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In an emergency call 999
For general enquiries call 01158388100
Monday - Friday -

Mental Health reporting

Consent Script

Please read the statement below before continuing with the visit.

Thank you for inviting us into your home. During the visit we will give you advice to help you be safer in your home, and if you agree, we will put you in touch with other services which may be able to help you. Please understand that this is a completely free service.

Nottinghamshire Fire & Rescue Service will store your information as a record of our visit and to use in statistics to evaluate our work. We will keep your details stored securely. We will only share your information with other services if you agree, or if we have to, for example, to keep you safe from serious harm.

If you would like to know more about how we store and use your details, please visit our website or you can find further contact details on the back page of your Safe and Well booklet.

Are you happy for us to proceed with the visit?

Possible mental health concerns?

Within the questionnaire, the below question is used to identify if you have concerns. The question is Not asking you to diagnose the occupant with any condition but signifies you would like to note risks that may be linked to the occupiers Mental Health wellbeing in relation to their fire safety.

Screenshot asking "Were possible mental health concerns identified during the SWV that may affect the occupier's wellbeing, safety or be a risk to crews? Yes / No"

If you answer YES

If you answer “Yes” to the above question, there are common Mental Health disorders that you may already be aware of. The below model will help you to relate commons signs and symptoms to those disorders. Remember, this is Not a diagnoses, but use of some common language may help in any further referrals made.

Common mental health disorders overview

This model may help you complete the below supporting information box but note that any concerns should be related to the occupier's risk of having a fire in their home or their ability to escape in the event of a fire. The concern may also affect NFRS’s ability to affect rescue of the individual.

  • Hoarding - High clutter rating, Single room existence.
  • Alcohol/substance Misuse - Impairment to carry out tasks safely.
  • Intellectual Developmental Disability - Cognitive and learning issues, Inappropriate response to risk.
  • Organic Conditions including dementia/cognitive impairment - Memory issues, confusion, communication difficulties, confabulation, lack of insight into difficulties, disorientation to environment
  • Depression, anxiety, bipolar disorder, bereavement, agoraphobia, PTSD, OCD - Chaotic living, reduced self-motivation, self-harm, suicidal tendencies, manic/chaotic presentation, difficulty making decisions, easily distracted, negative, poor sleep habits, refusal to leave home in an emergency, intrusive thoughts, missed medical appointments, poor concentration, restlessness, lack of energy, negative impact on ADLs, insomnia, making decisions considered risky/harmful.
  • Psychosis, Schizophrenia - Responding to stimuli that don't exist: auditory, smell, taste, visual/tactile. Delusional thoughts - unshakeable beliefs, confused/disturbed thoughts, suspicious.
  • Personality Disorder - Frequent caller, show disregard for social norms, regularly breaks the law, expressions of suicidality, self-harm.

Gaining Consent

Gaining consent is essential for any possible onward referrals to be made. Without consent, both NFRS and our Occupational Therapist are unable to proceed with the referral unless the occupier is at immediate risk of harm to themselves or others.

Occupant aware?

If consent has not been given is the occupant aware we might make a referral - Yes is no further action. If No information follows.

Screenshot of the safe and well referral form reading - "If consent has not been given, is the occupant aware we might make a referral? Yes/No"


Is there a reason to make a referral without consent? For further guidance see below.

Is there a risk of harm to self or others?

If you intend to make a referral without consent, it is essential that the guidance below which is behind the “i” tab by the question is read and understood as your rationale for referring.

No Consent mental health

A referral can be made under duty of care if

  • All reasonable steps have been taken to gain consent to the referral, and by not making the referral, the impact of the individual's mental health would place them or others at risk of harm in the foreseeable future.

No consent rationale

The reasons for you making the referral without occupier's consent must be recorded in the box as shown below

Screenshot of safe and well referral reading "Please explain below;"

What happens next?

If a concern is noted within the Safe and Well questionnaire, the information will then populate a Persons at Risk Team report within CFRMIS for any further intervention necessary. The Occupational Therapist working with NFRS will be involved in this process. Should any further information be required, you may be contacted.