Mental Health: 111 or 999? UK Support at Home and Care Funding

If someone is at immediate risk of harm, call 999 or go straight to A&E. For urgent but non-life-threatening help, call NHS 111 and select the mental health option, available 24 hours a day. From there, local crisis resolution and home treatment teams can often assess and support someone safely at home, alongside your GP or existing care coordinator.

TL;DR:

• Call 999 or go to A&E if life is at risk; NHS 111’s mental health option handles other urgent crises 24 hours a day.
• Samaritans at 116 123 and SHOUT by texting 85258 offer free emotional support; people already receiving care should contact their named team.
• Crisis teams can assess at home, review medication, and offer psychological support, but home treatment is time limited and unsuitable when the home is unsafe.
• Reablement after a crisis usually lasts one to two weeks and rarely exceeds six weeks; it focuses on restoring independence, unlike clinical crisis treatment.
• People deemed eligible by their council can use direct payments for personal care or respite, but not food, bills, or NHS services.

Table of Contents

• Urgent steps and helplines to use now
• How crisis teams and home treatment work
• Types of in-home mental health support and who provides them
• How to access home support and common referral routes
• Funding, direct payments and arranging paid home support
• Practical tips for families and carers supporting someone at home
• Our experience supporting people with mental health needs at home
• How we can help with ongoing home support
• FAQ
• Sources

Urgent steps and helplines to use now

When a mental health crisis happens, the first few minutes matter more than anything else. Knowing exactly who to call removes the guesswork at the worst possible time.

• Call 999 or go to A&E immediately if there is any risk of harm to life, including suicide risk.
• Call NHS 111 and choose the mental health option: this service runs 24 hours a day, seven days a week, and can connect you to local crisis teams or arrange a face-to-face assessment.
• For non-emergency emotional support, Samaritans (116 123) and SHOUT (text SHOUT to 85258) are free and available around the clock.
• If the person is already under care, contact their GP, named worker or community mental health team first where that is possible.

These routes work together rather than as alternatives. A call to 111 does not replace 999 in an emergency, and it should not delay a call for immediate medical help.

How crisis teams and home treatment work

Crisis resolution and home treatment teams, often shortened to CRHT or HTT, provide assessment and short-term support for people in crisis, sometimes at home instead of in hospital. NICE guidance describes these services as integrated, locally delivered care designed to prevent unnecessary hospital admissions.

Support from these teams commonly includes:

• Home visits for assessment and ongoing monitoring.
• Medication review and support with taking it correctly.
• Brief psychological interventions aimed at stabilising a crisis.
• Practical help with housing, benefits or safety planning where needed.

Pro Tip: Ask your team, while things are calm, how often they visit, who to contact out of hours, and whether you will have a named worker rather than a rotating roster.

Home treatment is assessed case by case and is time-limited. It works well for many people, but it is not suitable for every situation, particularly where the home environment itself carries risk.

Types of in-home mental health support and who provides them

Several different services fall under the umbrella of “home support,” and knowing which one fits the situation saves time when you need help quickly.

• NHS home treatment teams provide clinical assessment and short-term treatment aimed at avoiding hospital admission.
• Domiciliary care agencies can offer personal and domestic support, such as help with daily routines, shopping, companionship and medication prompts.
• Reablement or intermediate care is time-limited, typically lasting one to two weeks and usually no longer than six weeks, and focuses on restoring independence after a crisis or hospital stay.
• Talking therapies, delivered through NHS talking-therapies services or community providers, can take place remotely or in person.

Each of these can run alongside the others. A person might receive clinical home treatment for a few weeks while also having a domiciliary carer support daily routines and medication reminders.

How to access home support and common referral routes

Getting the right support quickly depends on knowing who to contact and having the right details ready.

1. Start with NHS 111 and the mental health option, your GP, A&E liaison psychiatry, or an existing community mental health team or care coordinator.
2. If there is already a care plan in place, use the named contacts and crisis plan within it to reach the local crisis team faster.
3. Have key information ready: current medications, diagnoses, who lives with the person, any recent changes in behaviour and any immediate safety concerns.
4. If you are self-referring, ask the local crisis team directly whether they accept contact from individuals or families, or whether a professional referral is required first.

