Here for someone

Supporting someone with psychosis or schizophrenia

Help with everyday life and times when someone is frightened by voices, visions or beliefs you do not share, whether or not they have a diagnosis.

What do you need help with?

Select a topic below.

Before talking

They haven’t spoken about it

 Right now

Paranoid, hearing or seeing things

 First episode

Getting an assessment

 Refused help

They won’t accept help

 Longer term

Day-to-day life and staying well

 Afterwards

Coming home and recovering

Services aren’t responding

They’re in hospital

Are you somewhere else? Read how to get urgent help from a distance, including what location to give. Support for a student away at university.

Advice for your relationship (optional)

The main guidance applies whoever you are supporting. Choose a relationship for advice about conversations and what you can take on.

My mum or dad

If you are under 18 and helping a parent, see support for young carers.

Talk about what you have noticed

Describe a particular change rather than trying to name an illness. Ask how things have been for them, and whether they want help arranging an appointment. The guide to starting the conversation has more ways to begin.[1]

Words you could use

“Mum, how have things been? Would you like some help making an appointment?”

They brush it off or say I’m interfering

Read what you can do when someone does not want help. If you need to pass observations to a doctor, you can do that even if the doctor cannot discuss their care. They may need to tell your parent what you shared.

Prepare a letter or questions for an appointment[2]

I live a long way away

Agree a way of keeping in touch that suits you both. Ask whether there is someone nearby they would want involved, and what you can share with that person. The contact guide covers worrying silence and unanswered doors. If help cannot wait, use the urgent route where your parent lives.

Everything falls to me

Make requests that someone can answer: “Can you take Dad to Thursday’s appointment?” or “Could you handle the shopping this week?” The guide to sharing support covers dividing practical jobs and planning for times you cannot help.

This brings back difficult memories

If you supported your parent as a child, today’s worries may come with a long history. You can seek support for your own mental health without making your parent part of those conversations.

Jonathan’s account of supporting his mother describes recognising the effect on his own life. It is one person’s story.[3]

For ongoing difficulties, see preparing a treatment review and help with daily tasks and living alone.

Changes in an older parent

If your parent is becoming more forgetful, or memory problems are affecting everyday life, offer to help them arrange a GP assessment. An adult usually needs to agree; you can encourage them but usually cannot make them accept help. You can still tell their GP what you have noticed and ask for advice. Avoid assuming you know the cause. Sudden confusion needs immediate medical help: call 999 or go to A&E.[4]

If daily tasks are becoming difficult, ask their local social-care service about a care needs assessment. You can separately ask for an assessment of your needs as a carer.[5] Read the older-parent guide for appointments, isolation, help at home and benefits.

Sources for this advice
  1. Starting the conversation

    Mind: helping someone seek support covers listening and offering practical help with appointments. The suggested words are ours; change Mum and the observations to fit.

    Back to the advice
  2. Sharing concerns with a doctor

    GMC: listening to those close to a patient (paragraphs 39 and 40) explains listening, disclosure and why information may need to be shared with the patient.

    Confidentiality: what you can tell the care team and what they may share.

    Back to the advice
  3. Growing up with caring responsibilities

    Rethink Mental Illness: Jonathan’s story is a lived-experience account, not clinical evidence or a prediction about other families.

    Back to the advice
  4. Memory changes and sudden confusion

    NHS: memory loss advises seeing a GP when memory problems affect everyday life. NHS: sudden confusion distinguishes gradual changes from confusion needing immediate help. These sources were checked on 5 October 2026.

    Back to the advice
  5. Care and carer support

    NHS care needs assessments and NHS carer’s assessments explain the separate assessments in England. The Rights & money guide links to the routes in Scotland, Wales and Northern Ireland.

    Back to the advice

Care-assessment links and older-parent signpost checked: 8 October 2026. Last full source check for this relationship advice: 2 October 2026

My partner

Talk about this week’s pressures

Choose a calmer moment to work out what needs doing and what each of you can manage. Be specific: meals, bills, school runs or a night of uninterrupted sleep. Ask who else could help with something neither of you can take on.[1]

Words you could use

“I want to help, but I’m struggling with everything that needs doing. Can we work out what we can each manage this week and what we need help with?”

