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The Royal College of Psychiatrists Improving the lives of people with mental illness

*  We are aware that Emergency Department staff need both skills in suicide prevention/mitigation and a knowledge of which specialist services to access for their patients. To make sure that the principles of 'Feeling on the Edge' are carried through in practice, we suggest that this leaflet is supported by appropriate local training for Emergency Department staff.

Feeling on the edge? Helping you get through it

About this leaflet

The person who gave you this leaflet is concerned about how you might be feeling and that you might feel like Feeling on the edgeharming yourself.

When you are so distressed, it can feel as though no one else really wants to know or understand. It can be hard to believe that someone you haven't met before can care about your situation. But there are people who do want to listen and understand. They will want to help you.

This leaflet is for you. It will help you understand what is going on and about the help you can get.

Who could ever understand?

It can be hard to share private thoughts and feelings, but it can help - and can be the best way of getting through a bad time. Whatever the reasons for your being in the Emergency Department (also called A&E), health professionals care about trying to understand you. They want to help you cope with what's going on in your life and help you to find ways to manage and find answers to your problems.

But it's happened before, and nothing's changed?

Self-harm can be a way of coping - it is not always possible to stop right away. But perhaps we can help you to find less harmful ways of coping. We'd also like to help you sort out the problems behind your distress. If you are not yet ready to do this, that's OK; just keep his leaflet in a safe place until you are ready.

I am in the Emergency Department - what will happen next?

You are about to be seen by a nurse or a doctor. He or she will listen to you and try to understand the difficulties that have brought you to the Emergency Department. They can offer you any medical treatment you might need. They can also talk with you about whether you'd like to see a specialist in mental health problems.

What happens if I go to a specialist mental health service?

You meet an experienced listener who has had specialist training and has helped people with all sorts of problems. They will have more time to ask about the problems you are having, and will do their best to help you get through them. They will not be shocked by anything you tell them and will not judge you.

Will this help me?

Just by talking about your worries, fears and distress with someone you can trust can make you feel better. It can also help you to get things clearer in your mind, to feel more hopeful, and to think about possible solutions.

How else can I find support?

It may feel as though you don't have anyone you can really talk to right now - even friends or family. But there may well be someone who is happy to listen to you - but they do need to know how you feel.

If you have felt like harming yourself, it can be helpful to:

  • tell a friend or relatives; or
  • contact your GP (family doctor); or
  • contact one of the organisations listed below; or
  • contact your care coordinator or mental health team if you have one; or
  • come back to the Emergency Department.

Can I help myself?

Yes, you can help yourself in lots of ways. You can start my making a 'safety plan' for yourself. A 'safety plan' is a plan you make to help you keep safe which includes what you can do for yourself and who you can speak to if you need support. It is more likely to work because you have chosen the kind of support that you feel comfortable with.

For young people under 18 especially those under 16

It is important to find support from an adult you can talk to and trust. Please don't feel that you have to cope with all of your problems alone. Most young people will turn to their parents or carers. If you feel you need support from outside your immediate family, please think about speaking to another relative, your teacher, school counselor, school nurse, youth worker or your social worker (if you have one).


Support organisations for people who are distressed, are experiencing suicidal thoughts or who self-harm and their families

Anything you tell them will be completely confidential. The volunteers are ordinary people who won't judge you. Some of the most popular are listed below. You may contact as many or as few as you like - it's up to you and it's OK to contact more than one.

SamaritansSamaritans: Tel: 116 123 (24/7); email:

A 24/7 helpline service which gives you a safe space where you can talk about what is happening, how you are feeling, and how to find your own way forward. Samaritans volunteers are ordinary people from all walks of life who understand that there are sometimes things that you just cannot talk about to the people around you. They know that very often, with some time and space, people are able to find their own solution within themselves.

PapyrusPAPYRUS HOPELineUK: Tel: 0800 068 41 41 (Mon to Fri 10am - 5pm and 7pm - 10pn & Weekends 2pm - 5pm). PAPYRUS aims to prevent young people taking their own lives. A professionally staffed helpline provides support, practical advice and information both to young people worried about themselves, and to anyone concerned that a young person may harm themselves. PAPYRUS has a range of helpful resources including HOPELineUK contact cards or call 01925 572444 or Fax 01925 240502 for a sample pack.


Specialist help for people who self-harm

The National Self-Harm Network: Tel: 0800 622 6000 (7pm to 11pm)

A forum and resources for those who self-harm and their families, and for professionals who support them. Tips on what to do or say and what not to do or say if you are supporting someone who self-harms. Advice on the use of distractions if a person is trying not to self-harm.

Get Connected: Tel: 080 8808 4994 (1pm to 11pm)

Offers help by telephone and email for young people (under 25) who self-harm.

