Triage Form

Are you in crisis?

    The Clare Project is not a crisis service.

    If you or someone else is currently planning a suicide attempt, please call:

    • Your GP Practice or mental health team

    • NHS 111 (call 111 and select option for mental health support)

    • The Mental Health Rapid Response Service: 0300 304 0078

    • NHS Emergency Services (call 999)

    If you or someone else is currently at imminent risk of being harmed by someone else, call:

    • Social services (any abuse): Access Point: 01273 29 55 55

    • Victim support (domestic abuse): 0300 323 9985

    • The police: (Emergency Services, call 999, non-emergencies, call 101)

    If you or someone else is currently unable to meet your/their basic needs e.g., washing, eating, toileting, please call:

    • Your GP Practice or mental health team

    • NHS 111 (call 111 and select option for mental health support)

    • Social services: Access Point: 01273 29 55 55

    However, if you would like a one-off phone or zoom appointment with a member of the Safeguarding Team for advice and support about accessing any of these or related services, please tick the box below and provide contact details.

    I would like a one-off appointment with the Safeguarding Team

    To get help from our support team, please complete the form below. Please provide your personal details and only fill out the sections that relate to the services you’re interested in.

    Please contact us if you need any assistance filling in this form.

      1. Your details

      You can change these with us at any time.

      Where do you live?
      Brighton & HoveEast SussexWest SussexNo fixed addressOther - please specify If you selected "Other", please specify

      2. General mailing list - social groups for all

      If you join our general mailing list, you will receive a weekly email with updates and details about the following services:

      Do you want to join the general mailing list?
      YesNo

      3. Specific mailing lists - specific social groups

      If you join our specific mailing lists, you will receive emails with updates and details about specific services:

      Please tick which (if any) specific mailing lists you want to join:

      Critical Discussion GroupRacialised TNBINeurodivergent GroupWest Sussex GroupsEast Sussex Groups

      4. Wellbeing support groups

      Anyone who is TNBI and struggling with their mental health or wellbeing can access these groups. However, this is not a crisis support space, so we ask you only to attend on days on which you feel safe and well enough to be around your peers, take part in the activity, and hear other people discuss their mental health difficulties.

      If you are accessing one of these services, could you please provide an emergency contact and/or GP surgery contact, so that we have someone to call if we are worried about you? We will only contact this person if we believe you to be at serious imminent risk of harm. Please enter their name and number here:

      4A. Wellbeing support groups - Group Nourish

      You can find more information about Group Nourish here.

      Do you want to sign up for Group Nourish?
      YesNo
      (Only if you want to join Group Nourish) What is your preferred method of contact e.g. email, phone, WhatsApp?

      (Only if you want to join Group Nourish) Do you have any dietary requirements e.g. vegan, gluten free?

      5. 1:1 Support

      Anyone who is TNBI and struggling with their mental health or wellbeing can access this support. This includes people who experience depression, anxiety, self-harm or suicidal thoughts, and people who have experienced violence, abuse or discrimination. You will not be excluded on the basis of being neurodivergent or disabled.

      However, this is not crisis support. If you are currently 1) acutely suicidal (e.g. planning a suicide attempt) or engaging in life-threatening self-harm, 2) having a lot of difficulties with unusual beliefs or experiencing things such as hallucinations, 3) using violence towards others, this may not be an appropriate service for you.

      If you are not suitable for this 1:1 support due to the above reasons, we can still offer a one-off call with our safeguarding team. Would you like a one-off call with the safeguarding team?
      YesNo
      (Only if yes) please provide a contact phone number:

      If you are suitable for one of these services, could you please provide an emergency contact and/or GP surgery contact, so that we have someone to call if we are worried about you? We will only contact this person if we believe you to be at serious imminent risk of harm. Please enter their name and number here:

      Have you been referred to our 1:1 support services already?
      YesNo
      If you have been referred already, when was it? Please give an approximate date if unsure.

      Please note we offer everyone who wants to access our 1:1 services an initial phone/zoom call once before they are added to the waiting list, so we can make sure this is the right support for you.

      5A. 1:1 Support - 1:1 Therapy

      Due to very high demand on this service, applications for 1:1 Therapy are currently closed. Please only fill in this section if you had already been referred but haven't filled in this form yet.

      Would you like to apply for 1:1 Therapy?
      YesNo

      If yes, please fill in the following details:
      What is your preferred method of contact e.g. email, phone, WhatsApp?

      Could you please tell us in 1-2 sentences, the issue that you would most like to work on in this short-term 1:1 therapy?

      5B. 1:1 Support - 1:1 Wellbeing Support

      Due to very high demand on this service, applications for 1:1 Wellbeing Support are currently closed.

      6. Submit

      Once you submit the form, we will send you an automatic email confirming that we have received it. Please check your spam folder if necessary. If you don’t receive the confirmation email within 24 hours, please contact us for assistance.