Supporting a Child in a Mental Health Crisis
A mental health crisis can include suicidal thoughts, a self-harm episode, an acute panic or anxiety attack, or a sudden, severe deterioration in a child or young person's mental state. Acting quickly and calmly can keep them safe. There is no 'right' age for a crisis — primary-age children can be in crisis too. UK statutory services treat under-18 mental health as a safeguarding matter, and you do not need a diagnosis to ask for help.
Immediate danger — call 999
If a child has taken an overdose, has caused themselves serious physical injury, or is about to attempt to end their life, call 999 now. Do not leave them alone. If they have taken anything, take the packaging with you to hospital.
What to report
- •Direct statements about wanting to die, not wanting to be here, or having a plan
- •A self-harm episode that needs medical attention, or escalation in self-harm frequency or severity
- •A sudden change in behaviour — withdrawal, giving away possessions, saying goodbye
- •Severe anxiety or panic that is stopping the young person eating, sleeping, or leaving the house
- •Hearing voices, paranoia, or other signs of psychosis
How to report
999 — Emergency services
When to use
When there is an immediate threat to life — overdose, serious self-injury, an in-progress attempt, or the child cannot be kept safe in the moment
How to contact
Call 999 and ask for an ambulance. Stay with the child. If they have taken medication or another substance, bring the packaging to hospital.
What to expect
Ambulance crews are trained to respond to mental health emergencies. The child will usually be taken to A&E, where a mental health liaison team or CAMHS crisis team will assess them. Under-18s are normally admitted to a paediatric ward overnight if a same-day assessment is not possible.
NHS 111 — option 2 for mental health
When to use
When the child is in crisis but not in immediate physical danger, and you need urgent NHS advice — 24/7
How to contact
Call 111 and select the mental health option when prompted. In most parts of England this routes to an all-age or CAMHS crisis line. You can also use 111.nhs.uk.
What to expect
A trained mental health professional will triage the call and either offer phone support, arrange a same-day crisis assessment, signpost to local CAMHS, or escalate to 999 if needed. Ask for the local crisis line number for future use.
Samaritans — 116 123
When to use
When the young person, or you as the adult supporting them, needs to talk to someone — free, 24/7, any age
How to contact
Call 116 123 (free from any phone, does not appear on the bill) or email [email protected]. The young person can call themselves, or you can call for support.
What to expect
Samaritans listen without judgement and will not pressure the caller to take any specific action. They do not contact the emergency services on the caller's behalf unless the caller asks. This is a listening service, not a clinical one.
Papyrus HOPELINE247 — 0800 068 4141
When to use
When the person at risk is under 35 and there are thoughts of suicide — for the young person, or for an adult worried about them
How to contact
Call 0800 068 4141 (free, 24/7), text 88247, or email [email protected]. HOPELINE247 is specifically for suicide prevention in under-35s.
What to expect
Trained suicide prevention advisers will work with the young person on a safety plan and follow up if invited to. They can advise adults on how to support a young person at risk and on next steps with NHS services.
Shout — text SHOUT to 85258
When to use
When the young person cannot or does not want to speak on the phone — free, 24/7, silent
How to contact
The young person texts SHOUT to 85258. The service is free on all major UK networks and does not appear on the bill.
What to expect
A trained crisis volunteer responds by text, usually within a few minutes at busy times. They will help de-escalate and signpost. Shout will involve the emergency services if there is a clear, imminent risk to life.
YoungMinds Crisis Messenger — text YM to 85258
When to use
When the young person wants a text-based crisis service framed specifically for under-25s
How to contact
Text YM to 85258 — free, 24/7. This routes through Shout's clinical infrastructure with a YoungMinds-branded entry point.
What to expect
The same trained-volunteer model as Shout, with onward signposting to YoungMinds parents' helpline and resources for the supporting adult.
The Mix — 0808 808 4994
When to use
When the young person is under 25 and wants a non-emergency listening service — phone, web chat or email
How to contact
Call 0808 808 4994 (free, 3pm–midnight every day), use the web chat at themix.org.uk, or email through the site.
