Crisis resolution home treatment service - referral guide for non-mental health professionals

• GPs and other healthcare professionals. 
• Police, ambulance, and fire service. 
• Non-mental health professionals (e.g. adult social care, housing, substance misuse). 
• Voluntary, community, faith and social enterprise partners (NHS Greater Manchester contracted partners only). 
• Acute and urgent care services, including A&E. 
• Crisis mental health services (mental health liaison teams, NHS 111, mental health urgent triage)  
• Community mental health services (neighbourhood mental health, specialist mental health and early intervention teams). 
• Inpatient services (supported early discharge and appropriate 72-hour follow up). 
• Approved mental health professionals (AMHP) 

A referral will be accepted if:

• Aged 18-65 (day before 65th birthday) and live within one of our boroughs. GP registration is not essential. 
• Experiencing crisis, requiring urgent assessment. 
• Likely to result in admission, without intervention. 
• Need short-term intensive home-based support, risk management, or frequent/daily contact. 
• Require intensive support following discharge from a ward.  
• Risks can be safely managed in the community. 
• Able to engage, or engagement can be developed. 
• Co-existing substance misuse doesn’t exclude assessment where crisis is present. 
• You may be experiencing:  
  • Self-harm, suicidal thoughts, significant emotional distress, behavioural disturbance, or other indicators of an escalating mental health crisis. 
  • Rapid deterioration in mental health and wellbeing associated with: 
    • Breakdown or loss of support systems. 
    • Abuse, exploitation, or safeguarding concerns. 
    • Acute interpersonal or environmental stressors.

Referral may not be accepted if:

• There is no acute change or crisis, and difficulties are longstanding/chronic. 
• Safety cannot be maintained in the community and requires 24-hour supervision. 
• Needs can be met through primary care or service/s already involved in their care. 
• Primary need is substance misuse without mental health crisis, organic disorder, requiring specialist support, a learning disability, neurodevelopment disorder without crisis, housing, social care or practical support. 
• Physical health needs urgent intervention. 
• Under effects of intoxication or withdrawal, preventing meaningful assessment. 
• Severe cognitive impairment or reduced consciousness. 
• Requests for routine review, medication monitoring, or planned care. 
• Need for longer-term intervention beyond the scope of a crisis service. 

All referrals must be made via phone allowing the practitioner to discuss and understand the patient’s needs and what support is most appropriate. 

People in crisis should be referred immediately to avoid delays and ensure support is provided within the required 4-hour and 24-hour response.

Where a practitioner isn’t immediately available, they’ll aim to phone you back within 30 minutes.

Before referring to us, please assess the patient (face-to-face or via phone by exception) using the referral guidance above.  

Where clinically appropriate, the patient should remain available during triage to provide additional information, agree appointment arrangements, and explore alternative support options identified during the discussion. 

Up to date patient contact details are vital. 

Some questions you may be asked during triage include: 

• Concerns and reason for referral. 
• Current risks. 
• Relevant mental health history. 
• Medication and physical health needs. 
• Social circumstances and support networks. 
• Current service involvement. 
• Safeguarding concerns. 
• Next steps 
• Substance use (type, frequency, last use, risks e.g. withdrawal/overdose). 
• Mental Health Act status (where applicable). 
• Consent to referral, where obtained, and relevant information-sharing considerations. 
• Carers, family or others involved in their care.

Following patient triage:  
If the referral is accepted: the practitioner will agree next steps, taking account of the patient’s preferences and needs. In most cases this will include a face-to-face assessment within four hours (very urgent) or 24 hours (urgent). 

If the referral isn’t accepted: the practitioner will discuss and agree the most appropriate next steps with you and the patient, which may include advice and guidance, signposting, referral onwards, or support to access alternative sources of help, where appropriate.