From chaos to calm: Putting people at the heart of mental health crisis care

When someone is experiencing a mental health crisis, it can be one of the most frightening and difficult moments of their life. Decisions may need to be made quickly, risk needs to be understood, and, sometimes, professionals have significant legal powers.

But behind the processes, assessments, and legislation is a human being.

Approved Mental Health Professional (AMHP) team managers Rob Goemans and Mandy Pritchard discussed their work supporting people through mental health crisis in an It's All About People Podcast.

They explored the responsibility that comes with the AMHP role, but also something much broader: what genuinely personalised, strengths-based and compassionate care looks like when somebody may be at their most vulnerable.

Start with the person

AMHPs are specially trained professionals who have an important role under the Mental Health Act, including coordinating assessments where someone may need to be detained in hospital.

That brings considerable responsibility and power. For Rob, this makes the values underpinning the role particularly important.

“To hold that power only works if it’s balanced against really, really good values.”

Being person-centred is therefore not an optional extra. It means understanding the individual, involving them as much as possible, and recognising the power imbalance that can exist when someone is in crisis.

Rob described this as constantly judging how much control a person can take over their own journey:

“We’re sort of measuring all the time how much can this person lead for themselves - and it’s got to be the maximum.”

Sometimes somebody may be too unwell to take the lead completely. But the aim remains the same: to work with the person wherever possible rather than simply doing things to them.

See the whole person, not just the crisis

A strengths-based approach asks us to look beyond symptoms, diagnoses, and immediate problems. What has happened in this person’s life? What matters to them? Who is around them? What strengths, relationships and resources can help?

As Rob explained:

“When we sit down with that human being and we look at them, we start from there.”

That means recognising that people often understand their own lives and risks better than anyone else.

“They can tell us about their own risks. They’ve lived with this situation for a long time.”

The conversation also highlighted the importance of understanding people's lives in their wider social context. Trauma, isolation, relationships, purpose, and what has happened to somebody can all be important.

For Rob, understanding mental distress therefore requires a deeply human approach:

“It’s about what’s going on for people, what’s happened to them in the past, what’s going on for them now.”

Rather than seeing somebody simply as a condition or a crisis to be managed, this approach asks professionals to understand the person within their own unique circumstances.

Bring the person into the calm

One of the most powerful images in the conversation came from Mandy.

Mental health crises can involve many different people and services, each bringing concerns, responsibilities, and sometimes different opinions about what needs to happen.

Mandy: “We almost sit in the eye of a storm.”

The role of the AMHP is not simply to add another professional voice to that storm. Instead:

“We bring the person to the centre of that storm with us.”

From there, the focus can move towards understanding what is really happening: What are the risks? What does the person want? What support already exists? What could make the situation better?

Crucially, detention should not automatically be the answer. AMHPs are required to consider less restrictive alternatives.

Mandy: “Something does need to be done, but is that something detaining a person… to hospital? Not very often it’s not.”

That is strengths-based practice at its most important: resisting the pressure simply to “do something” and instead taking time to understand what might genuinely help this particular person.

Protecting people's rights

Personalised care is also about rights.

When somebody is experiencing mental distress, they may feel that control over their life is slipping away. In these circumstances, dignity, respect, choice, and involvement become even more important.

Rob: “Our role is to try and kind of transfer some of our power and the power of the whole process to the person.”

People have a right to understand decisions being made about them and, wherever possible, to be involved in making them.

The team therefore places strong emphasis on advocacy, listening, and empowerment, alongside the legal and human rights underpinning the Mental Health Act.

As Mandy explained when describing the team's shared values:

“We support people experiencing mental distress with compassion, empathy, respect and kindness.”

And importantly:

“We see and understand people within their own unique system. And whenever possible, we work with that system.”

These principles help turn “person-centred care” from an aspiration into something practical and meaningful.

Relationships make better care possible

Personalised care does not happen in isolation.

AMHPs may work alongside mental health services, hospitals, police, ambulance teams, and many others. Different professionals may bring different perspectives, and sometimes those perspectives clash.

But disagreement does not have to become a barrier.

Rob described the value of accepting different perspectives and using them to build: “a more holistic view.”

Mandy also highlighted the importance of curiosity - listening to another person's perspective and asking why they see the situation differently.

Those relationships need to be built before a crisis happens.

The team therefore invests time in regularly meeting colleagues across other services. The result is that, when difficulties arise, people already know who to call and have relationships they can draw upon.

Mandy: “The more we’ve got that, the less things escalate.”

For the person experiencing the crisis, that can mean less time waiting while different parts of the system work out how to respond.

Compassion for the workforce matters too

Perhaps one of the most important messages from the podcast is that compassionate, personalised care depends upon a workforce that is also treated with compassion.

AMHPs can find themselves making extremely difficult decisions in highly emotional circumstances. Supporting them afterwards matters.

“You can’t sit with a person, stand with a person in those times of our lives, in those extremes, and not take on those emotions.”

The team creates time and space for people to talk, reflect, and decompress. Managers are approachable, colleagues support one another, and staff are trusted.

When something goes wrong, Mandy described the first question managers ask: “How are you?”

That simple question says something powerful about the culture they are trying to create.

Rob summed up the connection between workforce wellbeing and compassionate care:

“We expect our staff to go out there and treat people with compassion, respect, and kindness. And if we can’t treat our staff team with those very same things… then we’ve got no right to ask them to go and do it for anybody else.”

Supporting staff is therefore not separate from personalised care. It is one of the things that makes personalised care possible.

Creating the conditions for people to do their best

The conversation also contains an important lesson for leaders.

Staff often know what good, person-centred care looks like. The challenge can be creating the conditions that allow them to provide it.

Rob and Mandy see part of their role as removing unnecessary barriers. They jokingly compare themselves to the sweepers in curling, clearing the ice so the team can move forward.

Mandy explained: “The staff can do this job brilliantly. And we need to clear everything out of their way.”

That means trusting experienced professionals, supporting their wellbeing, addressing systems that do not work, and creating a culture where people feel safe to ask questions, challenge each other, and learn when things go wrong.

When people feel trusted and supported, Mandy says: “They can absolutely flourish as a team.”

It is a lesson with relevance far beyond mental health services: if we want people to deliver compassionate, strengths-based care, our systems and leadership need to help them do it.

From chaos to calm

Towards the end of the conversation, Mandy captures what makes the AMHP role so rewarding.

“There’s nothing like it, going home at the end of the day, knowing that you’ve taken a situation that was chaos, and you’ve brought it to calm in the best way possible for that person.”

That phrase - for that person - matters.

Personalised and strengths-based care is not about ignoring risk or pretending difficult decisions never have to be made. It is about ensuring that, even in the most difficult circumstances, we continue to see the human being in front of us.

It means listening before assuming. Understanding what has happened to someone rather than simply asking what is wrong. Recognising their knowledge, relationships, strengths, and rights. Sharing power wherever possible. Building strong relationships between services. And giving staff the trust and support they need to do the right thing.

Perhaps most importantly, it means remembering that behind every assessment, service, professional title, and process are people.

And when someone is experiencing one of the hardest moments of their life, that humanity matters more than ever.