What to expect
The Mix supports under-25s on mental health, relationships, money, and other pressures. They can hold the call while you make a 999 or 111 plan together.
Childline — 0800 1111
When to use
When the child is under 19 and wants to talk things through themselves, confidentially
How to contact
The child calls 0800 1111 (free, does not appear on the bill) or uses 1-2-1 chat at childline.org.uk.
What to expect
Childline counsellors are trained to support children in crisis and will only break confidentiality if the child is in serious immediate danger. They can help the child plan how to tell a trusted adult.
Evidence checklist
Gather this information before or during your report. Do not delay reporting while collecting evidence — but preserve what you can.
- A short, factual note of what the child has said or done in the last 24-48 hours
- Any medication in the house, where it is kept, and what has gone missing
- Names and contact details of the GP, school DSL, and any CAMHS worker already involved
- A list of trusted adults the child has named in the past
- Recent changes — bereavement, exam pressure, bullying, a relationship breakdown, sleep disruption
- Any prior referrals, assessments, or open cases with CAMHS, social care or school mental health teams
What to say
You do not need to use a script, but this template may help if you are nervous about making the call. Adapt it to your circumstances.
"I am calling about a young person aged [age]. They have [briefly state — e.g. told me they want to end their life / taken an overdose / cut themselves and won't stop]. They are currently [safe in the room with me / alone in their bedroom / at school]. There [is / is not] medication in the house. They are [known / not known] to CAMHS. I am their [parent / carer / teacher / relative]. I need [an ambulance / advice on the next step / a same-day crisis assessment]."
What happens next
If 999 is involved, the child will be taken to A&E for a physical assessment first, then seen by a mental health liaison or CAMHS crisis team. They may be kept overnight on a paediatric ward while a community plan is put in place. If you go through 111 or a crisis line, the typical outcome is a same-day or next-day crisis assessment by a CAMHS clinician, a written safety plan you keep at home, and a referral into community CAMHS for follow-up. The child's GP and school DSL should be informed so support continues across settings. NHS Long-Term Plan commitments mean every area now has a 24/7 all-age crisis line, even where there is no separate CAMHS line.
What not to do
- ✗Do not promise the child you will keep what they have told you a secret — promise instead that you will only share with people who can help keep them safe
- ✗Do not leave a child who has spoken about ending their life alone, even briefly, while you decide what to do
- ✗Do not search the internet for symptoms instead of calling 111 or 999 — crisis services are free and you do not need a diagnosis to use them
- ✗Do not remove or destroy diaries, notes, or messages — clinicians may need to see them to make a safe plan
- ✗Do not assume CAMHS waiting lists mean nothing is available today — crisis pathways sit outside the routine referral queue
Frequently asked questions
The child says they will run away if I call anyone — what do I do?
Their safety comes before their permission. Stay calm, stay with them, and call 111 (option 2) or 999 if the risk is immediate. You can tell them honestly that you have to involve someone because you love them and cannot keep them safe on your own. Childline (0800 1111) can speak with them directly while you make the call.
Is a mental health crisis a safeguarding matter?
Yes. Working Together to Safeguard Children 2023 treats serious mental ill-health and risk of suicide in a child as a safeguarding concern. School DSLs and children's social care should be informed in line with local thresholds, alongside NHS crisis services.
We have been waiting months for CAMHS — does a crisis change that?
Yes. Crisis assessment is a separate pathway from the routine CAMHS waiting list. After a 111 or A&E mental health assessment, the child will usually be moved into urgent follow-up, and any open referral can be re-prioritised. Ask explicitly for the local crisis line number to keep for any future episode.
Sources and further information
- Papyrus — HOPELINE247 — Papyrus UK
- YoungMinds — Crisis Messenger — YoungMinds
- Samaritans — How we can help — Samaritans
- Working Together to Safeguard Children 2023 — Department for Education
This guidance is for informational purposes. It is not a substitute for emergency services or professional safeguarding support. If a child is in immediate danger, call 999 (UK) or 911 (US) now.
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Last reviewed: 2026-05-22. This page provides general educational information, not legal or professional safeguarding advice. UK helplines and legislation may change — verify current details with the relevant organisation.