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IN CRISIS?

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Responding to a crisis – simple coping strategies

Talking with others

Getting help quickly – what to do in an emergency

Home | Living with Voices | In crisis?

Going through a crisis can be a terrifying and devastating experience.

Every crisis is different, and only you know what it looks like, how it feels and what it means to you. You might have arrived here because your voices have become unbearable to live with, because you’re feeling overwhelmed or paralysed by pain, overcome with despair or shame, or feel utterly powerless. You might be here because you don’t know how it’s possible for you to get through the next week, day or hour. Any hope of things changing may feel completely lost to you. You may be thinking about, or have begun to plan, ending your life.

If you’re feeling desperate and suicidal, and you need help right away, skip straight to Getting help quickly. Otherwise, continue reading on to explore some of the strategies used by voice-hearers to help them cope in a crisis, and follow the links to other sections of the website.

Need help quickly?

Responding to a crisis

There’s no ‘answer’ to a crisis, just as there’s no ‘right’ or ‘wrong’ way to manage the pain, distress or chaos that may ensue. You might be experiencing a crisis for a reason, or several reasons, and you might be dealing with other problems like poverty or unsafe housing, which aren’t easy to address and in many instances make it that much harder to cope with difficult or distressing voices.

It might be helpful to take a moment to identify what it is that you’re feeling right now – are you terrified, overwhelmed, exhausted, despairing, lost, hopeless?

Identifying what it is that you’re feeling might give you some clues as to what you, or other people, can do to help. Are you frightened and in need of somewhere safe to be? Are you overwhelmed by panic or anxiety, and need to feel calm? Are you in need of some rest, to cry or scream, or a hug from someone you trust?

You might find it supportive to focus only on how to get through the next few minutes, hours or days, rather than looking too far ahead or trying to make bigger plans. You might try focusing on some of small things, such as:

  • Breathing slowly and deeply to bring down your heart rate if you’re experiencing panic
  • Practicing mindfulness, by focussing all of your attention on your breathing or a specific part of your body, or by picking an object in your environment and being attentive to how it looks, feels, smells, sounds or how it might taste
  • Hugging yourself, wrapping up in a duvet or blanket, or holding a hot water bottle
  • Eating or drinking something you find soothing or comforting
  • Walking around the room, or round the block
  • Looking at soothing pictures or photographs
  • Watching or listening to something you enjoy
  • Writing or speaking aloud how you’re feeling, or using mantras or affirmations

Taking small steps like these may not have much of an effect on what your voices are saying, or on the challenges you might be facing in life, but they may halt things from feeling more and more out of your control, chip away at some of the immediate overwhelm and distress or create a bit of space to explore in more detail other means of coping – from the shorter to longer term.

The Coping strategies module explores practical techniques that can help us to manage these challenges, and shares ideas from voice-hearers living with distressing and difficult voices and experiences.

I would say in moments of absolute crisis, try to think to yourself ‘is there a way for me to go to sleep for 20 minutes?’ ‘Is there a way for me to have a glass of water?’ ‘These things sound tiny but if you feel you cannot feel any worse, try just thinking ‘OK, maybe I can’t stop feeling like this, but I can stop myself getting dehydrated in the process, I can stop myself getting incredibly sleep deprived and maybe that might make this all a tiny bit better.

Sometimes I just lie very still and repeat my mantra ‘you will not drown’ over and over until something changes, even if it’s hours.

Talking with others

Talking about the crisis you’re experiencing may feel like an incredibly difficult and daunting thing to do, especially if you’re concerned about how other people might react, or worried about the actions they might take. Lots of voice-hearers worry about the people they care about under or overreacting in a crisis, or taking steps that don’t reflect their wishes – and it’s understandable if you’re feeling these fears or worries too.

Can you think of anyone in your life you could reach out to right now? It could be a trusted family member or friend, or a professional you find calm and reassuring in a panic.

If speaking with someone you know feels too difficult or unhelpful, or if you don’t have anyone you could turn to in a crisis, you might find it supportive to contact a listening service. It might help you to feel less alone, afraid, overwhelmed or distressed, explore what’s going on for you, what’s happened to you, or support you to think about the things that you could do to get you through this period of crisis. Here are some examples:

  • Breathing slowly and deeply to bring down your heart rate if you’re experiencing panic
  • Practicing mindfulness, by focussing all of your attention on your breathing or a specific part of your body, or by picking an object in your environment and being attentive to how it looks, feels, smells, sounds or how it might taste
  • Hugging yourself, wrapping up in a duvet or blanket, or holding a hot water bottle
  • Eating or drinking something you find soothing or comforting
  • Walking around the room, or round the block
  • Looking at soothing pictures or photographs
  • Watching or listening to something you enjoy
  • Writing or speaking aloud how you’re feeling, or using mantras or affirmations

Every listening service has its own confidentiality policy, so it’s best to check their websites for the details, or ask a telephone responder to explain, if you’re unsure of what information – if any – they’d want to pass on to another service if they felt seriously concerned about your safety.