We barely feel like a couple

Ask whether there is something you would both enjoy that does not revolve around appointments or how they are feeling. It might be watching something together or getting out for a coffee. Leave room for either of you to say no.

Keeping your relationship alongside the support[2]

They want me to be available all the time

Use the boundary guide to work out what you can keep offering. During a calmer spell, plan who to contact when you are unavailable. If the situation is urgent now, use urgent help.

The children are noticing

Living together: children, relatives and home life.

You might be trying to explain cancelled plans, changed routines or why their parent is in hospital. Mind’s guide to parenting and mental health has ideas for arranging family support. If children are taking on caring tasks, the young-carer guide explains how to find help for them. If you are worried about a child’s safety, use safeguarding guidance.

They seem irritable or we keep snapping at each other

Pause a conversation that is getting heated and return to one practical issue when you can both talk. Ask what has changed and what is hardest, without deciding for them what the cause must be. Responding when you get the blame includes ways to pause and set limits.

Work out what needs to change and what you can keep offering.[3]

I feel frightened or controlled

For threats, intimidation or feeling unsafe at home, go to help when you feel frightened or threatened. It includes specialist domestic-abuse support. You can ask for advice about your own safety.

Sources for this advice
  1. Sharing everyday responsibilities

    Mind: looking after yourself while caring supports being realistic about what you can do and finding help. The household examples and suggested words are ours.

    Back to the advice
  2. Staying close

    Mind: caring for someone with a mental-health problem discusses changes in relationships; Mind’s self-care guidance includes shared interests beyond caring tasks.

    Back to the advice
  3. Limits and support for you

    Mind: looking after yourself while caring covers being realistic about what you can do and sharing the support. The boundary guide gives the sources for its practical suggestions. This Mind source was checked on 5 October 2026.

    Back to the advice

Last full source check for this relationship advice: 2 October 2026

My adult son or daughter

Offer help they can have a say in

Ask what would make getting help easier: booking an appointment together, writing down their concerns or going with them. Let them choose which parts they want you involved in. If they do not want help, there are still ways to respond.[1]

Words you could use

“I’m worried about you. Would you like me to come to the appointment, help you write things down, or leave you to speak to them on your own?”

Services won’t tell me anything

You can give a doctor information even when they cannot discuss your son or daughter’s care. Say what you have noticed and when. The doctor may need to tell them what you shared, so explain any concerns about that.

Write down your concerns or prepare for a meeting. If help cannot wait, use the urgent-help route; do not wait for a letter to be read.[2]

If they want the team to share some information with you, they can use the information-sharing template to prepare their own choices.

We live together and it affects everyone

Try discussing one practical pressure at a time: disturbed sleep, meals, visitors or who is doing the shopping. Agree what you can each manage this week and when to talk again.

The household guide covers children, relatives and the strain on a couple. For more help, use setting limits, help for children taking on caring tasks and sharing the support.

I keep thinking I caused this or should have noticed

If you keep going over the past, give yourself somewhere to talk about that too. Feeling guilty does not tell you what caused their difficulties. You can seek support for yourself while helping them.

Guilt, anger and other difficult feelings · Talk to other parents and supporters[3]

They live away from me

Ask what contact suits them: a regular call, occasional messages or a visit you arrange together. Check which practical things they would welcome help with. Agree what you should do if an expected call does not happen; an unanswered message alone does not tell you what is wrong.

If they want you involved, agree who else nearby can help and what information they are happy to share. Use sharing the support and confidentiality to work through the arrangements.

They won’t speak to me, or I’m being shut out

Respect a request for space. You could leave one brief message saying how they can contact you, without asking them to explain or reply. If they prefer another trusted person, ask whether that person can help; avoid turning contact into a group effort to persuade them.

If there are specific concerns about their health or safety, you can pass observations to their GP or team. If they are suspicious of you, use the guidance for that situation. If help cannot safely wait, use urgent help.

If this is an argument rather than suspicion, see when you are getting the blame. A diagnosis does not explain every disagreement.

They have just turned 18

If they are leaving children’s services, the guide to moving to adult mental-health services covers the handover and your involvement. For a younger child or teenager, use supporting someone under 18.

Sources for this advice
  1. Offering help

    Mind: helping someone seek support. Practical appointment support should follow what the person wants. The suggested words are ours.

