Exam Pass Notes

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A Simple Safety Memory Aid

• Notice the warning words
• Stay within role
• Use the local route
• Record the facts
• Hand over clearly
• Close the loop

Recognise

• Mental health crisis wording can include suicidal thoughts, a plan or intent, goodbye messages, or an inability to stay safe.
• Self-harm, overdose, intoxication, access to means or serious injury may require emergency medical response in addition to mental health support.
• Command voices, severe agitation, paranoia, confusion or threats to others should not be managed by reception staff alone.
• Children, dependants, domestic abuse, exploitation or other safeguarding concerns increase urgency.
• Third-party concerns still need escalation when the patient cannot be reached or is at risk.

Respond

• Use the local urgent escalation route as soon as crisis wording is clear.
• Do not diagnose, counsel or clinically risk-assess from reception, care navigation or call-handling roles.
• Do not promise confidentiality when safety concerns may require urgent information-sharing.
• Do not give routine reassurance or tell the person it is safe to wait when urgent wording is present.
• Escalate uncertainty rather than attempting to resolve unsafe situations yourself.

Record and Handover

• Record exact words, time, contact route, current or last known location and safe call-back details.
• Record immediate risk details such as overdose, self-harm, access to means, threats, children or dependants if disclosed.
• Record action taken, including who accepted ownership and which crisis, emergency or safeguarding route was used.
• Document complications such as refusal, failed call-back, disconnection, online delay or remaining uncertainty.
• Keep urgent wording visible rather than reducing it to vague phrases like "low mood" or "mental health query".

Practice Systems

• Staff need visible prompts, clear scripts, named urgent clinical contacts and backup routes.
• Monitor online requests and routine queues so crisis wording is not missed.
• Failed-contact rules should state what to do when calls drop, people cannot be reached or urgent ownership is delayed.
• Staff should receive support and debrief after distressing or threatening crisis contacts.
• Use near misses for learning and system improvement rather than only for individual reminders.