For more ideas on how to talk with others about your voices and other experiences, including a conversation guide for voice-hearers and tips for supporters, visit Talking about voices.

Getting help quickly

If you’ve arrived here feeling hopeless, suicidal or at risk of harm, there are a few different ways that you can get immediate help and support:

Emergency services

Telephoning 999 and requesting an ambulance is one of the quickest ways of getting help in a crisis. If you’re not able to make the call yourself, you might try asking someone to do so for you.

You might prefer to go to your nearest Accident and Emergency department, and speak with someone there.

If you’re not sure whether contacting the emergency services, or attending A&E, would be right for you, you might prefer to call NHS 111 – a non-emergency service – and speak with a responder to explore other options that might feel better for you.

Your GP may also be able to offer you an emergency appointment.

For some people, a hospital admission may be the best option for them. It might be possible to be admitted as a voluntary patient, although this will depend on the Trust and on the number of beds available.

Mental health crisis teams

Mental health crisis teams are known under different names in different parts of the country, e.g. some are called home treatment teams or rapid response services, and they’re designed to support people in crisis in their own homes.

Many mental health crisis teams require a referral from a GP, or A&E, but some accept self-referrals. You can find out if you can self-refer by visiting your local NHS Trust’s website, or by phoning NHS 111.

Mental health crisis services should arrange assessments quickly – within a day or a few days of receiving a referral – where different support options can be explored. Support might include medication, regular home visits, or referrals to other services for longer-term help.

Crisis houses and services

Crisis houses and services offer intensive, short-term support, usually in a community or residential setting, as opposed to a hospital setting. They can be run by NHS services, independent organisations or charities. Crisis houses or services might offer out of hours support or overnight stays.

Some crisis houses or services accept self-referrals, and others only accept referrals from mental health services.  There might be an assessment, which could take the form of a conversation with a member of staff, where they’ll consider the support they can offer, including, if it’s residential, the length of stay they can offer – often limited to a number of days or weeks.

The only non-statutory, residential crisis house in England is Maytree Respite Centre. You will need to phone or email to be assessed. Maytree, in London, offers a one-off short stay (maximum 4 days) for people experiencing a suicidal crisis. It is only possible to stay there once. They have a no drugs or alcohol policy (apart from prescribed medication), and the assessment process is in place to determine whether or not they are the best place to support you.

Edinburgh Crisis Centre, run by Penumbra, offers one-to-one support (appointment only, self-referral), as well as residential stays for up to a week for people experiencing a crisis.

Coed Arian Community Crisis House, run by Gofal, offers the only residential crisis house in Wales. Open to residents of the Vale of Glamorgan, referral needed.

Some mental health trusts offer residential crisis care outside of a hospital setting, for example Drayton Park Women’s Crisis House in North London. Another example is Leicester, Leicestershire and Rutland Crisis House, run by Turning Point. Bristol’s Men’s Crisis House and Women’s Crisis House offer residential support, and operate on both a referral and self-referral basis. Granvue Crisis House offers referral-only residential crisis support (maximum 2 week residential stay) to people living in the Torquay and Teignbridge areas. Statutory residential crisis services tend to be referral-only and may only be available to residents within a certain mental health trust or geographical area.  Check with your GP or MH team to find out what is available in your area.

Leeds Survivor-Led Crisis House offers a telephone helpline (open every day from 18.00-02.00) and a crisis house from 18.00-02.00 for people in crisis. For people visiting for the first time, it’s possible to turn up in the evening between 18.00 and 19.00 (all spaces will be allocated by 19.30). People who have visited before need to contact the service to book a place. The crisis house is also open to parents with children.

James’ Place is a referral-only, non-clinical support centre in Liverpool providing suicidal crisis support for men. It is not residential.

Crisis cafes might also be offered in some mental health trusts. They are usually drop-in offer out of house (evening and weekend) support spaces. Check with your GP or MH team to find out what is available in your area.

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