Mental Health Support and Getting Help

Mental health is not a separate part of life. It shapes thoughts, feelings, behaviour, relationships, sleep, physical health, work, education and the ordinary tasks of a day. When it slips, the first sign is often something practical — post left unopened, calls not answered, a job that suddenly feels impossible.

You do not need a formal diagnosis before asking for help. You do not need to have reached breaking point, and you do not need to describe things perfectly. Difficulty coping is reason enough to speak to someone.

• Mental distress is not weakness, laziness or attention-seeking.
• Problems can be mild or severe, short-lived, recurring or long-lasting — and the same person can move between those over a lifetime.
• Many people recover fully. Others learn to manage symptoms well enough to live the life they want. Both are real outcomes.
• Physical illness, prescribed medicines, hormones, sleep, alcohol, drugs, trauma, bereavement, poverty, discrimination and isolation can all affect how someone feels.
• This page cannot diagnose a condition. It is a starting point for understanding what help exists and how to reach it.

There is no single picture of poor mental health. The changes below are common reasons people seek help, particularly when several appear together, last for weeks, or start to interfere with daily life.

Feelings

• persistent sadness that does not lift
• anxiety, fear or panic
• irritability or anger that feels out of character
• hopelessness, guilt or feeling worthless
• emotional numbness, or feeling detached from everything
• unusually high, excitable or rapidly changing mood

Thoughts

• poor concentration or difficulty making decisions
• racing thoughts
• intrusive thoughts that are distressing and unwanted
• suspiciousness or feeling watched
• unusual beliefs that others do not share
• hearing or seeing things that other people do not
• thoughts of death, self-harm or suicide

Behaviour and daily life

• withdrawing from friends, family or usual places
• losing interest in things that used to matter
• sleeping far more or far less than usual
• eating far more or far less than usual
• neglecting hygiene, the home or responsibilities
• drinking or using drugs to cope
• impulsive or risky behaviour, including with money
• struggling with work, education, money or relationships

Physical signs

• unexplained aches and pains
• exhaustion that rest does not fix
• shaking or trembling
• breathlessness during panic
• digestive problems and nausea
• headaches
• noticeable slowing down, or restless agitation

These signs can have many different causes, including physical illness. Recognising them does not prove any particular diagnosis — it simply means it is worth talking to someone.

Short introductions, not checklists. Nobody should diagnose themselves from a list, and many people experience more than one of these at once.

Symptoms that look like a mental illness can sometimes be caused or worsened by something physical. That is one of the main reasons a GP appointment is a sensible first step.

• thyroid problems, either over-active or under-active
• anaemia or vitamin deficiencies, including B12 and vitamin D
• infection, which in older or frail people often shows as confusion
• neurological conditions, including after a stroke or head injury
• hormonal changes, including pregnancy, postnatal changes and menopause
• persistent pain
• sleep disorders, including sleep apnoea
• prescribed medicines, including steroids and some heart and hormone treatments
• alcohol and drugs, including cannabis and stimulants
• withdrawal from alcohol, benzodiazepines, pregabalin, gabapentin, opioids or other substances

Get urgent medical assessment for sudden confusion, behaviour that is changing rapidly over hours or days, a first seizure, collapse, a serious head injury, or any sign of stroke such as face drooping, arm weakness or slurred speech. Call 999 for those stroke signs.

Do not stop any prescribed medicine or substance suddenly because of this page. Ask a GP, pharmacist or prescriber how to do it safely.

A GP is the usual route into most mental health care, and it is a routine part of their work. You will not be wasting anyone's time.

Preparing

• ask for a longer appointment if the surgery offers them
• write down the two or three main problems before you go
• bring a list of medicines, including anything bought over the counter
• take somebody trusted with you if you want to
• ask for communication adjustments — a quiet room, a phone or video appointment, written notes
• explain the effect on everyday life, not only the feelings
• be honest about self-harm, suicidal thoughts, alcohol and drugs; it changes the help offered
• ask what happens next and when you will be contacted

What a GP may do

• ask about symptoms, safety and what is going on in your life
• review your medicines
• consider a physical examination and blood tests
• discuss talking therapies, medication, or practical and social support
• refer to a specialist service where that is needed
• arrange urgent assessment if there is significant risk

Sometimes the first conversation does not go well. That is frustrating, and it is not a reason to stop.

