Responding to shouting, tears and repeated contact

Shouting, crying and repeated calls can push staff to rush, promise too much or end the contact prematurely. A calm, steady response reduces risk and keeps the interaction clearer.

These behaviours have different safety implications. Shouting can become abusive or threatening. Tears may indicate distress, fear or shame. Repeated contact may mean the patient did not understand the process, the process failed, or the level of risk has changed.

When someone is shouting

Lower your own volume rather than matching theirs. Use short, direct phrases. If they interrupt repeatedly, briefly state the next practical step instead of arguing.

• "I want to help, and I need us to speak one at a time."
• "I can explain the next step if we keep the volume down."
• "I am going to get a supervisor if the shouting continues."

When someone is tearful

Tears do not always indicate clinical risk, but they do mean the person may need a slower, clearer response. Offer privacy if it is safe and available. Do not rush to end the conversation because staff feel uncomfortable.

Use plain wording: "Take a moment. I am still here. Let us work out the next step." If the distress suggests immediate danger, a mental health crisis or a safeguarding concern, escalate via the urgent route.

When someone contacts repeatedly

Repeated contact can be frustrating, but it may show that the process has not worked. Check the record before assuming the patient is unreasonable. Look for missed calls, wrong numbers, unresolved tasks, failed online requests, language barriers or new symptoms.

Circular Conversations

Repeated contact may be frustrating, but it may also be a sign that the route has failed or the patient is not reassured.