What to Do In a Mental Health Emergency - Suicide, Depression, Anxiety Disorders

Many people are confused about what to do in the face of a mental health emergency. What constitutes a mental health emergency? As with any medical emergency, a mental health emergency can be life threatening. Most of the time mental health emergencies are those involving the threat of suicide or the occurrence of an actual suicide attempt. Other types of mental health emergency may involve the threat of harm to another person. In a situation where a patient is decompensating or becoming psychotic and is being guided by audio/visual hallucinations it is sometimes possible that there is a threat posed to another person. This is relatively rare but it can happen if someone is extremely agitated, on hallucinatory drugs or is in the grip of an extremely serious psychotic episode with paranoid thoughts that others are planning to harm the individual.

Friends, family and neighbors are often confused about what to do in the event of such an emergency because they do not who to call for help. Generally, people expect to call their doctor's office and get an emergency appointment if someone has a high fever or other type of physical symptom. However, it mostly unlikely that anyone can call their psychiatrist for an appointment under the circumstances above. Most psychiatrists are not equipped to handle emergencies in their private offices. That is why, when people attempt to call their therapist during off hours they usually hear a recorded message instructing them to go to the emergency room in the event of a crisis.

When someone is in the midst of a severe emotional crisis characterized by suicidal or homicidal intent it is unlikely that they will willingly go to the emergency room even if accompanied by a friend or family member. That is why it is most often necessary to call emergency services at 911 and report that someone is in danger of attempting suicide or has already swallowed pills, cut themselves or done something life threatening. Emergency services in most communities will then send both the police and an EMT ambulance to the site of the reported threat. Both police and the EMT workers will assess the situation and decide whether or not the person needs hospitalization. If the threat is deemed as serious as the phone call indicated they will bring the patient to the hospital emergency room where they will undergo further evaluation and wait until arrangements are made in a local psychiatric facility. Once moved to a psychiatric hospital the patient will be medicated and stabilized until the crisis has passed. The treatment usually includes meetings with the psychiatrist and attendance at group psychotherapy sessions. Once the patient is deemed safe the psychiatric hospital will either return the person home with medication and with recommendations for continued treatment. This process includes meetings with the family members of the patient.

It is extremely important that threats of suicide be taken seriously. This is especially true if the threats have been voiced repeatedly or the person is inebriated or under the influence of drugs. It is a dangerous myth to believe that suicide threats are harmless attempts to get attention. I know of a recent case in which someone repeatedly threatened suicide, no one would listen and the individual, in despair, succeeded in their suicide attempt.

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The basic premise (go to the emergency room) is very unclear here. I ended up at this article because I was trying to figure out what to do short of calling 911 (If you have anxiety and you don't want to call 911, it's not going down). I just got back from emerg, and only now realised that the article tells you to do that. Don't worry though; you weren't the first source to fail me, nor were you the last.

Dr. Dombeck's Note: It's not possible to anticipate everyone's specific circumstances, and you are correct that there are cases where the advice to "go to the emergency room" is not the most optimal way to address the immediate problem. Our article is making the assumption that someone is in such pain that they will harm themselves unless restrained in some fashion and in this case, in the absence of ability to draw upon other appropriate resources (such as calling a therapist or physician directly) a visit to the emergency room where physicians can assess the problem and take action if they deem it necessary is the best fallback position. This is not to say that such a visit will be efficient or comfortable or anything less than infuriating; it's just the safest thing to do if there isn't a good alternative and the threat of suicidality is very real.

its so screwed n m so tired f dis...tryin ta giv reasons to mah life... its al so fake..i so much wanna end it...bt den u dont...

n i love em all so much...where da heck m i to go...i love u all...n m sorry..i donno hw things r gonna end up...m really tired nw...dont think i can take it nemore

I've been trying for the last week to get my son committed into a fulltime facility because he is mentally unstable. He's made threats to kill me, his dad, himself and because he is under the care of a professional already (a counselor that he's seen 2 times) I was told there was nothing I could do-that the counselor that sees him would have to have him committed. What do you do in a situation like that? Please help!

I cannot explain why you were treated this way. I regret that this happened the way it did and I know that it should not. The only thought that I have, but it does not explain anything, is that you never ask for an ambulance. Rather, you report an emergency and report what the emergency is. If you are suicidal, tell them, if it is chest pains, tell them, if someone is breaking into your house, tell them. You must be specific and there must be an emergency. Suicide is an emergency. However, I am baffled by what happened to you.

I will repeat what an earlier commenter said: Do not hesitate to call 911 if there is a real emergency.

I called for an ambulance to get me to Sacramento Mental Health Center. I receive SSI for mental disability and was not feeling well. I was met by a group of patrol men. They grabbed me and threw my cellphone. I was on the phone with the 911 operator. As I pleaded with them to talk to her to understand my needs, they detained me and placed me in a patrol car. No one spoke to me, no one asked me what I was doing there or even my name. About thirty to forty-five minutes later a patrol men sat in the car and took my info. He inform me they where looking for a black female, 5', 100 lb. I am a Caucasian male, 5' 9", 260 lb. I asked again for an ambulance. A patrol men handed me my cellphone (which had been thrown and stepped on) then sent on my way.

