After an attempt: the weeks that carry the most risk

The period immediately after someone leaves hospital or crisis care is one of the highest-risk windows in the whole picture, and it is also the point at which formal support tends to thin out fastest. Discharge is a handover between services, and the failures in a handover are usually administrative rather than clinical.

If you are the friend or relative collecting someone, it is worth knowing in advance what helps, because the measures that work in that window are undramatic and easy to carry out.

Get hold of the follow-up plan

Before or at discharge, someone in the care team should be able to say what the follow-up consists of: who will contact whom, when, and what to do if it does not happen. If that is not clear, ask. It is a reasonable question, and it is much easier to ask inside the building than to chase by telephone three weeks later.

Write the crisis numbers and the out-of-hours route somewhere physical as well as in a phone. Put the wallet card in the bag they come home with.

Reduce access to means

This is the single most effective measure available in a household, and it is also the most uncomfortable to raise. It rests on the strongest evidence of anything in this field, and knowing that in advance makes it easier to raise, because the awkwardness of raising it is the main reason it does not happen.

If there are medicines in the house, particularly ones the person has taken before, ask the prescriber or pharmacist about dispensing in smaller quantities, or about having them held by someone else and brought round daily. If there are other means in the home, have a direct conversation about temporary removal.

This is not a statement about trusting the person. It is about making a decision that has already been taken harder to act on during a bad hour. Most people, asked about it later, report relief rather than offence.

Be present in an ordinary way

The instinct is to arrange something meaningful. What tends to help more is ordinary, low-demand company: sitting in the same room, watching something, eating together, without requiring conversation. Company that does not have to be earned is what people most often describe as having carried them through.

It should not become a vigil. Being watched constantly can feel like being a problem. Aim for company that feels normal rather than like supervision.

What to watch for

• A sudden calm or settling after a period of distress, which can indicate that a plan has been settled on rather than that things have improved.
• A missed appointment. Follow-up appointments are easy to miss and are often read as a sign that the person is fine. They are worth chasing.
• Increased drinking or drug use.
• Giving things away, or putting affairs in order in a way that seems out of keeping.
• New access to a means of harm, including a prescription that has been refilled.

Look after the person doing the caring

You are inside this too, and you are likely to be carrying it quietly. Feeling frightened, resentful, guilty and exhausted in the same week is the ordinary course of events, not a sign that you are doing it wrong. The piece on looking after yourself sets out some boundaries that hold. You cannot remain a reliable support to someone else while running entirely on adrenaline.