Panic, distress and urgent mental health concerns

Some anxious contacts need urgent help. Severe distress, panic with possible medical concern, self-harm, suicidal thoughts, domestic risk or an inability to stay safe should prompt your local urgent process.

Distress is not always routine anxiety

Panic and anxiety can be frightening, but reception staff must not decide that symptoms are "just panic". A call that starts with anxiety may include chest pain, breathlessness, collapse, overdose, self-harm, domestic danger or suicidal thoughts.

If the caller's words suggest immediate physical or mental health risk, the contact has moved beyond routine reassurance and should be escalated.

Escalate when

• The patient mentions self-harm or suicide.
• The patient says they are not safe or cannot be left alone.
• There may be immediate physical danger, including severe breathlessness, chest pain, collapse or overdose.
• Domestic abuse, coercion or safeguarding concerns are disclosed or suspected.
• You are unsure whether routine handling is safe.

Keep within role

Do not attempt a clinical suicide risk assessment, decide whether the patient is exaggerating, or manage a crisis alone unless local procedure explicitly allows this and you have support. Use the urgent route promptly.

If local procedure says to keep the caller on the line while help is sought, do so when it is safe. If the call drops, follow the failed-contact process.

Do not try to contain crisis-level distress by reassurance alone; use urgent escalation.

Emergency wording