A project dedicated to supporting young people who are affected by self-harm. offers information and support to all the UK's 16-25 year-olds. It includes specific support and advice about self-harm.


Internet Self-Harm Support Community. It also provides support for any emotional problems, in addition to self-harm.


Support specifically designed for children and young people 

Big White WallBig White Wall

A safe, online, anonymous service for people over the age of 16. Get the support of others who feel like you, 24/7, and learn ways to feel better and how to get on top of your own troubles.


Call Helpline (Wales): Tel: 0800 132 737

A 24/7 service offering free emotional support and information/literature on mental health and related matters to people in Wales. Text 'help' to 81066.



CALM: Campaign Against Living Miserably: Tel: 0800 585858

Offers help via the website and a helpline for men aged 15-35 who are feeling depressed or down. Callers are offered support and information. Calls are free, confidential and anonymous. The helpline is open from 5pm - midnight, Sat, Sun, Mon and Tues, every week of the year. London callers may also call 0808 802 5858.


ChildLineChildline: Tel: 08000 1111

If you are worried about anything, it could be something big or something small, don't bottle it up. It can really help if you talk to someone. If there is something on your mind, ChildLine is here for you.

StepChange Debt Charity

Free online support service providing anonymous and practical advice about money matters and debt.

CRUSE Bereavement Care: Helpline: 0844 477 9400; email:

Depression allianceDepression Alliance: Tel: 020 7407 7584

Information, support and understanding for people who suffer with depression, and for relatives who want to help. Self-help groups, information, and raising awareness for depression. Email:

Depression UK

A national mutual support group for people suffering from depression. Email:

Drinksmarter: Helpline: 0800 7 314 314

Call free and at anytime to talk to someone in confidence.

Mind: Infoline: 0300 123 3393 (Mon-Fri 9am - 6pm)

Provides information in a range of topics including types of mental distress, where to get help and advocacy. They are able to provide details of help and support for people in their own area. Email:

National Debtline: Tel: 0808 808 4000

Free confidential and independent advice on how to deal with debt problems.

NHS Direct: Tel: 0845 46 47

For health advice and reassurance, 24 hours a day, 365 days a year.

SANE: SANEline: 0300 304 7000 (6pm - 11pm)

Emotional support and specialist information to anyone affected by mental illness, including families, friends and carers. SANE offers 1:1 support via helpline and email services and peer support via an online Support Forum where people share their feelings and experiences of mental illness, as well as exchanging information about treatment and support options.

Survivors of Bereavement by Suicide (SOBS): Helpline: 0300 111 5065 (9am - 9pm daily)

Support Groups

Details of UK patient support organisations, self-help groups, health and disease information providers, etc... Each entry is cross-referenced and details are checked annually.


Specific Support for people living in Scotland

Action on Depression Tel: 0808 802 2020 (Wed 2-4pm). Email: The national Scottish organisation working with and for people affected by depression.

Breathing Space  Tel: 0800 83 85 87 open 24/7, at weekends (6pm Fri - 6am Mon), 2.00am on Mon - Thurs. Phone and web-based service for people in Scotland experiencing low mood, depression or anxiety.

CRUSE Bereavement Care Scotland Tel: 0845 600 2227.

NHS24 Tel: 08454 24 24 24.  Open 24/7 356 days a year.

SAMH - Scottish Association for Mental Health Tel: 0800 917 3466. Email: Information on how and where to find support, including help in your own area.


Endorsed by the Royal College of General Practitioners

This leaflet was produced by the Royal College of Psychiatrists' Public Engagement Editorial Board.

Series Editor: Dr Philip Timms

Main Authors: Dr Alys Cole-King, Consultant Liaison Psychiatrists/Open Minds Alliance CIC with comments from James Bethel (previous RCN ED rep), Professor Carolyn Chew-Graham, Joe Ferns (Samaritans), Dr Gil Green (STORM), Dr John Henden, Dr Chris Manning, Professor Stephen Platt, Martin Seager, Dr Philip Timms, Keith Waters, Dr Julie Williams (PHW) and contributions from RCGP/RCPsych Mental Health Forum and College of Medicine Mental Health Advisory Board and Janet Roberts and colleagues of CALL Helpline.

Illustration by Lo Cole:



  Open Minds Royal College of General Practitioners College of Emergency Medicine RCN  Connecting with People

This leaflet reflects the best available evidence at the time of writing.

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© August 2015. Due for review: August 2018. Royal College of Psychiatrists.
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For a catalogue of public education materials or copies of our leaflets contact: Leaflets Department, The Royal College of Psychiatrists, 21 Prescot Street, London E1 8BB, Telephone: 020 3701 2552.

The Royal College of Psychiatrists is a charity registered in England and Wales (228636) and in Scotland (SC038369)