• Give specific examples and describe how daily life is affected.
• Ask what other causes have been considered, and whether tests would help.
• Request a follow-up appointment rather than leaving it open-ended.
• Ask to see a different GP at the surgery where that is possible.
• Ask whether a referral is available, or whether you can self-refer to a therapy service.
• Ask for the decision and the next steps to be explained clearly, and note them down.
• Use the NHS complaints route, or PALS in England, where things have gone wrong.
• Ask Sixpence Support UK for help putting a letter or complaint together.

Requesting a referral does not oblige a service to accept it, and thresholds differ by area. Even so, a clearly explained request, with examples, is far more likely to be acted on.

“Talking therapy” covers many different approaches. The right one depends on the person, the problem and what they feel able to do. Cognitive behavioural therapy is well known and well evidenced, but it is not the answer to everything.

Medication helps many people, and does not suit everyone. It is a decision to make with a prescriber, based on the problem, previous experience, physical health and personal preference. This page does not give doses and does not recommend particular medicines.

• Antidepressants are used for depression and several anxiety conditions. They are not addictive in the way that some other drugs are, but stopping them abruptly can cause withdrawal symptoms.
• Medicines sometimes used for anxiety include short courses of certain sedatives in specific circumstances. These carry dependence risks and are generally intended for short-term use only.
• Antipsychotics are used in psychosis, bipolar disorder and sometimes alongside other treatment. They need physical-health monitoring.
• Mood stabilisers are used mainly in bipolar disorder. Some require regular blood tests and careful attention to fluids, other medicines and pregnancy.
• Medicines used for sleep are usually short-term and selective, because tolerance and dependence can develop quickly.

Treatment is rarely only therapy or only tablets. What surrounds someone matters as much, and practical problems often need practical answers. None of the following replaces professional treatment, and telling someone to go for a walk is not a care plan.

• a workable sleep routine, rather than a perfect one
• regular meals and fluids, even when appetite has gone
• physical activity that is manageable on a bad day, not an ambitious plan
• reducing isolation with small, regular contact
• peer support groups, online and in person
• social prescribing link workers, available through many GP surgeries
• debt, housing and benefits advice — money worry is a genuine clinical issue
• occupational therapy to rebuild daily activity and structure
• substance-use support, working alongside mental health care
• crisis houses, safe havens, sanctuaries or crisis cafés where these exist locally
• community mental health teams for ongoing specialist care
• crisis resolution and home-treatment teams, providing intensive support at home
• inpatient care when someone cannot be kept safe or treated at home

A safety plan is a short, calm, written plan made in advance, for use when things get bad. It works best written when someone is relatively settled, and kept somewhere easy to reach.

• personal warning signs that things are slipping
• things that can help get through the next few minutes or hours
• trusted people to contact, with their numbers
• professional contacts and urgent numbers, including the local crisis team
• safer places to go — a friend's home, a public place, a safe haven
• making the immediate environment safer, with help from someone trusted
• arrangements for children, dependants or pets so that worry does not become a barrier
• keeping the plan somewhere accessible — phone, wallet, fridge door
• sharing it with trusted people and, where appropriate, with professionals

The dedicated Sixpence Support UK page has fuller guidance on getting through a crisis, including what to expect when you contact urgent services.

You do not need training, and you do not need the right words. Being steady and staying interested does most of the work.

• Choose a calm, private place and allow enough time.
• Listen without judgement, and let silences happen.
• Ask directly whether they feel unsafe, or whether they are thinking about suicide. Asking does not put the idea into someone's head — it usually brings relief.
• Take any answer seriously, including one that seems understated.
• Avoid arguing, minimising, or offering clichés about counting blessings.
• Help them make contact with support, and offer to sit with them while they call.
• Stay with them during immediate danger, if it is safe for you to do so.
• Call 999 when there is immediate risk to life.
• Look after your own safety, and step back if you are threatened.
• Follow up afterwards. A short message days later matters more than people expect.

Children and teenagers often show distress through behaviour rather than words: anger, withdrawal, refusing school, physical complaints, or sudden changes in friendships.

