* 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
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 harming 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
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
What happens if I go to a specialist mental health
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
- 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
- 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
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.
08457 90 90 90 (24/7); email: email@example.com
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.
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
Specialist help for people who self-harm
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.
Connected: Tel: 080 8808 4994 (1pm to 11pm)
Offers help by telephone and email for young people (under 25)
A project dedicated to supporting young people who are affected
TheSite.org offers information and support to all the UK's 16-25
year-olds. It includes specific support and advice about
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
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.
(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 0800 585858 or text
07537 404717, begin the first text CALM1.
Tel: 08000 111
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
Free online support service providing anonymous and practical
advice about money matters and debt.
Bereavement Care: Helpline: 0844 477 9400; email:
Alliance: Tel: 0845 123 23 20
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:
A national mutual support group for people suffering from
depression. Email: firstname.lastname@example.org
Helpline: 0800 7 314 314
Call free and at anytime to talk to someone in confidence.
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.
Debtline: Tel: 0808 808 4000
Free confidential and independent advice on how to deal with
Direct: Tel: 0845 46 47
For health advice and reassurance, 24 hours a day, 365 days a
0845 767 8000 (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: 0844 561 6855 (9am - 9pm
UK National Drugs helpline: Tel: 0800 77 66
A 24/7 service offering free and confidential telephone advice
and information for anyone who is concerned, or has questions,
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
Depression Tel: 0808 802 2020 (Wed 2-4pm). Email:
The national Scottish organisation working with and for people
affected by depression.
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.
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: info@samh,org,uk. 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 Education 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
Illustration by Lo Cole - www.locole.co.uk/
This leaflet is made available through the generosity of the
Charitable Monies Allocation Committee of the mental health charity
St Andrew's, Northampton.
This leaflet reflects the best available evidence at the time of
© June 2013. Due for review: June 2015. Royal College of
Psychiatrists. This leaflet may be downloaded, printed out,
photocopied and distributed free of charge as long as the Royal
College of Psychiatrists is properly credited and no profit gained
from its use. Permission to reproduce it in any other way must be
obtained from the Head of
The College does not allow reposting of
its leaflets on other sites, but allows them to be linked
For a catalogue of public education materials or copies of our
leaflets contact: Leaflets Department
Royal College of Psychiatrists, 21 Prescot
Street, London E1 8BB, Telephone: 020 7235
The Royal College of Psychiatrists is a
charity registered in England and Wales (228636) and in Scotland
Please note that we are unable to offer advice on individual cases. Please see our
advice on getting help.
Please answer the following questions and press 'submit' to send your answers OR
E-mail your responses to email@example.com
On each line, click on the mark which most closely reflects how you feel about the
statement in the left hand column.
Your answers will help us to make this leaflet more useful - please try to rate
Did you look at this leaflet because you are a (maximum of 2 categories please):
Age group (please tick correct box)