    Back to the advice
  2. Sharing concerns with a doctor

    GMC: listening to those close to a patient (paragraphs 39 and 40). Listening to information and disclosing information are different; secrecy cannot be promised.

    Confidentiality: what you can tell the care team and what they may share.

    Back to the advice
  3. Guilt and support for you

    Mind: your mental health as a carer covers guilt and the effect of caring on your own life. This page does not try to establish the cause of anyone’s illness.

    Back to the advice

Last full source check for this relationship advice: 2 October 2026

My brother or sister

Ask what they want from you

A conversation between the two of you may be different from a family discussion. Ask whether they want company, practical help or someone to listen. If you usually share jokes, music or a hobby, there is still room for that.

Words you could use

“Would you like me to come over? We can talk about what’s happening if you want, but we don’t have to.”

I’m caught between them and our parents

Living together: children, relatives and home life.

Before agreeing to pass on an update, ask your sibling what they want shared. If you are being asked to settle every disagreement, be clear about what you can take part in.

Privacy and when to involve someone else · Words for setting a limit[1]

I’m worried I’ll have to take over their care

If your parents are getting older or finding support harder, put this on the agenda before it becomes urgent. Ask your sibling what they want. Write down the help currently provided and which parts need another arrangement; avoid leaving it as “you’ll look after them”.

Planning for changes in who can help

The family’s attention is always on them

You can love your sibling and still want time with your family that is about your own life. The difficult-feelings guide has help with resentment and guilt. You do not have to wait for another crisis to talk about the effect on you.[2]

I want to talk to another sibling

Rethink Mental Illness’s group finder has a Siblings filter. Check each group’s location, age range and whether it meets online, then contact the organiser about joining.

You can also read Eleanor’s account of supporting her sister. It is one person’s experience, not a model everyone has to follow.[3]

Sources for this advice
  1. Family roles and your own needs

    Rethink Mental Illness: Eleanor’s story is a first-person account of sibling support and changing family roles. The conversation and planning prompts here are editorial examples.

    Back to the advice
  2. Difficult feelings

    Mind: your mental health as a carer describes anger, guilt and the strain on a supporter’s own life.

    Back to the advice
  3. Sibling peer support

    Rethink Mental Illness: groups in your area provides a Siblings filter. Individual group arrangements must be checked with the organiser.

    Back to the advice

Last full source check for this relationship advice: 2 October 2026

A friend

Stay their friend

You do not need to manage their treatment or become their only support. Keep room for the things you usually enjoy together. Ask whether they would like invitations even when they often say no.

If you do not know their GP or care team, you can still seek advice about a concern. For urgent help, use the route where they live; you do not need to find their GP first.

For unanswered messages, privacy and passing concerns to a professional, use keeping in touch and knowing when to get help.

Sources for this advice

Mind: supporting someone with a mental-health problem and looking after yourself. The full contact guide preserves the sources for privacy and sharing concerns.

Last full source check for this relationship advice: 5 October 2026

A colleague or someone I manage

Find a private moment to ask

Mention what you have noticed, then give them room to answer. They may not want to discuss personal details at work. A quiet conversation is a better place to begin than asking in front of the team.[1]

Words you could use

“You’ve seemed a bit unlike yourself lately. How are things? We could go somewhere quieter if you’d like to talk.”

I’m their colleague

Ask what would help at work. You could offer to go with them to speak to their manager, or help find details of any staff support. If you are already covering extra work and cannot keep doing it, raise the workload problem without giving the team private information about them.

Listening without trying to solve everything

I’m their manager

Ask which parts of work are difficult. Discuss possible changes to hours, tasks, deadlines or communication, and arrange a time to review them. Check what HR, occupational health or an employee assistance programme can offer, where these are available.

Acas: examples of mental-health adjustments explains options for employers in Great Britain. In Northern Ireland, see nidirect’s workplace support and advice contacts.[2]

They can also check Access to Work in England, Scotland and Wales, or Access to Work in Northern Ireland, for help with disability-related support at work. Eligibility and the help offered depend on their circumstances. These schemes do not pay for adjustments the employer is legally required to make.

They want me to keep it secret

Be clear about what you can keep private. If there is a good reason to involve someone else, explain who and why. As a manager, follow the organisation’s confidentiality process and discuss what, if anything, colleagues need to be told.

