Self-harm, overdose, intoxication and access to means

Contacts about mental health crisis may involve immediate physical danger. Someone might have taken an overdose, harmed themselves, be intoxicated, have access to tablets or weapons, or be unable to keep themselves safe while waiting.

Reception staff must not try to make clinical judgements about toxicity, the seriousness of injuries, or whether intoxication explains behaviour. Those are clinical or emergency decisions. The safe action is to follow the agreed local escalation route and pass the contact on.

Listen or look for

• Overdose or possible poisoning: tablets, alcohol, drugs, chemicals or unknown substances.
• Self-harm: cutting, injury, strangulation attempt, burning or other self-inflicted harm already done or imminent.
• Access to means: tablets visible, weapons nearby, ligatures, bridges, railways, water or isolated locations.
• Intoxication with risk: confusion, drowsiness, aggression, collapse, unsafe location or children present.
• Refusal or inability to seek help: hanging up, saying goodbye, refusing emergency help or being hard to contact.

Keep within role

Do not ask reception staff to judge whether a dose is toxic, whether bleeding is severe, or whether someone is "really" suicidal. Collect the factual details required by the local script and hand the contact to the appropriate urgent route.

If there is immediate physical danger, call emergency services rather than arranging a routine mental health appointment. Local protocols should specify this so staff do not have to improvise.

Physical safety note

When crisis wording includes overdose, injury, intoxication or access to means, treat the contact as urgent until the appropriate service has taken ownership.