Should I Go to the ER for a Mental Health Crisis?

People experiencing a mental health crisis may not know where to turn and what resources are available. In this article, we hope to offer some guidance and helpful information. 

If you are in immediate danger or thinking about harming yourself, going to the emergency room, calling 911, or calling 988 is the right call right now. 

Should you go to the ER for a mental health crisis?

In short, going to the emergency room is the right choice in an emergency. 

When the ER is the right choice

The emergency room is the right choice when people are not safe in their home or community environments. Mental health emergencies can include: 

• Having an active plan or intent to end one’s life
• Thoughts or plans to seriously harm or kill others 
• Experiencing symptoms of psychosis, such as voices telling you to harm yourself or others, or not being able to tell what is real
• Dangerous substance use, intoxication, or withdrawal

Additional signs you need emergency care now

Mental health crises usually build up over time, and some additional signs that someone is experiencing significant mental health concerns can include but are not limited to:

• Changes in energy level, behavior, or mood
• Feelings of being a burden to others or hopelessness
• Giving away possessions, telling people goodbye, making or updating one’s will
• Withdrawing from relationships and social connections 
• Risky behaviors, such as increased substance use or driving unsafely
• Difficulty doing activities of daily living, such as eating, getting out of bed, showering
• Trouble sleeping or sleeping more than usual
• Panic attacks, or severe anxiety that includes physical symptoms
• Feeling disorientated
• Self-harm thoughts or actions 
• Being aggressive towards others or property

How to get emergency help safely (988, 911)

Staying safe until you connect with professional help is critical. If you are alone, we recommend calling 911 or 988. If you have a loved one or support person with you, they can transport you to the nearest emergency room.

If you are unsure whether going to the emergency room is the right decision, contacting 988 can help. They can assess your situation and make recommendations, including contacting emergency services on your behalf. The 988 Suicide & Crisis Lifeline staff can connect you with local resources, including mobile crisis teams and mental health response units.

Reaching out for help is a sign of strength and hope for your future self. If you are in crisis, reach out by calling either 988 or 911 now. 

What happens in the ER for a mental health crisis?

Here are a few things to keep in mind if seeking help for a mental health crisis in the emergency room.

What to expect

First, the initial contact will be for triage to assess your concerns and any safety risk. Then you will meet with medical providers to assess your current areas of risk and mental health symptoms, as well as your social and overall health history.

They will make a recommendation, which can include admission to an inpatient hospitalization program or a referral to residential or outpatient treatment. Before you are discharged, there should be a plan put in place for ongoing treatment and support. 

What are the alternatives to the ER for a mental health crisis?

If situations are not life-threatening, many people benefit from mental health crisis alternatives to the ER. If there is an immediate medical emergency, going to the nearest emergency room or calling 911 is recommended. 

Crisis stabilization care

Many areas are creating crisis stabilization units or programs to respond exclusively to mental health needs, rather than relying on ERs where people present for a multitude of concerns.

Crisis stabilization units are short-term, voluntary treatment programs that operate 24/7 to provide support when people need it most. Stabilization-focused care is provided in a safe, therapeutic environment. The team makes recommendations and facilitates referrals to ongoing care, such as outpatient programs and services. 

‍Crisis lines and warmlines (988)

Crisis lines such as 988 can help provide immediate support and link the person to the treatment they need. Veterans in need of support can call 988, then dial 1 to reach the Veterans Crisis Line. 

Warmlines are never a substitute for seeking emergency care or crisis support. They can, however, be an excellent resource to help prevent stressful situations from escalating into a crisis. Warmlines can be used to help with problem-solving or to have someone to talk to during difficult times. Many people use warm lines if they lack a healthy support network or want to talk to someone who can be more objective than the people in their lives. Check out warmline.org to find a peer support warmline in your area. 

How do you decide between the ER, crisis care, and outpatient help?

In general, here is a quick summary of each option and who it may be right for. Please note that this is general guidance, and no one is expected to make this call on their own. If you are unsure what route is best for you, reach out to the crisis hotline by calling or texting 988. 

• Emergency Room: Best for people who are in immediate danger. Harm to self or others is a serious potential outcome of not seeking support and getting somewhere safe. 
• Crisis Care: Best for people who are experiencing significant mental health concerns that could potentially cause harm to themselves or others. People may not be in active danger now, but the situation could escalate without intervention. This may also be for people who lack safe and stable housing or a healthy support system. 
• Outpatient Treatment: Best for people who are experiencing mental health concerns, aren’t in an active crisis or a danger to themselves or others, and who have safe and stable housing and supports in the community.

How Willow Health Can Help

Many people who need urgent support don’t always need the intensity of the emergency room, but can’t wait to begin alternatives such as intensive outpatient programs (IOP). We know that if people get support when they are struggling, many mental health crises can be prevented. 

That’s where our crisis stabilization program comes in. We offer same- or next-day appointments with both a therapist and a medication provider, as well as peer support coaching and care management services. This ensures that people get the help they need, when they need it, without delay. Our treatment team focuses on providing targeted support to help people find stability and the next steps of their recovery journey. 

To learn more about Willow Health’s crisis program and intensive outpatient program (IOP), call us at 646-814-1530. 

Frequently asked questions

Here are some commonly asked questions about going to the ER for mental health concerns.

What happens if you go to the ER for depression or suicidal thoughts?

You will be triaged by the intake nurse to identify your presenting problem, then assessed by the medical team who will make recommendations on what’s next. This could include inpatient hospitalization or a referral to another program. You will leave with a plan of care which should include appointments for ongoing treatment programs and/or providers. 

Can you be admitted from the ER for a mental health crisis?

Yes, the physicians at the emergency room may recommend that you be admitted to an inpatient treatment program. 

What's the difference between the ER and a crisis center?

The emergency room handles health emergencies of all kinds, while crisis centers specialize in supporting people experiencing a mental health crisis. 

Sources

Warmline.org 

988 Lifeline 

Warning Signs of Suicide - National Institute of Mental Health (NIMH)