisis Assessment Service
CNWL’s MHCAS is open 24 hours a day at St Charles Hospital Mental Health Centre, Exmoor Street, London W10 6DZ. Its current information describes walk-in access without a referral for adults in mental health crisis who do not have an urgent medical need.
The service identifies Kensington and Chelsea, Westminster, Brent, Harrow, and Hillingdon in its local access criteria. It advises current patients to contact their usual community team or CNWL’s 24-hour Single Point of Access on 0800 0234 650 if unsure whether MHCAS is appropriate. An overdose requires emergency medical care instead.
Enfield: North London NHS Mental Health Crisis Assessment Service
North London NHS Foundation Trust’s Enfield MHCAS provides 24-hour assessment for adults aged 18 and over at The Chase Building, 127 The Ridgeway, Enfield EN2 8JL. The service lists direct attendance as an option and recommends calling NHS 111’s mental health option for initial advice.
The team describes assessment followed by a plan for crisis support and any ongoing care. It explicitly directs people with an overdose, physical emergency, or immediate danger to life to 999 or A&E. This is a mental health crisis route, not a general medical emergency department or a residential addiction program.
Goodmayes: NELFT’s crisis assessment hub
NELFT’s 24/7 Mental Health Crisis Assessment Hub is at Block 8, Goodmayes Hospital, Barley Lane, Ilford IG3 8XJ. Its information describes access for adult NELFT residents by telephone, walk-in, or referral, for urgent mental health needs that do not require acute medical intervention.
Goodmayes is in Greater London despite the hospital’s postal address sometimes including Essex. Check that the pathway is appropriate rather than using a county label to decide eligibility. The hub’s published contact is 0300 300 1882, option 3; NHS 111’s mental health option is also listed among its referral routes.
What an urgent assessment may cover
The team will need to understand the current symptoms, immediate risks, physical health, medicines, substance use, and available support. The NHS guide to mental health assessments explains that assessment considers the person’s wider circumstances and needs. It is an opportunity to describe what has become difficult and what help feels necessary.
Be specific about changes. “They have barely slept and their behavior is very different from last week” communicates more than “they are acting strangely.” Report what you have observed, and distinguish it from what you suspect. If the person cannot give a full account, family observations can still help the team understand the timeline.
In a general hospital, liaison psychiatry may contribute alongside medical staff. The Royal College of Psychiatrists describes liaison services as connecting physical and mental health care. This is particularly relevant when a crisis also involves injury, overdose, illness, or symptoms requiring medical investigation.
How relatives and supporters can help
You can seek advice because you are worried about someone else. Explain the immediate concern, the person’s location, and what support is available. If safe and welcomed, help them make the call or attend an assessment. Do not physically confront or restrain someone to force agreement with your preferred treatment plan.
Ask the assessing team how to share relevant information and what they can discuss with you. Respect for the patient’s privacy can affect what staff disclose, but it does not stop you from offering observations. Separate factual changes from arguments about blame, past disappointments, or what the person should have done earlier.
Listening services can offer emotional support too. The NHS lists Samaritans on 116 123. Such support can be valuable while someone is distressed, but it should not replace emergency medical care or an urgent clinical assessment when those are needed.
Before leaving, understand the next step
Tell staff if the proposed plan depends on something unavailable, such as a safe place to stay, a working phone, transport, or a relative who cannot provide the assumed support. Those practical details can change whether follow-up is workable. Raise them during assessment rather than discovering the difficulty only after leaving.
Ask what the team has recommended, who will make the next contact, and what to do if things worsen before that happens. Clarify medication changes and any follow-up for physical health. A discharge or referral is easier to use when the person understands the actual next action rather than only the name of another service.
If planned admission is recommended later, our psychiatric hospital and rehab comparison explains the different settings. The immediate priority remains the assessment of current need. If safety deteriorates after a plan is made, seek help again through the urgent or emergency route rather than waiting simply because an appointment is scheduled.