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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

What to Do In a Mental Health Emergency

Allan N. Schwartz, LCSW, Ph.D. Updated: May 18th 2007

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.

Your comments are welcome and encouraged.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

What to do in a mental health emergency - Sarah - Mar 6th 2015

If the above had been done to me 30 years ago wherein the police and EMTs were called, I would not be alive today. 



car acciden now im depressed and get anxiety - dt - Feb 26th 2015

I was in a car accident in november and i have went to the er to try to get treated for this. they referred me to a clinic ( after waiting 6 hours at the er) which wanted me to pay 40 dollars to see a doctor. Now if that doesn't get you even more depressed then I don't know what does.  If I still had my job ( lost it mainly due to me being so called slow and an idiot by other workers and being late excessively). idk where I was going with that but I have been practicing avoiding these types of situations. long story short, er sucks a*s and my next appointment to finally see a psyciatrist is march 13 so ill try to stay alive by taking sleeping pills to sleep my life away until that day comes because its too depressing to deal with each day.

Nobody Cares - - Jan 29th 2015

I've been to the ER and recieved little to no treatment for severe depression. I even revealed to them about my history of suicidal attempts; they simply do NOT care, especially if you don't have health insurance. Yeah, they'll send out a physiatrist to "talk" to you for two to five minutes or so, write you out a script for some kind of cheap anti-depressant medication and then send you on your way. Trust me, most of these people don't have enough compassion and thus don't want to bothered.

No immediate help for the mentally ill - - Oct 22nd 2014

I called 911 and begged them to take my son to the erwho was threatening to kill himself, with a gun.  Five police officers showed up and they told me it's not against the law to put a gun to your head. Thanks **** County Police Department. As I am writing this my son has deeply cut himself and rufuses to go to the er. No use calling 911 they didn't care to help before I have no reason to believe they will this time. Perhaps if they did their jobs then we wouldn't be here now. 

911 is ill equipped or even deadly. - Cacique - Aug 26th 2014

I discovered this article seekin advice after reading a news article about police shooting and killing a person with psychiatric illness. This is not the first time I see a story about untrained officers responding in this manner. I don't agree with this advice to call police. EMT are not may not be trained either but at least they won't hurt the patient. 

It is our right - - May 27th 2013

If we do not want to live then leave us alone I had a therapist and he told me it was my right to live or not I am in the planning stages leave me alone. Leave the others that make that choice alone also.

help - crazy myself - Mar 13th 2013

Please find a way to help!! My mother is mentally ill and now my daughter is having parinoia.  There is no way to get help.  The think they are okay and others are trying to distroy them even their family members.  We can't help them because they don't trust us. 

There has to be a way.  I took my daughter to get help a couple of weeks ago and they're still not doing anything to help her. 

wake up people - - Jan 25th 2013

Dr Schwartz,

I know your well meaning and a carrying Doctor but the reality of the mental health system in this country is a joke. Its all about money and until insurance covers mental issues like they do phyicial problems then we will continue to be shuned by this socieity. I have seen this first hand and also have tried to help other family members and its a total waste of time unless you have money to get into a expensive program that really is design for people with means, and As we know most mentally ill people have no means. I could go on all day about the nightmares I have faced trying to get help for myself and others but don't have enough room here. No wonder we have mentally ill people commiting mass murder and do you hear about reforming the mental health system NO we hear about gun control my god wake up people. 

Some things that help - Jay Sheckley - Aug 18th 2012

Maybe you could help me get the word out about a free online book on suicide which lets distraught folk felt enjoyably sane. Give it a click & see- then share

enjoy it now!!


also this article explains that this site

helps you take care of yourself.

Good luck everyone and be gentle with yourselves.

help - vicki - May 14th 2012

My son is 17 and has over the past 6 weeks has had episodes which have increased from weekly to allmost nightly, he first complaned of heart palpitations which sent him into a rage, now it is insomnia, the episodes which include screaming punching walls, punching his head, suicide threats, screaming his hatred of me and storming out of the house, these only happen at night and seem to only happen at home with me, this has me very confused, he controls himself at school and with friends, he has been to many doctors and hospitals, if this is bipolar or he has a mental illness how can he contol it away from his home? this behaviour is destroying my life and my career. I cant find a solution.

