psychosis.au
Not OK right now? Tap for help Not OK right now? In danger, call 000. To talk to someone, Lifeline 13 11 14, 24 hours. More help

In danger, call 000. To talk to someone, Lifeline 13 11 14, 24 hours.

More ways to get help

For families and friends

You can see it coming. Here's what to do.

Families usually notice first, and are usually told least. This page is the part that was missing: what to do tonight, in your state, and how to be useful without burning out.

What to do tonight How to talk to them

Tonight

What to do tonight.

Pick your state or territory. You'll get the number that can actually send someone, the words to say, and what to ask for.

  1. If anyone is in danger right now, call 000.

    Say "mental health emergency". Tell them the person has a history of psychosis if they do, what you're seeing, and whether there are weapons or anyone hurt. Ask for a mental health trained response if one is available. Stay on the line.

  2. Otherwise, call your state's mental health line.

    Choose a state above to see the number.

  3. Say this.

    Fill in the two blanks and read it out. Clinicians make faster decisions when they hear history, change and timeframe in the first sentence.

    I'm calling about my family member, Sam. They have a history of psychosis. Over the last few days they have not slept for three nights, says the neighbours are watching. This is a change from how they usually are, and I'm worried it's getting worse. I'm asking for a mental health assessment tonight. What can you do, and what should I do while I wait?

  4. Ask for these, by name.

    • A mental health assessment, tonight if possible, and whether an acute team can come to the house.
    • A time they'll call back, and a direct number for you.
    • What to do if things get worse before then.
    • Whether to go to an emergency department, and which one, and whether they'll call ahead.

    If they say they can't help unless the person calls themselves, say: "I understand you can't share information with me. I'm giving you information, and I'm asking you to act on it." You are allowed to do that.

  5. While you wait.

    • Fewer people, lower lights, less noise. One calm voice.
    • Don't argue about what they're seeing or believing. Talk about how they feel, and that you're staying.
    • Offer water, food, their medication if they take it. Not alcohol or drugs.
    • Keep yourself safe. If you feel unsafe, step outside and call 000. That is not a betrayal.
    • Write down what you see and when. You will be asked.

  6. If they refuse all help.

    It happens, and it is one of the hardest places to be. You still have options: give the mental health line or their GP the information anyway, ask the line what the threshold for an assessment without consent is in your state, and keep the door open. "I'm not going anywhere" is a plan. See also what confidentiality does and doesn't stop.

Next time, it can be easier. When they are well, ask them to make a Safety Net Card and a plan, and to put you in it. Then tonight has a script already written, in their words.

How to talk to someone experiencing psychosis

You don't have to agree. You do have to stay.

To the person, what they are experiencing is real. Arguing about it rarely helps. Being calm, honest and present nearly always does.

Do

  • Talk about the feeling. "That sounds frightening." "You seem exhausted." You can be fully honest about their feelings without agreeing about the cause.
  • Say what you see, simply. "You haven't slept in three days and I'm worried." Behaviour, not labels.
  • Slow down. Short sentences. Pauses. One question at a time. Thinking is hard work right now.
  • Offer choices. "Tea or water?" "Here or the kitchen?" Control is in short supply. Give some back.
  • Be honest about what you'll do. "I'm going to call the mental health line because I'm worried. I'll stay with you while I do."
  • Keep it quiet. Fewer people, less noise, dimmer lights. Turn the TV off.

Don't

  • Argue about what's real. You will lose, and so will they. "I don't see it that way, but I can see how scared you are" is enough.
  • Pretend to agree either. Playing along builds the belief and breaks trust later.
  • Whisper, crowd, or touch without asking. All of it reads as threat to a frightened mind.
  • Use the words "crazy", "psycho", "insane". Even as a joke. Especially as a joke.
  • Make threats or ultimatums. "If you don't go to hospital I'm leaving" closes the one door you need open.
  • Try to do it alone. Call someone. Tonight, that's the mental health line. This week, it's a carer service and a friend.

Confidentiality

They can't tell you. You can tell them.

Families hit this wall constantly: "We can't discuss their care." It's true, and it is only half the story. Confidentiality stops a service from sharing information about an adult without consent. It does not stop you from giving information, and services are expected to listen to it.

  • You can always call the mental health line, the GP, or the treating team and tell them what you're seeing. Write it down first. Dates, sleep, specific changes.
  • You can ask general questions. "What are the signs that someone needs an urgent assessment?" "How does your service respond to a family's concern?"
  • You can ask to be named. When the person is well, they can nominate you as a support person, or sign a consent for information sharing. In Victoria, a nominated support person has a legal right to be informed and consulted.
  • You can ask for carer support in your own right. Many services have carer consultants whose job is you.

The Safety Net Plan has a "who holds this plan" section for exactly this. Being written into it, while they're well, is the simplest consent there is.

Looking after yourself

You're in this for the long run. Plan for that.

Carers of people with psychosis have some of the highest stress levels of any group. That isn't weakness. It's the job description. Support for you is part of treatment for them.

  • Carer Gateway

    National, free, government-funded. Counselling, peer support, coaching, and emergency respite if you suddenly can't be there.

    1800 422 737

  • SANE

    Support for families and carers of people with complex mental health issues, including psychosis. Counsellors who know the territory.

    1800 187 263

  • Other families

    Carer peer groups exist in every state, through organisations such as Mental Health Carers Australia, Wellways, Mind Australia and Mental Illness Fellowship. Nobody understands like someone who has done it.

  • Your own GP

    Tell them you're caring for someone with psychosis. You can have a mental health treatment plan of your own.

  • Family work

    Structured sessions for the family alongside the person, offered by many public services. Some of the strongest evidence in psychosis care. Ask for it by name.

  • If you share your story

    Online or in person, Mindframe's guidelines help you do it in a way that gets people help rather than frightening them away. Especially around suicide: no methods, always a number.

Your part in the safety net

The best time to be let in is when they're well.

Ask to be in the plan. Learn their early signs in their own words. Agree, in advance, what you'll do when you see them: who you call, what you say, when you go to the house. Written down, that agreement is the difference between a family that is helpless at 2am and one that isn't.

See what's in the plan Early signs check, for someone else