An adult usually needs to agree to assessment and treatment. You can encourage them, but usually cannot make them accept help. You can still pass concerns to a professional or seek urgent advice if they refuse. Consent, refusal and what you can do.
You may be helping with appointments every week, or be a friend who has noticed something worrying and knows little about their care. Start with the part that fits. This guide is about adult services; support for someone under 18 has different routes.
If help cannot wait, use urgent help for their UK nation. Do not wait for an ordinary referral if the situation has become urgent. What might happen after you call for urgent help?
For questions about sharing concerns, calling on someone else’s behalf and your rights, see what to know about services and your rights.
Where to start
They have not had help yet
A GP is a usual starting point. They can discuss what is happening, consider physical health and medicines, offer treatment and refer to another service when needed. Not everyone needs a specialist team. Some services accept people directly, so check the local service’s own referral information.[1]
If the person is willing, offer something specific: help booking, writing down concerns, getting there or coming with them. They can ask for you to attend; they can also choose to speak to the professional alone. For preparation, use write to their GP or prepare for a meeting.
England
Adults can usually refer themselves to NHS Talking Therapies for anxiety and depression, without a diagnosis or GP referral. Some services also accept 16- and 17-year-olds. This is a particular service, not the route for every mental health difficulty. Check its local requirements; a GP can help identify other routes.[2]
Wales
Ask the GP or local health board about primary mental health support. Local services can offer assessment, brief psychological help and onward referral. Referral arrangements vary; for example, Cwm Taf Morgannwg’s primary mental health service requires a GP referral. Do not assume England’s Talking Therapies self-referral route applies.[3]
Scotland
Speak to the GP or another health professional about psychological therapy and local services. Some GP practices have mental health practitioners, and some areas offer direct access to digital therapy. Check the NHS board or local service for its actual route.[4]
Northern Ireland
A GP can assess difficulties, offer treatment and refer to mental health services through the local Health and Social Care Trust. The service will explain its assessment and appointment arrangements. See NI Direct’s explanation of mental health services.[5]
Find the service for their area
Use the area where the person needing care lives, which may be different from yours. These official starting points help you find services and local providers:
- England: NHS guidance on finding local mental health services, including routes through a GP and services that accept self-referrals.
- Wales: NHS 111 Wales health board directory. Find the local board, then check its mental health services and referral information.
- Scotland: NHS 24’s service finder links to GP practices and health and wellbeing services. A GP practice can help identify the relevant mental health service.
- Northern Ireland: Health and Social Care Trust contacts. Use the local Trust’s site to find its mental health services.
Check the area and ages a service covers and whether it accepts self-referrals or needs a professional referral. If the route is unclear, ask the service or GP practice. If help cannot wait, use urgent mental health help by UK nation.
Consent and refusing help
Encourage them without taking over
An adult usually needs to agree to an assessment or treatment. Consent means understanding what is proposed and choosing freely. You can offer help with booking, notes or getting there, but do not pressure them or hide what an appointment is for. They do not have to agree with your view of the problem before they can ask for help.
If they decline, ask what worries them and what help they would accept. You can still pass factual concerns to their GP or team and ask for general advice. Staff may be unable to discuss their care with you and may need to tell them what you shared. See what you can do if they will not accept help.
If help cannot wait, seek urgent advice without waiting for their agreement. Do not try to force them into treatment yourself. Decisions about treatment without consent belong with the relevant professionals under the applicable law. Refusing help or having a diagnosis does not by itself mean someone cannot make a decision. The guides to mental capacity and Mental Health Act assessments explain the distinction and UK differences. For a child or teenager, use the under-18 consent guidance.
Sources for this section, checked 7 October 2026: NHS: consent to treatment; NHS: capacity; Mind: helping someone seek support; GMC: listening to people close to a patient, paragraphs 39 and 40. The linked legal guides explain when professional decisions may be made without consent.
I am a friend or do not know their care arrangements
You can still ask for help or pass on concerns
You do not have to be a relative, next of kin or a registered carer to tell a professional what you have noticed. If you know their GP or team, ask how to send information securely. Give concrete examples, dates and what has changed. Staff may be unable to confirm the person is a patient or discuss their care with you, but they can listen to concerns.[6]
If you do not know their GP or team, ask the person if they would like help finding the details. You can help them contact their own practice or look up local NHS services together. If they do not want help, see when they will not accept help. For an urgent concern, use the urgent route where they are and explain what you know, even if their care arrangements are unclear.
