Crisis Information Sheet

Crisis Information Sheet

BPD UK

1. Recognising a Crisis

Caring for someone with Borderline Personality Disorder can involve moments of intense emotional distress — both for them and for you. It’s important to know when a situation becomes a mental health crisis, and what steps you should take.

A crisis means someone is at immediate risk of:

  • Suicide or a suicide attempt
  • Self-injury that could be dangerous or life-threatening
  • Hurting someone else
  • Losing touch with reality (e.g. hallucinations or severe paranoia)
  • Becoming completely unable to care for themselves or stay safe

🚩 Signs of a Potential Crisis in the Person You Care For

  • Talking about wanting to die or feeling like a burden
  • Engaging in risky or impulsive behaviour
  • Saying they can’t go on or feel empty inside
  • Self-harming more severely or frequently than usual
  • Withdrawing completely and refusing all contact or care
  • Showing signs of psychosis (e.g. hearing voices, believing others want to harm them)

🚨 Signs That You Are in Crisis as a Carer

  • You feel completely overwhelmed, frozen, or emotionally numb
  • You’re afraid you might lose control or harm yourself
  • You can’t stop crying, shaking, or panicking
  • You feel hopeless and unsure whether help exists
  • You’re afraid to be alone or afraid to be near the person you’re caring for

Recognising a crisis early helps you take action before things escalate.

2. What to Do in a Crisis – Step by Step

When a mental health crisis occurs, the most important thing is safety — for the person you’re caring for and for yourself. Here’s a clear, step-by-step guide to follow if you believe someone is in danger, or if you feel you can’t cope:

🧭 Step 1: Stay Calm and Grounded

Even if emotions are high, try to keep your voice steady and your body language non-threatening. You might say:

“I can see you’re in a lot of pain. I’m here. Let’s figure out what we need to do to keep everyone safe.”

If you are the one in crisis, take slow breaths and remind yourself that help is available — you are not alone.

📞 Step 2: Call for Help

If someone is at immediate risk of suicide, serious self-harm, or harming others, call 999 right away.

If it’s not life-threatening but you need urgent mental health advice, you can contact:

  • NHS 111 – Option 2 (mental health support, 24/7 in many areas)
  • Samaritans – Call 116 123 (free, 24/7, for listening and emotional support)
  • Shout – Text 85258 (free, confidential crisis text line)
  • GP or local NHS crisis team – If already involved in care

🧒 Step 3: Make the Environment Safer

While waiting for help or if things escalate, you can:

  • Remove sharp objects, medications, or anything that could be used for harm
  • Avoid giving ultimatums or arguing — focus on de-escalating
  • If possible, don’t leave the person alone unless your safety is at risk

If you need to remove yourself to stay safe, that is OK. Prioritising your own safety is not selfish — it’s essential.

💬 Step 4: Say Simple, Supportive Things

Use short, calm sentences. Avoid judgement, advice, or long explanations. You might say:

“You’re not alone.”
“We can get through this together.”
“I’m not angry — I just want you to be safe.”
“Let’s get someone who can help.”

Avoid saying things like “You’re being dramatic” or “You have so much to live for.” These can feel invalidating and make things worse.

3. What BPD Coach Can and Cannot Do in a Crisis

It’s important to understand the limitations of the BPD Coach tool — especially during moments of high distress. This tool is designed to help carers learn and prepare for difficult situations, but it is not an emergency response service.

✅ What BPD Coach Can Do

  • Offer general strategies for de-escalation and communication
  • Provide role-play examples of things you might say or do
  • Suggest skills based on evidence-based therapies (like DBT or MBT)
  • Help you prepare for future challenges with more confidence
  • Encourage self-care for carers and explain how to set healthy limits

❌ What BPD Coach Cannot Do

  • Detect real-time danger — it uses keyword detection, not human judgement
  • Respond immediately — no part of the tool is monitored by clinical staff
  • Replace emergency services — it cannot call for help or intervene
  • Provide mental health treatment — it does not diagnose or prescribe
  • Assess risk — the tool is educational, not therapeutic

⚠️ What Happens if You Enter Crisis-Related Language

If you mention suicide, serious self-harm, or phrases that suggest a crisis:

  • The system may pause and show a crisis signposting message
  • It may direct you to NHS 111, Samaritans, or other emergency options
  • In some cases, the interaction may be restricted until the next day to avoid unsafe engagement

This is a safety feature — not a punishment or diagnostic label. We want to encourage real help-seeking, not dependency on a tool that can’t intervene.

4. Safety Planning – Tools You Can Use

When you support someone with BPD, it helps to have a simple, practical safety plan in place — for both their safety and your own peace of mind. A safety plan is a personal guide you can use during moments of crisis to stay calm, take action, and reduce harm.

📋 What Is a Safety Plan?

A safety plan is a written or digital list of:

  • Warning signs that a crisis may be starting
  • Helpful distractions or coping strategies
  • Trusted people or services to contact
  • Ways to make the environment safer
  • Reminders of reasons to stay safe

The best safety plans are short, accessible, and created before a crisis happens.

🧠 Create a Plan in 5 Simple Steps

  1. Identify Warning Signs
    “What thoughts, words, or actions tell me or my loved one that a crisis may be coming?”
  2. List Helpful Distractions
    “What usually helps us stay grounded, even a little? (E.g. music, walking, texting a friend, colouring, cold water.)”
  3. Write Emergency Contacts
    “Who can we call if things get worse?”
    • NHS 111 (option 2)
    • Samaritans 116 123
    • GP / Crisis Team
    • A trusted friend or family member
  1. Make the Environment Safer
    “What items or situations might make things worse? What can we move, change, or avoid right now?”
  2. Add Words of Hope
    “What are the reasons to keep going? What’s one thing we’ve survived before?”

🗂 Tip: Keep It Handy

Print your safety plan, keep it on your phone, or share it with someone you trust. BPD Coach may soon include a digital safety plan template, but even a handwritten note is enough to start.

5. Crisis Support Contacts (UK-specific)

If you or someone you care for is in immediate danger, do not wait for this tool to respond. Call 999 right away.

Below is a list of trusted UK-based services you can contact for help in a mental health crisis — whether you’re the carer or the person in distress.

🆘 Immediate Danger

  • Emergency Services (Police / Ambulance):
    📞 Call 999
    Use if there is a serious risk of suicide, self-harm, or violence, or if someone has already been harmed.

☎️ 24/7 Listening and Crisis Lines

  • Samaritans
    📞 Call 116 123 (free, any time)
    🌐 www.samaritans.org
    A non-judgemental, confidential listening service for anyone in emotional distress — including carers.
  • Shout Crisis Text Line
    📱 Text 85258 (free, 24/7 in the UK)
    🌐 www.giveusashout.org
    A free text messaging support service, particularly helpful for those who cannot speak on the phone.
  • NHS 111 (Option 2 – Mental Health)
    📞 Call 111, then press 2
    For urgent but non-life-threatening mental health concerns. Available 24/7 in many regions.

🏥 Local Mental Health Crisis Teams

If the person you care for is under the care of a Community Mental Health Team (CMHT) or has a care coordinator, they may have a direct crisis number.
If not, contact your local NHS trust and ask about their mental health crisis service.

💬 Support for Carers

  • Rethink Mental Illness Carer Support
    🌐 www.rethink.org/help-in-your-area
    Resources and support lines specifically for carers of people with mental illness.
  • Mind Infoline
    📞 0300 123 3393
    📧 info@mind.org.uk
    🌐 www.mind.org.uk
    Mental health information and signposting, including for carers.