Confidentiality: what you can tell the care team and what they may share.[3]

I’m worried they may not be safe

If you are worried about suicide, use the guide to asking and responding. If help cannot wait, use urgent help and what to say when you call. Do not wait for an HR meeting to get urgent help.[4]

Sources for this advice
  1. Talking privately

    Acas: talking about mental health at work recommends private, supportive conversations. The suggested words are ours.

    Back to the advice
  2. Support and changes at work

    Acas: mental-health adjustments covers individual changes and review. nidirect: counselling at work describes workplace support and employment-advice contacts in Northern Ireland. Availability depends on the workplace; this page is not an employment-law guide. GOV.UK: Access to Work and nidirect: Access to Work (NI) explain the separate programmes and their limits, checked 2 October 2026.

    Back to the advice
  3. Confidentiality at work

    Acas: being clear about confidentiality explains permission and being clear when information needs to be shared.

    Back to the advice
  4. When urgent help is needed

    Acas: if you think a worker is at risk includes seeking help and responding to immediate danger.

    Back to the advice

Last full source check for this relationship advice: 2 October 2026

If they have not spoken about what is happening

1. Describe the change

Mention sleep, speech, fear, withdrawing or everyday tasks. Do not name a diagnosis.

2. Ask, then listen

Ask how things feel from their point of view. Leave room for them not to answer immediately.

3. Think about safety

If speaking directly may increase fear or put you at risk, stay in touch from a safe distance and pass observations to their GP or care team.

You could say“You seem frightened, and you've hardly slept. What's been happening? Is there anything I can help with right now?”

If they want help, find an assessment route. If they do not, read about refusing help.

If they seem paranoid or are hearing or seeing things

If they think you are involved in what is frightening them: responding, giving space and asking someone else to help.

Psychosis: help right now: what to do if they are very frightened or things are escalating.

The experience may feel completely real to them. Stay with the fear or distress without claiming that the belief or experience is true.

What to say, what to avoid and how to give them space

If they already have a care coordinator or mental-health team, use that contact. If this may be a first episode, continue to professional help below. Use the urgent route if the situation cannot safely wait.

If they are awake but unusually still, scarcely speaking or responding, especially if eating or drinking has stopped: seek urgent medical advice. Contact their team if you can reach them, or use the urgent-help route for their UK nation. Catatonia is one possible cause and can be linked to physical illness. Describe what you see without trying to diagnose it.

If they cannot be woken or are not breathing normally, call 999. Follow the call handler’s instructions.[1]

Need an assessment? Find professional help. Already asked and not getting a response? Follow up with services.

Find the right professional help

If this may be a first episode, seek help promptly. Contact their existing mental-health team or ask for an urgent GP appointment. Ask about the Early Intervention in Psychosis team. If you cannot reach the team, do not know their GP or are unsure how to get prompt assessment, use the urgent help for their UK nation. In England, call 111 and select the mental-health option. Say what you have noticed and that you are calling about someone else. Call 999 if there is immediate danger.

An adult usually needs to agree to assessment and treatment. You can encourage them and offer practical help, but usually cannot make them accept it. If they refuse, you can still tell their GP or team what you have noticed and ask for advice. Read what you can do if they refuse help and how consent works. If help cannot wait, seek urgent advice without waiting for their agreement.

What might happen after you call for help?

Can I contact an Early Intervention team directly?

Some NHS Early Intervention in Psychosis (EIP) teams accept referrals from the person, relatives or friends without going through a GP. Other teams use a GP or local mental-health access service. A referral from someone else may need the person’s consent.

  1. Search for “early intervention in psychosis” and the town or area where they live. Open the local NHS service’s page.
  2. Check the ages and area it covers, its opening hours and how to refer.
  3. Use the contact details given for referrals. Ask whether you can refer directly, what information they need and whether they need the person’s agreement. If another service must refer, ask which one to contact.
Ask about a referral“I’m worried someone I know may be experiencing psychosis for the first time. Can a friend or family member refer them directly? What information do you need, and do they need to agree to the referral?”

If help cannot wait, use the urgent-help route for their UK nation. Do not wait for an EIP team to open or call back.

Prepare what you have observed

  1. What changed, and when.
  2. Changes in sleep, food, hygiene, work, study or contact with other people.
  3. Alcohol, drugs, medicines or physical-health changes that may be relevant.
  4. Any immediate risk, using the person's own words where possible.