If they want you involved, ask them and the service to agree what may be shared with you, how staff should contact you, and whether you can attend appointments. Permission to receive information is different from authority to make decisions for them. See recording information-sharing preferences.
Do not assume what you send will stay secret from the person. Professionals may need to discuss information that affects care and where it came from. Tell staff if revealing your involvement could put you or someone else at risk. More about confidentiality and being heard.[6]
What happens after a referral
Check which stage the referral has reached
A referral asks another service to consider providing help. The receiving service may assess the information, request more detail, arrange an assessment or recommend a different service. A referral being sent does not mean it has been accepted or that treatment has begun. Local arrangements differ.[7]
- Has the service received and accepted it?
- Is the next appointment an assessment or the start of treatment?
- When should they hear, and who should they contact if they do not?
- Who is providing care while they wait?
- What help is available now, and what should they do if things get worse?
Ask with the person, or help them write the questions down if staff cannot discuss the referral with you. Keep the service name, contact details and any promised dates in one place.
There is no single waiting-time promise for all mental health services. In England, particular services have their own standards; NHS England has not set a general community mental health waiting-time standard. Ask the actual service about the expected wait.[8] If there is no response, a refusal or a worsening situation, see when services are not helping.
Who the teams and professionals are
The names can be confusing
Teams have different names and referral rules locally. They are not a ladder everyone must climb. Someone may receive help from more than one service at a time.[9]
GP and primary care
The GP can offer treatment, check physical health, prescribe or review medicines within their role, and arrange referrals. Other mental health professionals may work in or alongside the practice. Ask who will handle prescriptions and reviews if a specialist service is also involved.
Community mental health team (CMHT)
A team providing specialist support outside hospital, often for more complex or continuing needs. It can include nurses, psychiatrists, psychologists, occupational therapists and social workers. You may also hear names such as neighbourhood mental health service. Check what the local team actually offers.[9]
Crisis or home treatment team
Provides more intensive support during a mental health crisis, sometimes as an alternative to admission or to support leaving hospital. It is different from ordinary ongoing community care. Eligibility, referral routes and visiting arrangements depend on the service.[10]
Early intervention and other specialist teams
Early intervention in psychosis teams specialise in a first episode of psychosis. Other teams may focus on eating disorders, mental health around pregnancy, older adults or other needs. Use the condition guides for the relevant treatment and referral information.[10]
Psychiatrist, psychologist, nurse and named worker
- Psychiatrist: a medical doctor specialising in mental health, including medical assessment and treatment.
- Psychologist or psychological therapist: provides assessment or psychological treatment within their training and role.
- Mental health nurse: can assess needs, provide ongoing support and help with treatment and monitoring.
- Occupational therapist: helps with daily activities, routines and participation in life.
- Social worker: may help with social needs, safeguarding and access to support.
- Named worker or care coordinator: a person identified to help coordinate care. This is a responsibility, not necessarily a separate profession.
Not everyone sees every professional. Ask who your contact is, what they can help with and who covers when they are away.[9]
The assessment
What an assessment is for
An adult usually has to agree to the assessment. You can offer support, but cannot decide for them simply because you are family or a friend. Read about consent, refusal and urgent concerns.
If autism or ADHD affects communication or appointments, see autism, ADHD and mental-health support. If they have just been given a diagnosis, see the first days after a diagnosis.
An assessment is a conversation about what is happening and what help is needed. It can cover symptoms, safety, physical health, medicines, alcohol or drugs, relationships, housing and daily life. It is not an exam, and it is not always conducted by a psychiatrist.[11]
If the person wants you there, agree beforehand what they want help explaining. A few notes about changes, previous treatment and the questions they want answered can help. Ask in advance about interpreters, communication needs or other adjustments.
- What have you understood about the difficulties?
- What help are you recommending, and why?
- Are there other options?
- What happens next, and who will contact whom?
- What should happen if the recommended help is not working?
Language, culture and communication
Help them explain what matters to them
Ask the person what they want staff to understand about their language, culture, faith, identity or previous experiences of care. Do not assume that everyone from the same background wants the same support. With their agreement, help them explain what has been missed and what would make the appointment easier.
Ask the service in advance for a professional interpreter or the communication support they need. Say which language and dialect they use, or whether they need British Sign Language, accessible written information or another form of support. Confirm what has been arranged. Being a supportive relative or friend does not mean you have to interpret a sensitive assessment.
In England, NHS inpatient guidance calls for independent interpreters, attention to cultural and religious needs, culturally appropriate advocacy and clear ways to report racism or discrimination. For disability-related communication needs, see the Accessible Information Standard guidance. Ask the actual service how it will meet the person’s needs.
