If you are in danger now
- Life at risk: call 999 or go to A&E.
- Urgent but not life-threatening: call NHS 111 and select the mental health option, or use 111 online.
- To talk: Samaritans, 116 123, free, any time.
- To text: SHOUT to 85258, free, confidential, 24/7.
The short version
Use text where you can, write everything down, and follow every call with a written note. If nothing happens, you still have a dated record showing who was told, when, and what they did or did not do. Never assume someone will do what they said they would do: check, and ask again in writing.
1. Use routes that leave a written record
- Text SHOUT to 85258. Free and confidential, 24/7, for anyone in the UK who is struggling to cope. Some NHS areas use their own keyword with the same number (for example CALMER in North East and North Cumbria); your local NHS trust or integrated care board website will say if yours does. Otherwise text SHOUT. Tell them plainly, in writing, what is happening and the effect your treatment, or the lack of it, is having on you.
- Can't use a voice call? Register for emergencySMS now, before you need it. Text the word register to 999 and follow the reply. Registration lets you text 999 in an emergency. The service is for people who are deaf, hard of hearing or speech impaired. You must register in advance, and again if you change your number (Relay UK: contact 999).
- Email or write to your GP practice rather than only phoning. Keep a copy.
- Use PALS, the Patient Advice and Liaison Service at the hospital or mental health trust, for help with a problem you have not been able to sort out. Contact them in writing (NHS: what is PALS).
2. Keep a record of every contact
For every call, message, letter, appointment and 999, 111 or crisis contact, note:
| Record | Example |
|---|---|
| Date and time | 3 October, 14:20 |
| How | Phone, email, text, letter, in person |
| Who, and their role | Receptionist; duty GP; crisis team nurse |
| What you told them | Medication stopped 6 weeks ago; not sleeping; struggling to work |
| What they said they would do, and by when | "The GP will call you back by Friday" |
| What actually happened | No call by Friday |
After any phone call, send a short email confirming it: "To confirm our call today at 14:20, you said…". A phone call leaves no record you can show anyone. A follow-up email does. Keep everything in one place: an email folder, a notes app or a notebook.
3. A short message you can copy
Keep it brief and factual, so whoever reads it can act on it quickly:
Subject: Request for review: [your name], [date of birth]
I am writing to tell you how my [treatment / lack of treatment] is affecting me.
What has happened: [e.g. my ADHD medication stopped on (date)].
How it is affecting me now: [sleep, work, safety, daily life].
What I have already tried: [calls, dates, who].
What I am asking for: [e.g. a review, a named person responsible for the next decision, and a date].
Please reply in writing. I find written communication easier, and I am asking for this as a reasonable adjustment.
Asking for written communication as a reasonable adjustment is explained on access and adjustments.
4. Spend your energy where a decision can be made
Some people genuinely want to help but have no power to act. They can only pass you back to your GP, sometimes as a single message. Do not wear yourself out arguing with every one of them. Ask each service once, in writing: "Who is responsible for the next decision about my care, and when will it be made?" Record the answer, then direct your follow-up to that person or team. Ask a friend or family member to help with the calls and emails if you can.
5. Plan for the worst (the author's own approach)
This is the site author's personal approach, from lived experience. It is not NICE guidance or clinical advice.
Assume the worst and prepare for it: keep your own records, your own backup plan and your own support around you. If things turn out better, that is good news. If services let you down again and again, even to the point where it feels as if the people meant to help are working against you, you will still be disappointed. But you were not relying on them, so it is less likely to push you over the edge.
6. If you can't face the admin
If you are in this situation and don't know what to do, or simply can't handle the admin, email mjb.adhd.advocacy@gmail.com and I will try to help. This is one person, not an emergency or clinical service, so replies are not immediate. Please do not send full medical records. In an emergency, use 999.
Limits
This page is general information, not medical or legal advice. Service details were checked on 5 October 2026 and can change. A written record shows what you told people and when. It does not by itself prove that anyone acted wrongly.
Sources
- NHS: where to get urgent help for mental health (999, 111 mental health option, Samaritans)
- Shout 85258
- Relay UK: contact 999 and emergencySMS registration
- NHS: what is PALS