Report what you have seen and heard, without trying to diagnose the cause.

Use the meeting-notes option to prepare questions and record what is agreed, or choose a GP letter to pass on your observations.[2]

After a first episode

What should we ask the Early Intervention team?

An Early Intervention in Psychosis team can assess needs and offer treatment and practical support. The first appointments may cover symptoms, physical health, medication, psychological support and the effect on everyday life.

Ask who your main contact is, when the next appointment will be, how family can be involved with the person’s agreement, and who to call outside working hours. Ask about family intervention and support with education or work. The plan and pace will depend on the person.[3]

What if cannabis or other substances are involved?

Cannabis and other drugs can trigger psychotic episodes. Tell the assessing team what you know about substances, medicines and recent changes, including when they were taken. If you do not know, say so. Do not assume it is only intoxication or wait for it to wear off when someone is unsafe.

Mental health and substance use together.[4]

If they will not accept help, read what to do if they refuse help. If the service does not act, follow up here.

If they do not think anything is wrong

Do not make accepting a diagnosis the price of support. Look for something they will discuss, such as sleep, fear, stress, food, getting home or speaking to one trusted person. Offer one manageable option and try again later unless risk has become urgent.

Avoid

  • “You're psychotic. Admit it.”
  • “None of this is real.”
  • Threatening or forcing them into routine help.

A GP or care team may be unable to disclose information to you, but they can receive factual observations and safety concerns. Ask for the information to be handled sensitively, but do not assume it can be kept secret from the person.

Write to the GP or care team“I understand you may not be able to discuss their care with me. I'm giving you information that may be relevant to their assessment. The changes I've observed are: [dates, their words, sleep, daily life and any safety concern]. Please add this to their record and handle it as sensitively as possible.”
Mental-health services have said noBuild a GP letterSectioning and Mental Health Act assessmentsWhat capacity means

[5]

More ways to respond when someone refuses help · If services are not responding

Supporting day-to-day life

Start with what they want from ordinary life: company, an interest, work or study, or help with something that is difficult. Agree your part in it, and make room for contact that is not about their health.

Ask about family intervention

Ask the care coordinator, Early Intervention in Psychosis team or psychiatrist about family intervention. It can cover understanding psychosis, working through difficulties and planning for crises.

NICE recommends this for families who live with or are in close contact with the person: at least 10 planned sessions over three months to a year. Ask who can attend, what the sessions involve, how to access them and what support is available while you wait.

Asking for family support does not mean accepting blame for the illness or responsibility for preventing every relapse.[6]

Everyday support
  • Agree which part of a task they want help with, rather than taking it over.
  • Keep inviting them to things they might enjoy, and accept it if they decline.
  • Keep medicine and treatment decisions with the person and their clinician.
  • Offer help with physical-health appointments if they want it.
  • Make a shared crisis plan without watching them constantly.

Lancaster University’s REACT toolkit suggests keeping the person’s interests and enjoyment in view, alongside everyday tasks. If getting started is difficult, ask which part they would like help with and notice the effort they make. A shared activity they enjoy may matter more to them than finishing every household job.

If symptoms return or they stop medication

Changes in sleep, withdrawal or familiar unusual beliefs can be reasons to contact their team early. Use their agreed crisis plan and describe what has changed. If they have stopped medication, ask what made it difficult, such as side effects or how it made them feel, and help them contact the prescriber. Stopping suddenly can bring symptoms back. Do not change doses, restart treatment for them or hide medicine in food. Get urgent help if the situation cannot safely wait.

When Early Intervention support ends

Before discharge, ask for a written plan: who takes over, who reviews and prescribes medication, the next appointment, early warning signs, and daytime and out-of-hours contacts. Ask how they can get back into specialist care if symptoms return. If they have already been discharged and you are worried, contact their GP or current team; use the urgent route if help cannot wait.

You can also ask for a carer’s assessment of your own support needs. If compulsory assessment or admission becomes an issue, read about the nearest-relative role in England and Wales. It is a specific legal role, not simply the person’s chosen next of kin; the law differs elsewhere in the UK.[7]

If you are worn out, get support for yourself. If their health changes, contact their team or seek an assessment.

Coming home and recovering after an episode

If they have been in hospital, use the discharge guide for the care plan, follow-up, medicines and who to contact. For everyday arrangements, return to day-to-day support.

