Going to A&E with someone

The person who is unwell should not drive themselves. If you are considering taking them, think about whether the journey is safe for both of you. If they are too unwell, very agitated or you fear harm on the way, call 999 and describe the situation. Do not try to force them into a car.^[1]

If readily available, bring:

• Medicines or an up-to-date medicine list, allergies and information about recent doses.
• Any crisis plan and the care team’s contact details.
• A brief note of what happened and when.
• A charged phone, charger, glasses or hearing aids, and something comfortable or familiar.

You can bring information later if needed. If you do not know something, say so. Ask staff before offering food, drink or medicines during assessment or treatment.

Tell reception or the triage nurse why they need help now. Triage is the initial assessment used to prioritise care. Patients are not necessarily seen in arrival order, and an ambulance does not automatically mean a shorter wait.^[2]

Be specific. Explain any injury, overdose, suicidal words or actions, severe confusion, unusual behaviour, or concern that they may leave and come to harm. Share what you actually know, including uncertainty about substances, amounts or timing.

Ask for a private conversation if the information is sensitive. Tell staff about communication, sensory or disability needs. Ask for an interpreter if needed; do not assume you must interpret for them.^[2]

A&E can be noisy, bright and busy. Ask whether there is a quieter place they can wait and how to let staff know where you are. A separate room may not be available. Keep your voice calm, avoid arguing about what they believe, and offer simple choices if that helps.

Tell the nurse promptly if they become more distressed, confused, drowsy or physically unwell, talk about harming themselves, or you become worried about anyone’s safety. An earlier assessment does not cover every later change.

• Who should we speak to if something changes?
• Are we waiting for physical treatment, a mental health assessment, or both?
• Has the mental health team been contacted?
• Is there anything they need while waiting, including help with usual medicines?

You do not have to watch them alone or manage unsafe behaviour. If you need a break, cannot stay or feel unsafe, tell staff and ask who will take over. Explain your limits before leaving. See responding when they are frightened or hearing things for help with conversation.

If the person wants you involved, ask staff to record what they agree can be shared and whether they want you present. They may also want time to speak privately. You can help without answering every question for them.

You can tell staff your concerns even when they cannot discuss the person’s care with you. Being a friend does not prevent you from supplying information. Confidentiality can limit what staff share back; it is not a reason to refuse to listen.^[3]

A brief note can help if you might miss the assessment. Include what changed, dates, relevant words or actions, treatment details you know and your contact number. Ask how to get it to the assessing clinician. Avoid sending sensitive information to an unverified address.

Do not assume the note will remain secret from the person. Staff may need to discuss information that affects care. Tell them if revealing your involvement could put someone at risk. See confidentiality and being heard.^[3]

Getting urgent help when you are not with them covers calling before they reach hospital. Support for a student away at university.

If you are supporting from a distance, phone the hospital switchboard and ask how to pass urgent concerns to the emergency department. They may be unable to confirm whether the person is there. Tell staff where your information came from and what you do not know.

Staff may need to treat injuries, an overdose or other physical problems as well as assess mental health. A liaison mental health team, crisis team or equivalent service may be involved. Ask who is doing which part. The mental health assessment considers the person’s circumstances, needs and safety, and what help should follow.^[4]

If they seem calmer by the time they are seen, explain what happened earlier as well as how they are now. Tell staff about changes in sleep, eating, daily life or behaviour that you have observed, and any current support that is no longer available.

After self-harm or a suicide attempt: NICE recommends a psychosocial assessment by a mental health professional at the earliest opportunity. It should not be delayed simply until physical treatment finishes. Ask whether this has happened and what it found about their needs.^[5]

Assessment can lead to support at home, referral, admission or further observation. Attending A&E does not automatically mean a psychiatric admission. Ask what is recommended and why. For an explanation of the roles, see mental health teams and professionals.

Tell the nurse immediately, including what worries you about them leaving. Ask a clinician to speak with them and explain the options. Do not try to block the exit, restrain them or chase them into danger.

After self-harm, NICE says staff should assess safety and mental health problems if someone wants to leave before a full psychosocial assessment. This does not mean you can detain them yourself.^[5]

If they have already left, tell staff when, their direction and any immediate risk you know about. If there is immediate danger, call 999. Ask staff what happens next and what you should do. Decisions about whether someone can lawfully be prevented from leaving belong to the relevant professionals, under the law that applies locally. See Mental Health Act assessments and sectioning.

Ask the person what they have understood and whether they want help asking questions. If information can be shared with you, check:

• What is the plan for the next few hours and overnight?
• Who will contact them next, when, and what if that contact does not happen?
• Which number should they use if things worsen, including outside opening hours?
• Are there medicine changes, prescriptions or physical checks to arrange?
• What practical support is being assumed at home?
• Can they have the instructions and contact details in writing?

If you are worried about discharge, ask to speak to the nurse or assessing clinician before you leave. Explain the concern and what is missing from the plan. You may not agree with the decision, but your concerns should be heard and recorded.

Do not agree to being their only source of safety or overnight support if you cannot do it. A friend giving them a lift is not necessarily able to stay, house them or manage medicines. Ask how they will get to a suitable place safely and what happens if the proposed arrangements are unavailable.

After self-harm, ask about the assessment, care plan and aftercare arrangements. After a suicide attempt explains the first days and relevant follow-up guidance. Coming home after a crisis covers the wider handover and discharge plan. Follow-up arrangements depend on the situation; do not assume a crisis team will visit.

Once home, seek urgent help if safety changes; do not wait for a promised appointment. Use the urgent route for their UK nation. For continuing gaps or refusals, see when services are not helping. You may also need a break and support for yourself.