Mental health, self-harm, threats and safeguarding

Red flags include mental health and safeguarding concerns. Someone who may harm themselves or others, be at risk from another person, or be unable to keep themselves safe requires urgent escalation via local crisis, safeguarding or emergency routes.

Mental health and safeguarding contacts can be hard to manage at the front desk. The patient may be distressed, angry, frightened, intoxicated, under someone else's control, or unable to speak freely. Reception staff should remain calm, record the patient's exact words and follow local procedures rather than trying to manage the risk alone.

Listen or look for

• Suicide risk: phrases such as "I do not want to live", "I cannot stay safe", "I have tablets" or "I have a plan".
• Self-harm or overdose: current injury, recent overdose, access to means or escalating intent.
• Threats to others: clear threats, weapons, violence risk or fear that someone may be harmed.
• Domestic abuse or coercion: fear of a partner, being monitored, not being allowed to speak, or other urgent safety concerns.
• Safeguarding concerns: risk to a child, an adult at risk, a baby, a pregnant patient or a dependent person.

Do not leave crisis wording unresolved

A crisis contact must not be treated as a routine message, a future appointment request or an unattended online task. If the patient disconnects, refuses help, or cannot speak safely, follow the local failed-contact and safeguarding procedures.

Do not promise confidentiality beyond what is safe. If there is immediate risk to the patient or someone else, the priority is urgent help and safeguarding action according to local policy.

Safety and privacy note

When someone may not be safe, the contact needs urgent ownership - reception staff should not hold that risk alone.