Talking about what happened

Wait until the crisis has settled, ask permission and keep the first conversation short. They do not have to agree with your account of every event before you can plan together.

You could say“I don’t want to argue about what happened. I’d like to understand what felt frightening, what helped and what you'd want me to do if you felt like that again.”

If trust has been damaged

If you said or did something you regret, apologise for that specific part rather than defending the whole crisis. Ask what contact they want now. Ordinary time together can matter as much as another conversation about illness.

Use what you have learnt

When they are willing, record early changes, what helped, what made things worse and who they want contacted. Include existing team details and anything they want supporters to avoid. Keep treatment decisions with the person and their clinicians. Make or update the plan together.[8]

If the episode has affected you

You may feel exhausted, frightened, angry or constantly alert. Speak to your GP if your own health is affected and use support after caring through psychosis, even if you do not identify as a carer.

Support with ordinary life · Support for you

If services are not responding

Use Services aren’t helping to follow up a referral, ask what decision was made or explain what has changed since an assessment. Keep a brief record of who you spoke to and what was agreed.

If confidentiality is getting in the way, read what you can tell the team and what they may share. If you have been told the person has capacity, this explains what that means.

If the person refuses an assessment, use refusing help. If help cannot safely wait, use urgent help instead of waiting for a complaint or routine reply.

If they are in hospital

Start with the ward and visiting guide: the direct number, what to bring, contact with staff and how the person wants you involved.

If you need to understand compulsory assessment or admission, use sectioning and Mental Health Act assessments. This is a separate question from whether you can visit or pass on information.

When discharge is being discussed, use coming home after a crisis. Ask about the practical support that will be available, and say what you can and cannot provide.

For contact and rebuilding trust after an episode, go to coming home and recovering.

Related help
Support for youTalk to people who understandMake a crisis plan

Supporting a friend? Help with unanswered messages, privacy and when to involve someone else.

Supporting a child or teenager? Start with age-appropriate help and contacts.

Sources and how this guide was written

  1. If they seem paranoid or are hearing or seeing things

    Rethink advises calm communication, focusing on feelings and simple practical help. Royal College of Psychiatrists: catatonia. St John Ambulance: an unresponsive person and CPR and emergency help.

    Back to the advice

  2. Finding professional help and contacting EIP

    Local referral examples in England: Hampshire and Isle of Wight Healthcare allows direct referrals but lists a different route for Portsmouth. Bradford District Care accepts referrals from friends or family with the person’s consent. Check the arrangements where the person lives. These two referral routes rechecked: 8 October 2026.

    NHS psychosis diagnosis and help for others, NHS psychosis treatment and NHS England Early Intervention in Psychosis access standard.

    Back to the advice

  3. What should we ask the Early Intervention team?

    Back to the advice

  4. What if cannabis or other substances are involved?

    Back to the advice

  5. Avoid

    GMC confidentiality guidance and Rethink guidance for carers.

    Back to the advice

  6. Ask about family intervention

    NICE: family intervention for adults with psychosis or schizophrenia. This describes recommended care; it is not a promise of local availability or a start date.

    Back to the advice

  7. When Early Intervention support ends

    NHS: treatment and stopping medication and NICE: recovery, relapse and transfer of care.

    Back to the advice

  8. Use what you have learnt

    Rethink: communication and making a crisis plan and NICE: collaborative care in psychosis.

    Back to the advice

  9. What this area is based on

    Rethink: supporting someone experiencing psychosis, NHS psychosis information and NICE guideline CG178.

    Back to the advice

Last full source check: 29 August 2026

Consent and seeking advice wording checked: 7 October 2026. Sources and explanation.

Later checks: REACT, relapse and discharge additions checked: 26 September 2026. Catatonia signposting checked: 30 September 2026; urgent medical advice and unresponsiveness wording rechecked: 8 October 2026. Editorial changes and help-route wording checked against the linked guidance: 1 October 2026.

What this area is based on

Rethink Mental Illness advises staying calm, focusing on the person's feelings, reducing noise and pressure, and offering simple practical help. NHS and NICE guidance covers professional assessment, Early Intervention in Psychosis and support for families.

[9]

Independent information, not a medical or crisis service. This guidance has not been clinically reviewed. How we use sources.