PTSD - sue - Dec 9th 2011

Going to the emergency room for my depression was the worst thing I ever did.  I waited 10 hours in the cold, was refused any food, even a juice, after not having eaten the day before and without medical attention I laid awake after not sleeping for days, the other patient was allowed  to rant all night long. I was not even given an aspirin when my head was going to explode.  I'm a normal professional person that has had some really bad experiences lately, not that anyone should be treated like this.  The guards lied about the Dr. coming in an hour, in an hour, in fact he had gone home although he was there when I arrived.  I would have said or done anything to leave, and when I left, I really wanted to die.  I was then sent a bill for $6,000.

suicidal son arrested facing felony charges - sandra - Aug 18th 2011

My son has PDD-NOS with moderate to severe depression. He has a previous felony from resisting arrest and therefore is not allowed to possess a gun. He was suicidal got a gun, I called the police because I thought he was going to kill himself and I needed help ASAP. He put the gun down and ran, due to distrust in the criminal system. I found him that night and took him to the hospital. The police came to the hospital and arrested him and he is currently facing 2 years in prison for a felon in possession of a firearm I find the justic system to be very ignorant to mental illness. Be careful before you call them in an emergency such as this. He could not get admitted to the hospital without being suicidal. So what options are left? Disillusioned in Michigan's justice and mental health system.

Blame the Government - Allan N. Schwartz - May 30th 2011


For the sake of clarification, hallucinations and delusions are not triggers for your daughter's psychotic episodes. They are very serious symptoms of her psychosis, her schizophrenic illness. Howeve, there is nothing illegal about experiencing hallucinations and delusions. The only time a person with schizophrenia, or another type of psychosis, will be hospitalized is if they are threatening to commit suicide or to harm another person. Also, when someone with schizoprenia is doing these things or saying these things, it is highly doubtful that they can suddenly collect themselves and behave better for the police, at least, in most cases. In any case, the situation must be very serious to cause a hospitalization.

Dr. Schwartz

Blame the Government? - Robert - May 28th 2011

There are many heart rendering stories of those with mental health problems. I myself have a daughter who is schitzoprenic who has psycotic episodes, sometimes due to medication adjustment, sometimes who knows. Halucinations and paranoia seem to trigger her and it turns in to being psycotic when you don't react in understanding toward her.

Our problem is that if we were to call for help, she will have time to calm down and be sorry for her actions, then the police or psyciatrist do not know what to do with her. Psychiatrists are part of the problem. She only sees him once or month or so and of course she puts on her best face when she goes to him. It's like one person above said, if you haven't already cut your wrist when you see the psychiatrist, you won't get anything but a counselling session and send you back home. I am considering my wife and I going on a private session with the psychiatrist and tell him how she acts when she is not in his presence, but can you believe no doctor will talk to you about a child that is not underage regardless of the circumstances. All to do with privacy laws.

Our government has always been behind the curve when it comes to mental health. That is all the way from federal down to city. So just who is in charge here???

You might answer that question by saying WE are. Well then it is us that are at fault then........hmmmmm? We have surely waited too long in waiting on someone else to take care of every problem we have that we are now loosing the right to exercise our right, and are having our rights entirely taken away by the power of our government. Then what will happen is your's and mine will be solved by our government whether we like it or not. We have the choice of electing Representatives and Senators  to do our bidding or doing it ourselves. But where do we find statesmen of old that are honest and not self serving? Seems to be none to be found, nothing but self serving politicians with an agenda, who will lie to get into office and then enrich themselves and get on with their true agenda? Sound familiar?

Jesus said we (the Church) are to take care of the poor, the lame, the widows, orphans and the mentally ill and disadvantaged people due to no fault of their own. He never said we were to be taxed by the government and have the government take care of it for us. Reason being the government is corrupt, but being as that is what we have determined to do, it is our responsibility to insure our taxes are used to do our bidding, what is right. But your government now is so corrupted that your taxes are being used to put you and I under their control and they then will deal with you or dispose of you as they so desire. Then these people I mentioned will be a problem to the government and this country will be cleansed, just as the Nazis's of Germany did.

What's wrong with this picture? We are!!!We whine and fuss about it, but nothing interferes with our golf game, of our sports, or fun things we all do. Who caused the economy to fail? Who voted for these corrupt politicians? Who believed the propaganda and lies these people did to get elected and who amoung us just voted for selfish reasons without considering or caring for the welfare of the country as a whole? We did!