- Scotland: NHS Inform explains communication support and involving you.
- Wales: ask the local health board about appointment support. When calling NHS 111 Wales, ask for an interpreter as soon as you reach the call handler.
- Northern Ireland: see HSC interpreting information for patients and ask the service to arrange support.
If they feel dismissed, misunderstood or discriminated against, help them describe what happened and what they want put right. Ask about an independent advocate or a local community organisation they trust. The complaints guide has the routes for each UK nation.
Police, courts and prison
Find support for the stage they are at
If someone is in police custody, tell the custody staff about urgent health concerns, medicines or communication difficulties you know about. Ask who is arranging healthcare and whether an appropriate adult is needed. An appropriate adult supports understanding and communication; they do not replace a solicitor. Use the guidance for the nation where the person is:
- England and Wales: GOV.UK explains arrest, custody and appropriate adults, with a separate section on free legal advice at the police station.
- Scotland: mygov.scot explains custody rights and support from an appropriate adult.
- Northern Ireland: nidirect explains custody and bail, and support when dealing with police or courts.
In England, ask about Liaison and Diversion. These NHS services identify health and support needs when people come into contact with police or courts and can refer them for care. They do not decide whether someone is charged or what a court will decide. NHS England explains the service.
For more detail, Rethink’s police, courts and prison information covers mental health in custody, court proceedings and prison healthcare. Check each article’s stated coverage: much is for England, while its criminal-courts guide covers England and Wales. A solicitor can explain the individual case and local process.
Treatment and keeping in contact
Know the plan and the contact person
Treatment may involve psychological therapy, medicines, practical or social support, or a combination. The right options depend on the person’s needs and preferences. Ask what each option is meant to help with, its risks or drawbacks, and when it will be reviewed.[7]
For adult mental health services in England, NHS England’s July 2026 guidance describes a shared care and support plan, a named worker, regular checks on whether support helps, and agreement about how family or friends are involved. These are expectations for care; ask what has actually been arranged. Other UK nations use their own arrangements and terminology.[7]
- What is the current plan, and can the person have a copy?
- Who is the main contact, and who covers when they are unavailable?
- Who handles medicines, physical health checks and treatment reviews?
- When is the next review, and how can an earlier one be requested?
- Who should be contacted during opening hours and outside them if things worsen?
A plan should not quietly rely on you doing things you cannot manage. Explain what you can offer, what you cannot, and any change in your availability. This matters whether you live together or are a friend checking in from a distance. See when services assume you will fill the gaps.
Moving between services or back to the GP
Make the handover clear
When specialist support ends or care moves to another team, ask who takes over and when. Returning to GP care does not necessarily mean all difficulties have gone. The person needs to know the ongoing plan and how to seek further help.
- Has the next service or GP received the plan?
- Who supplies and reviews medicines, and are any checks due?
- Are the next appointments arranged?
- What changes should prompt another referral or an urgent call?
- What involvement has the person agreed for you?
Hospital discharge needs a more detailed plan. See coming home after a crisis for preparation and follow-up. If no one is taking responsibility or the handover leaves a gap, use when services are not helping. If help cannot wait, use urgent help.
Sources and how this guide was written
Starting with a GP and local services
NHS: accessing mental health services.England: direct access to Talking Therapies
NHS: find Talking Therapies.Wales: one local primary care route, not a rule for every health board
Cwm Taf Morgannwg: local primary mental health service.Scotland: psychological therapy and local access
NHS Inform: psychological therapy.Northern Ireland: GP, referral and assessment
NI Direct: mental health services and support.Listening to concerns and confidentiality
GMC: confidentiality for direct care, paragraphs 39 to 40.Accepted referrals, care plans, named workers and treatment reviews: England
NHS England: your mental health care; what you can expect (17 July 2026).Waiting-time standards: England
NHS England: mental health access and waiting-time standards.Professional roles and community teams
NI Direct: mental health care professionals.Crisis and early intervention teams
NHS: psychosis diagnosis and referral.What assessments cover
NHS: mental health assessments.
This guide brings together official information with practical questions for supporters. The questions are suggestions, not quotations or guarantees of local service provision. National differences are labelled; local referral rules still need checking.
Last full source check: 5 October 2026. Review due: 5 April 2027.
The four official service-finding links in “Find the service for their area” were checked on 8 October 2026. This was a check of those starting points, not a review of every service listed by them.
Independent information, not a medical or crisis service. This guidance has not been clinically reviewed. How we use sources.
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