• changes in behaviour, sleep, eating, school attendance or friendship groups
• bullying and cyberbullying, including group chats and social media
• exam pressure and fear of failure
• family conflict, separation, illness or bereavement at home
• abuse, grooming, exploitation and county lines involvement
• self-harm, which needs a calm response rather than punishment
• eating problems and worries about body image
• neurodiversity and unmet support needs — distress is often about the environment rather than the child

Where to turn: school or college pastoral and safeguarding teams; the GP; local children and young people's mental health services; Childline for the young person themselves; and the urgent and emergency routes above when safety is at risk. Young people can call 999 or attend A&E in an emergency.

Confidentiality has limits. Professionals will normally keep things private, but they must act if a child or someone else is at risk of serious harm. It is fairer to say this at the start than to promise secrecy that cannot be kept.

Friends can be an enormous support, but a young person should not be left carrying this alone, and neither should the friend who is worried about them. There should always be a trusted adult involved.

Mental health problems during pregnancy and after birth are common and treatable, and they are nobody's fault. Specialist perinatal mental health services exist in much of the UK.

• Antenatal and postnatal depression — persistent low mood, exhaustion beyond normal tiredness, guilt, and difficulty enjoying the baby.
• Anxiety — constant worry about the baby's health or safety, checking, and panic.
• Intrusive thoughts — frightening, unwanted thoughts about harm coming to the baby. These are distressingly common, and having them does not mean somebody will act on them. They should be shared with a midwife, health visitor or GP, who will have heard it before.
• Postpartum psychosis — a rare but serious illness that usually begins in the days or weeks after birth and needs urgent specialist assessment.

Midwives, health visitors and GPs all ask about mental health as a routine part of care. Saying yes when asked leads to support, not to babies being taken away.

Depression and anxiety in later life are often missed, dismissed as ageing, or hidden behind physical symptoms.

• Depression is not an inevitable part of growing older, and it responds to treatment at any age.
• Bereavement and loneliness accumulate, particularly after the loss of a partner.
• Physical illness and persistent pain both affect mood heavily.
• Medicines and interactions can cause low mood, confusion or agitation.
• Untreated hearing and sight loss increase isolation and can be mistaken for confusion.
• Dementia is a different condition from depression, though the two can look alike and can coexist.
• Sudden confusion is not dementia and needs urgent medical assessment.
• Caring for a partner can be exhausting, and carers need support of their own.
• Losing independence, driving or a home can be a genuine grief.

Being disabled or neurodivergent is not a mental illness. However, inaccessible services, unmet support needs and repeated poor treatment do affect mental health, and adjustments should be offered as a matter of course.

• information in writing, in plain language, or in an accessible format
• extra time to process questions and to answer them
• a quiet waiting area, or waiting outside until called
• help with forms and applications
• communication aids, interpreters, or communication passports
• involvement of a trusted supporter, with the person's consent
• appointments by phone, video, text or email where that works better
• recognition that distress may be expressed differently — through shutdown, meltdown, silence or repetitive behaviour rather than obvious upset

Ask for adjustments to be recorded on the person's file so they do not have to be requested at every appointment.

Relatives often hold a great deal of worry with very little support, and are sometimes made to feel they are interfering. They are not.

• Ask services how to pass on concerns, and who to send them to.
• Confidentiality limits what professionals can tell you, but they can almost always listen to information you give them. Passing on what you have seen is not a breach of anyone's privacy.
• Professionals cannot normally share private details without consent, so do not expect a service to confirm what has been discussed. Ask instead for general advice on how to help.
• Ask the local council for a carer's assessment — it is a right, separate from the other person's care.
• Make an emergency plan for what happens if you are ill, away or unable to help.
• Ask about respite, practical support and carer support groups.
• Take carer burnout seriously; exhaustion and resentment are signals, not failures.
• Raise safeguarding concerns with the council or the police if an adult or child is at risk of harm, neglect or exploitation.
• Young carers looking after an adult are entitled to an assessment and support of their own.
• If you cannot keep everyone safe, say so clearly to services and, in an emergency, call 999. Being direct about the risk usually changes the response.

Mental health problems and work interact in both directions. Sensible adjustments early often prevent a long absence later.