Yes of course, something needs to be done with our mental health system, in addition to a mind boggling list of other things, but it is you and I that has to step up to the plate, get our heads out of our rear end and solve these problems from the bottom up, not the top down.And we do not need to wait around for election time. There is still a right to impeach those violating the Constitution. And those who are trying to overthrow the country should be jailed. Think about it!!!!

jerry springer - ggnlou - Apr 22nd 2011

My spouse started making threats toward his doc. he was suicidal and homicidal. i called and expained everything. we had no guns in house.45 min later the police showed up. i stated that my husband had mental illness(i was very descriptive and thought for certain he would get help.)camera on table the police held it up pretending to take our picture. turned and said,smile you are on jerry springer!!! they took him to emergency rm(i went too)In 30 min we were out of the veterans hopital. absolutly no help!!! It has been 3 mons and i still have no help for him. this man is serious-5 times he overdosed---died 3 of those times and was recessitatedHELP_HELP_HELP!!

Helllp - Allan N. Schwartz, PhD - Feb 25th 2011


When a mentally ill family member gets out of control and threatens suicide or homicide is the time to call 911. However, its crucial that, when the call is made, that you are reporting a mentally ill person who has become out of control and threatening. If not, if you simply report danger, without specifying mental illness, there will be an arrest rather than the  hospital emergency room. You must make it clear that there is nothing criminal going on but something psychiatric and very serious and that you believe he should go to the emergency room for evaluation. That way, you avoid the court system.

Hope this helps.

Dr. Schwartz

helppppp - Sarah - Feb 25th 2011


What NOT to do! - - Feb 23rd 2011

We had a very similar expereince to Dazed and Confused. I had been told by a mental health worker that if my son should get into an out of control state again, and make me feel unsafe, I would have to call 911 and ask the police officers to transport him to the hospital for psych evaluation.

The police officers had only one thing on their mind when they arrived - 45 minutes after my call. That was to arrest my son and file a restraining order on my behalf. I did not request this, I only wanted my son to be evaluated by proper medical professionals. We ended up posting his bail, after having to leave him locked up in county jail for 2 weeks. After several stays, the judge ordered psych evaluation on an outpatient basis, at my son's expense. My son had no resources so when the eval never happened, the judge dismissed it all.

What did we learn? Not only can we not trust our law endforcement officials, we can also not heed the instructions of health care professionals either.

This was now seven years ago. My son has not worked in that time, incapable of getting a job, his mental state has deteriorated even further. As far as I can tell there is nothing we the parents and homeowners can do, except to have himn incarcerated, again. Which as far as I can tell will only further degrade the situation.

I am lucky when I can get 3 hours of sleep before having to get up and go to work in the morning. He spends all night raving at the top of his lungs til he loses his voice, in the room directly below my bed. He will not talk to me except for occasional rants that seem to be direct insults about what I do and don't do.

Tough love does not seem to be the answer. We have a long cold winter here. I refuse to be responsible for his death, just because I didn't have quite enough patience. I am not a murderer.

So would you please publish how to get this to work, in spite of uneducated police officers?


System Forces You Into Suicide - dogslickedmyheart - Mar 29th 2010

ER is fine if you're suicidal, but what about those people in terrible mental pain who really DON'T WANT to kill themsleves but just want some relief, some hope, some help, some simple human contact??? Where are THEY supposed to go? What can THEY do? Who helps THEM?

I'll tell you how it is in this country: if you're in mental agony and suffering like a dog, then you'd BETTER BE READY to slit your wrists at the ER desk if you ever want to get any help, otherwise they'll just give you an aspirin and tell you to deal with it.

So despite all the the Medical Establishment's talk about early intervention and "getting help", the REAL message they're sending is: KILL YOURSELF FIRST AND MAYBE THEN WE'LL TALK.

hmm... - - Oct 25th 2009

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. 

duznt matter - duznt matter - Sep 29th 2009

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 den u dont...

its tears me apart...dat no1 sees it...no1 bloody one...

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

my 17 yr old son - motherindistress - Sep 5th 2009

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!

Emergency - Allan N. Schwartz, PhD - Aug 27th 2009

Hello Dazed and Confused,

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.

Dr. Schwartz

dazed and confused - Bill - Aug 27th 2009

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?

3. Why did the patrol officer not grant my request for 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?


make money your LAST concern - - Jul 31st 2009

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.

if you don't have money - - May 31st 2009

if you don't have money you're screwed

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

Treatment - Aaron Parks - Dec 7th 2008

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!

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