Reviewer check: Yes. YMYL handled with cautious language, clear safety-first framing, and authoritative references.
Yes, an ER can assess a crisis, keep you safe, check for medical causes, and set up urgent next-step care.
If you feel unsafe with yourself, an ER is a reasonable place to go. You don’t need perfect words or proof. You can arrive by car, rideshare, ambulance, or with a friend. Tell staff you’re there for a behavioral crisis and you need help staying safe.
People hesitate because they worry they’ll be dismissed, billed into a hole, or placed on a hold. Those fears are real. You still deserve care. This guide explains when an ER visit fits, what usually happens inside, and how to leave with a plan you can follow.
Can I Go To The ER For Mental Health? When It Makes Sense
Go to the ER when safety is in question. Common reasons include suicidal thoughts, self-harm urges, a recent attempt, threats of harm toward others, hearing or seeing things that others don’t, or feeling so panicked or agitated that you can’t function.
Go right away if you have a plan, access to a method, or you feel close to acting. If you can’t promise you’ll stay safe for the next few hours, treat that as urgent.
When symptoms might be medical
Some “mental” symptoms start with a medical trigger. Sudden confusion, fainting, seizure, head injury, high fever, low blood sugar, medication reactions, intoxication, and withdrawal can change mood and behavior fast. The ER can check for these causes while keeping you safe.
Your right to be evaluated in the emergency department
In the United States, most hospital emergency departments must provide a medical screening exam when you request emergency care. That duty comes from EMTALA. The CMS EMTALA overview lays out the requirement to screen and provide stabilizing treatment when an emergency medical condition exists.
If you want a plain-language explanation, the HHS OIG EMTALA summary explains that ERs must screen people who ask for care and can’t turn them away based on insurance or ability to pay.
What happens after you arrive
Every hospital runs a little differently, yet most ER visits follow the same flow: triage, medical screening, crisis assessment, calming care if needed, then a discharge or admission plan.
Triage and immediate safety steps
You’ll be asked what brought you in and whether you feel safe. If you say you might hurt yourself or someone else, staff may place you in a safer room, remove items that could be used to injure, and use closer observation. It can feel strict. It’s meant to prevent a split-second decision from turning into lasting harm.
Medical screening exam
A clinician will ask about symptoms, recent stressors, substance use, medications, sleep, and past history. They may check vital signs and do a brief physical exam. Tests vary. Some people need blood work, urine testing, an ECG, or imaging if there’s concern about overdose, withdrawal, infection, head injury, or another medical trigger.
Emergency medicine guidance notes that testing should match the story and exam, not a blanket checklist. The ACEP emergency department guidance includes discussion of medical evaluation and common ED practices.
Crisis assessment
You’ll get direct questions about suicidal thoughts, a plan, access to weapons or pills, past attempts, self-harm, violent thoughts, hallucinations, and whether you can stay safe if you leave. Be blunt. Clear answers help the team choose the safest path.
Symptom relief
If you’re in acute distress, the ER may offer a quiet space, hydration, simple grounding steps, or medication for severe panic, agitation, or insomnia. If intoxication or withdrawal is part of the picture, they may treat that first. When a person is at immediate risk, staff may use one-to-one observation. Restraints and sedating medication are typically last-resort measures tied to safety.
Disposition
After assessment, several outcomes are common: discharge with a written safety plan and rapid follow-up, transfer to a crisis stabilization setting, or hospital admission. The right choice depends on risk, medical stability, substance use, home safety, and whether a trusted person can stay with you.
Common crisis patterns and what the ER usually does
This table helps you match what you’re feeling to what an ER often does. It’s a map, not a promise.
| What’s happening | Why it fits an ER visit | What the ER often does |
|---|---|---|
| Suicidal thoughts with a plan or access to a method | Immediate safety risk | Safety precautions, risk assessment, possible admission or crisis transfer |
| Recent self-harm or suicide attempt | Injury care plus high short-term risk | Treat injuries, medical screening, observation, crisis evaluation |
| Threats of harm toward others or fear you may act | Safety risk to others and to you | Safety steps, evaluation, possible hold depending on local law |
| Voices, paranoia, severe disorganization | Reality testing may be impaired | Medical screening, calming treatment, plan for stabilization |
| Mania with unsafe behavior or no sleep for days | High-risk behavior and exhaustion | Medical check, symptom relief, admission or crisis transfer if needed |
| Panic with chest pain, fainting, or numbness | Can mimic heart or neurologic events | Rule-out testing, symptom relief, discharge plan if stable |
| Substance intoxication, overdose concern, or withdrawal | Breathing and heart risks, impaired judgment | Monitoring, withdrawal treatment, safety planning after stabilization |
| Sudden confusion, seizure, head injury, or fever | Medical emergency can drive behavior change | Urgent medical workup, then crisis evaluation as needed |
What to say at triage
Stress can make words vanish. Use short sentences. Say what you fear will happen if you leave.