Having this information prepared before a crisis happens makes the first call far more productive.

Funding, direct payments and arranging paid home support

Under the Care Act 2014, people who are assessed as eligible by their local authority can receive direct payments to arrange and pay for their own social care. This follows a formal care needs assessment carried out by the council.

• Direct payments can cover personal care, respite care, daytime activities, minor home adaptations and employing a personal assistant.
• They cannot be used for regular living expenses such as food or bills, or for services that the NHS already provides.
• Local authorities offer guidance, and payroll or management services exist for people who cannot manage the payments themselves.
• Families who are paying privately can contract directly with a domiciliary care agency for ongoing visits or live-in support.

Direct payments give families real choice over who provides care and how, rather than relying solely on commissioned services.

Practical tips for families and carers supporting someone at home

Small, consistent routines make a genuine difference to someone recovering at home, and they reduce the pressure on carers too.

• Build structure into the day: regular check-ins, scheduled appointments and simple routines help reduce isolation and support recovery.
• Agree a written safety plan with the GP or crisis team and keep emergency contact numbers somewhere visible.
• For medication support, use reminders where appropriate and clarify what a carer can do and what requires clinical staff.
• Before choosing a home care provider, ask about DBS checks, CQC regulation, staffing continuity, a named contact, and how they liaise with the clinical team involved.

Pro Tip: Keep a simple notebook or shared note of medication times, mood changes and appointments. It saves everyone from relying on memory during a stressful week.

Our experience supporting people with mental health needs at home

We provide home care across London, with carers who are DBS checked and regulated by the CQC. We see, day to day, how well-coordinated domiciliary care can support routines, medication and dignity alongside NHS treatment, rather than instead of it. Always follow the urgent clinical routes above first, then consider agency support for the ongoing, practical side of care.

— Dan

How we can help with ongoing home support

Once the urgent situation is managed, ongoing support at home is often what keeps someone well. We offer call-in visits, live-in care, medication assistance, companionship and respite cover, built around what each person actually needs rather than a fixed package.

• Call-in visits suit people who need regular check-ins and support with daily tasks.
• Live-in care works well where someone needs continuous support and company.
• Medication assistance and companionship help maintain routine and reduce isolation between clinical appointments.
• Respite cover gives family carers a proper break without worrying about continuity of care.

Our carers are DBS checked, and our service is regulated by the CQC. You can see the full range of home care services we provide, or download our free home care guide to understand your options before you need them.

This article is general information, not a substitute for advice from a qualified doctor. Consult a qualified healthcare professional about your own circumstances before acting on anything here.

FAQ

What should I do if someone is in a mental health crisis right now?

If there is any risk to life, call 999 or go to A&E immediately. For urgent but non-life-threatening support, call NHS 111 and select the mental health option, which operates 24 hours a day and can connect you to local crisis teams.

What are some effective ways to cope with mental health challenges?

Simple structure helps: regular check-ins, consistent routines and a written safety plan agreed with a GP or crisis team. Support from a home treatment team or domiciliary carer can reinforce these routines when a person is finding it hard to manage alone.

What are some common mental health conditions supported at home?

Home-based support commonly covers conditions such as depression, anxiety, bipolar disorder, psychosis and dementia-related needs, alongside support for people managing crisis episodes. The right type of support, clinical, practical or both, depends on the specific condition and current level of risk.

How long does home treatment or reablement usually last?

Crisis home treatment is generally short-term and reviewed regularly, while reablement or intermediate care typically lasts one to two weeks and rarely more than six. After this period, ongoing needs are usually met through domiciliary care or community services.

Can I pay for home care support myself or through direct payments?

Yes. Under the Care Act 2014, people assessed as eligible by their local authority can receive direct payments to arrange their own care, including personal assistants and respite support. Families can also pay privately and contract directly with a home care agency for ongoing visits or live-in support.

Sources

• Where to get urgent help for mental health – NHS
• Legislation
• Cambridge

Recommended

• Mental health support guide for London families
• 2–5, 5–10, 10–20 hrs: Plan Your UK Care Hours, Assessment & Funding
• Emergency home care in the UK: what to do right now
• Alternatives to care homes: a practical guide for families