• Speak to an employer, school or college where you feel able. You choose how much detail to give.
• A fit note from a GP can say you may be fit for work with adjustments, not only that you are unfit.
• Reasonable adjustments might include altered hours, reduced duties, a quieter space, homeworking, or changes to how supervision happens.
• Occupational health can advise the employer on what would help.
• A phased return can rebuild hours gradually after sickness absence.
• Access to Work can fund support, equipment or mental health support services for people in work or starting work.
• Disability protections may apply where a condition has a substantial, long-term effect on daily activities. This depends on the individual situation — not every mental health condition automatically meets the legal test.
• Keep a written record of adjustments agreed, and who agreed them.
• Get independent advice before resigning. Decisions made in a bad week are hard to undo.
• Students should ask about student support, disability services, mitigating or extenuating circumstances, and deadline extensions.

Poor mental health makes forms harder, appointments easier to miss, budgeting harder to hold together, and phone calls to organisations genuinely frightening. Debt and mental health feed each other, so dealing with the money side is part of treatment, not a distraction from it.

• Universal Credit — the main working-age benefit; ask about limited capability for work where health affects your ability to work.
• Personal Independence Payment — for the extra costs of a long-term condition, including mental health conditions.
• Employment and Support Allowance — relevant in some circumstances, usually where there is a National Insurance record.
• Statutory Sick Pay — from an employer during sickness absence, if you qualify.
• Housing support through the council, and help if you are at risk of losing your home.
• Council Tax reduction and, in some cases, other discounts.
• Free, independent debt advice — never pay for a debt solution before getting advice.
• Reasonable adjustments from DWP, councils, banks and utility companies, such as extra time, a named contact, or communication in writing.
• Appointeeship, where somebody manages benefits for a person who genuinely cannot do so.
• Advocacy to help someone speak up in meetings and assessments.

Payment rates and eligibility rules change, so check the current official pages rather than relying on figures quoted anywhere else, including here.

Mental health law is not the same across the UK. England and Wales, Scotland, and Northern Ireland each have their own legislation, and the details matter. What follows is a general outline only, not legal advice.

• Consent — treatment is normally given with agreement, after the options and risks have been explained.
• Confidentiality — information is kept private in most circumstances, but it can be shared where there is a serious risk to someone's safety or a legal duty to do so.
• Mental capacity — capacity is assumed unless assessed otherwise, is decision-specific, and can change over time. An unwise decision is not the same as lacking capacity.
• Advocacy — independent advocates help people understand options and be heard. Some forms of advocacy are a legal entitlement in particular situations.
• Care plans — you can ask for a copy, ask for it to be explained, and ask for it to be changed.
• Second opinions — can be requested, though they are not guaranteed in every situation.
• Access to records — you can normally request your health records.
• Complaints — every NHS service has a complaints process, and PALS can help in England.
• Detention — mental health legislation allows compulsory assessment or treatment in limited circumstances, with safeguards, rights of appeal, and access to advocacy. The criteria and processes differ by nation.

Admission is not a failure, and it is not a punishment. It is used when someone cannot be kept safe or treated well enough at home.

• Assessment usually involves talking with mental health professionals about symptoms, risks, history and what support exists at home.
• Voluntary admission means agreeing to come in, and normally being able to discuss leaving with the team.
• Detention under mental health legislation happens when strict legal criteria are met. It carries rights, including information about the reasons, the right to appeal, and access to advocacy.
• Belongings and medicines — bring regular medicines and a list, along with clothes, glasses, hearing aids, chargers and important phone numbers. Some items are restricted for safety.
• Contacting family or carers — usually done with the person's consent; say early who you want involved.
• Advocacy — ask for an advocate if it is hard to be heard, or to understand what is happening.
• Care planning — the person should be involved in decisions about their treatment wherever possible.
• Discharge planning — should start early and cover medication, housing, money, follow-up and a crisis plan.
• Follow-up — the period straight after discharge is a vulnerable time; make sure a follow-up contact is booked before leaving.
• Raising concerns — speak to the ward manager first, then use PALS or the formal complaints route.

Recovery is rarely a straight line. Good weeks and bad weeks both belong to it, and a setback does not cancel progress.

NHS (England) and national guidance

Across the UK: routes and telephone options differ by nation.

Work, money and rights