1. Why, when I was speaking to 911 and the line went dead, did they not send an ambulance?

2. Why did the Fire Department call me back, leaving a message asking me if I still needed an ambulance?

4. Why was my request to the city to replace my cell phone, which they broke, denied? Can they not tell that I have enough chaos in my life?

ERs have to provide you with stabilizing treatment regardless of your ability to pay. There's also sliding scale fees and other ways to pay. There are financial counselors at every hospital that will help you find a way to pay. Please, if it's an emergency, make money your LAST concern.

wow feel the same way - steve - Mar 17th 2009
wow i feel the same way i have been to the emergency room also and same feeling didnt tell them i was suicidal because of the same thoughts afraid they would take me away my whole life i have been battling the same thing never finished school cant keep a job had my own business figured i could work around my depression and really never worked because as soon as i got deprssed would make excuses and lose good customers i always felt this way seems like as long as i can remember and really dont no how it happen but i seem to only do simple things and everything is a huge task i have a 11 year old daughter and her mother is a alcoholic and i seem to only be here because im affraid for my daughter but lately i think im really bad because i was in a accident a few years back and i have some serious health problems now and i lost my business living in my brothers basement i try to hint around about the help i need but i truly think everyone thinks i just cant hold a job or i am lazy or something i have a heart of gold and would help anyone but seem to not beable to get help from no one including my family i have cried my eyes out to my mother telling her i need help yet she says im going through hard times and i say to her what my whole life i just want a stable life i have live i think since i was a kid had to be over 30 places always seems i cant hold a job to pay the bills and when i get a job i am uncomfortable around others and always mind racing so i get scred and either quit make excuses or get fiired for not coming in my whole life i have battled this and everyday i cry seems like i always thinking people are talking about me im always scared i have alot of real horifying experiences when i was younger to this day i wonder if that affected me i could be driving down the street and if a cop is behind me i will have a panic attack or if its quiet in my house and a loud sound occurs i freak out i guess thats a panic attack i cant concentrate on nothing i dont think i ever read a whole book in my life its pretty sad i know i think the only books i read are to my daughter short stories i just want my daughter to have a normal life thats all and nothing of my problems to reflect on her thats all i want just a stable place to live and to know my bills are paid i am tired of worry every second in my life i just would like to be something do somethin and follow threw just one time i cant even get a decent job because i cant even get my ged because i am so screwed up in the head i hae been for help many times maybe one or two appointments but never been finacial secure to follow threw or have some help me make sure i know i have to do it for myself but and i want to so bad i dont want to end my life one day because it got to bad for me to handle or i end up hoomeless and cant see my daughter i think she is the only thing that gives me hope i just need to beable to go somewhere and get help and god for sake dont have to worry about money !!!!!!! all these people today getting all this goverment assistance and i never had it once and i can get no help been surving on job after job and move after move i just want a normal life im tired of hiding in my house making excuses to everyone why i am not working so sad and in my accident a few years back i had garage door fall on me and since then its been worse my back and kneck have been messed up ever since then i was on painkillers and got addicted to those they actually made me feel good for once in my life well thats when everything really went down the tubes i lost everything i did accumalate my whole life and hit rock bottom for sure my brother gave me a place to live which if i didnt have him i would be homeless and probaly wouldnt see my daughter and my grandfather gave me his old mini van which i wouldnt even have a car well i did get off the painkillers and noticed i felt better afterwards but maybe for a couple months and just now i am back to the same ol me i have no fututre cant go to school no money no savings i have a daughter i have to feed and clothe and she is 11 so she is wanting alot more now and i cant give her nothing we have to scrape change just to get food or anything i cant get food stamps cause i dont have her more then 60 percent i am not disabled and not over 65 they basically told me nothing we can do for you at welfare if anyone can help me or lead me into directions on getting help please help me i want to be normal and not sit here thinking about my problems scred to leave the house or think everyones talking about me i want to beable to read a book and learn something on it i want to be succesful in life not end up being some weirdo please if someone could help me would be greatly to me and my daughter she is a perfect girl and does well in school i am so proud of her since the day she was born i haqve told her i loved her many times a day and she actually told me one time she loved me more then her mother made me cry since me and her mom are seperated i always had my daughter with me the mom never cared but i felt she needed that love because her mother is complety oppisite of me for sure she is my best friend and i think she is the only thing keeping me going i have had her every weekend since she was 2 and summers i have her almost everyday and when she wasnt in school i basically raised her while her my succeeded in her carrer but i also used i think my daughter to just keep going in life but i also knew she needed me seems for some strange reason god gave her to me for a reason so if someone could help lead me to something would be the world to me and my daughter future and mind of course thank you so much.....Steve

I am described in your article. My depression has been steadily increasing in severity over the past few years and just recently I attempted to commit suicide. No one in my life seems to be able or even willing to help me because my treatment would cost money and my depression keeps me from working. I have depression and high anxiety. I am dependant on people to tell me when/if I need to do something and yet no one will give me the attention and help I need. I am working on getting medicaid to get medical help, since I have no money it's my only choice, but I just can't go on living the way I am while I wait for people to get me on waiting lists and medicaid interviews. What can I do? I'm really at my wit's end. Please give me some advice or answers or something. I've tried the emergency room but I was afraid of being taken away somewhere so I didn't let on that I was suicidal. I just want to be content and noticed again like I used to be and not have so many things changing all the time. Help me please!