- “I don’t feel safe with myself right now.”
- “I’m having thoughts of suicide and I’m scared I might act.”
- “I’m hearing voices and I can’t sort what’s real.”
- “I haven’t slept in days and I’m doing risky things.”
- “I used alcohol or drugs, or changed meds, and now I feel out of control.”
If you have a plan or access to a method, say so. If weapons are in your home, mention it. If you’re scared you’ll leave before you’re evaluated, tell staff that too.
What to bring and what to leave at home
Bring a list of medications and doses, your pharmacy name, and any allergies. If you have a trusted person who can sit with you, ask them to come. A phone charger helps during long waits.
Leave valuables at home. Don’t bring weapons. If you arrive with items like a knife or pepper spray, tell staff right away so they can store them safely.
Cost worries and insurance questions
ER care can be expensive. Still, the ER is built for moments when safety is on the line. Under EMTALA, screening can’t be refused based on insurance status. Billing can be handled after you’re stable.
If you have insurance, you may face a deductible or copay. If you don’t, ask the billing office about financial assistance or a payment plan. Keep the request short: you’re asking for options and next steps.
Options that can work when you feel safe
Not every hard day needs an ER visit. If you feel safe and you can stay with a trusted person, you may do better with a crisis line, a mobile crisis team, or an urgent clinic that handles behavioral care.
In the U.S., you can call or text 988 to reach the SAMHSA 988 Suicide & Crisis Lifeline for immediate help and local routing. If you’re outside the U.S., look up your country’s crisis line and keep it saved.
Where to go based on what’s happening
If you’re unsure, the safer option is the ER. Use this table as a quick chooser when you have a bit of stability.
| Situation | Good first stop | What you get |
|---|---|---|
| Unsafe with yourself or others | Emergency room or emergency services | Immediate safety steps, medical screening, urgent evaluation |
| Hallucinations, paranoia, severe agitation | Emergency room | Medical check, calming care, plan for stabilization |
| Panic symptoms with chest pain or fainting | Emergency room | Rule-out medical causes, symptom relief |
| Distress but you feel safe with a trusted person | Crisis line (988 in the U.S.) | De-escalation coaching, local options, next-step planning |
| Need meds refilled soon, no crisis | Urgent clinic, primary care, telehealth | Prescription plan and follow-up scheduling |
| Ongoing symptoms, no immediate danger | Outpatient therapy or psychiatry visit | Longer-term care plan and medication management |
What an involuntary hold can mean
An involuntary hold is generally used when clinicians believe a person poses an immediate danger to self or others, or can’t care for basic needs due to severe symptoms. The rules and timelines vary by place.
If a hold happens, ask direct questions:
- “What is the reason for the hold?”
- “How long can it last here?”
- “What will you need to see for discharge?”
- “Can I contact a family member or friend?”
Staying calm and cooperative helps the team see stable behavior and clear thinking.
Leaving with a plan you can follow
Before you leave, ask for a written safety plan and a clear follow-up step. If you can, schedule the appointment while you’re still in the building. If the plan is “call tomorrow,” ask for a phone number and the best time to call.
Pieces that make a discharge safer
- Warning signs that tell you risk is rising
- Actions you can do in the next 15 minutes that reduce risk
- People you can contact right away
- A plan to remove or lock up weapons, pills, and other means
- A follow-up date, walk-in clinic, or crisis program
If you live alone, tell the team. They may recommend a higher level of care or help arrange a safer setting for the next day or two.
If you’re bringing someone you care about
Your job is to get them safely to care and stay steady. Don’t argue with delusions or try to reason someone out of panic. Use short phrases like “I’m here,” “Let’s get checked,” and “We’ll take it one step at a time.”
If you think there’s immediate danger, call emergency services. If you can transport safely, head straight to the ER entrance. At check-in, share concrete facts: what you observed, what was said, any substances, any meds, and whether weapons are at home.
References & Sources
- Centers for Medicare & Medicaid Services (CMS).“Emergency Medical Treatment & Labor Act (EMTALA).”Explains emergency department duties to screen and stabilize people who request emergency care.
- U.S. Department of Health & Human Services, Office of Inspector General (OIG).“The Emergency Medical Treatment and Labor Act (EMTALA).”Plain-language summary of EMTALA requirements and patient protections.
- Substance Abuse and Mental Health Services Administration (SAMHSA).“988 Suicide & Crisis Lifeline.”Describes the 988 contact options and the role of crisis services.
- American College of Emergency Physicians (ACEP).“Care of the Psychiatric Patient in the Emergency Department.”Clinical guidance on emergency department evaluation and care for behavioral crises.