How Emergency Mental Health Care Works — and Why It Matters to Therapy Clients

Mental health crisis care is among the most widely misunderstood services within the entire mental health system.

Few people, even those who are already seeing a therapist, know exactly what to expect when a psychiatric emergency occurs. This lack of understanding can escalate an already terrifying situation into a wholly overwhelming one.

Here's the truth...

When you understand how crisis mental health care works, you can be better prepared. Prepared for you. Prepared for someone you love.

Here's What You'll Discover:

• What Is Mental Health Crisis Care?

• How Common Are Mental Health Emergencies?

• What Happens in the ER During a Psychiatric Emergency?

• How Hospital Telepsychiatry Is Closing the Gap

• The Different Types of Emergency Mental Health Support

• What Therapy Clients Need to Know Right Now

What Is Mental Health Crisis Care?

A mental health crisis occurs whenever someone becomes overwhelmed by their feelings or thoughts to the point that they cannot cope – and need help right away.

This could include suicidal thoughts. Totally losing touch with reality. Extreme dissociation. Or even a panic attack that is so severe you cannot reach the individual through normal means.

Emergency Mental Health Crisis Care is the system of services designed to stabilize individuals during a crisis. This includes ED departments, mobile crisis teams, crisis stabilization units, and inpatient psychiatric facilities.

Always the same 3 goals: Stabilize the individual. Determine the need. Connect to appropriate level of care.

And here's something most therapy clients don't fully realise...

Crisis intervention and long-term treatment aren't separate spheres of care — they're one sphere. Learning where solutions like hospital telepsychiatry fit into the cycle of emergency mental healthcare can empower clients when a crisis occurs. Especially if it's a crisis they're facing with someone they care about.

It really does change everything.

How Common Are Mental Health Emergencies?

Here's a number that might surprise you...

Nearly 1 in 10 adults reported experiencing a mental health crisis in the past year. That's tens of millions of scared people trying to figure out their options, with extremely limited information on what those options actually are.

And a large portion of that burden is being shouldered by emergency rooms. There are 5.9 million emergency department visits annually where a mental, behavioral, or neurodevelopmental disorder is listed as the primary diagnosis. Emergency rooms were designed to treat patients experiencing medical crises, not psychiatric ones. They're loud, chaotic places with lots of stimulation designed around people with physical injuries — which can be traumatizing for people experiencing acute psychological crises.

That is why understanding mental health crisis care completely is important.

What Happens in the ER During a Mental Health Crisis?

The emergency room is America's default front door for mental health crisis care.

When someone arrives at an ER in psychiatric distress, here is what typically happens:

• Triage: Staff assess the level of immediate risk and physical safety.

• Psychiatric evaluation: Situation is evaluated by a mental health professional (face to face or remotely).

• Safety planning: If discharge is appropriate, a structured follow-up plan is created.

• Transfer to inpatient facility: If the client's risk is too high to release, they are sent to a psychiatric unit.

Hours of waiting. Sterile surroundings. Cold hallways. Once you know what to expect, it's not so scary.

Disclaimer: If you feel you are in immediate danger, please call 911 or proceed to your nearest emergency room immediately.

How Hospital Telepsychiatry Is Closing the Gap

Here's where things get really interesting...

A major challenge facing emergency mental health care access is this: there are far too few psychiatrists to serve the need — particularly in rural and underserved communities.

Telepsychiatry helps address that challenge. Through secure video technology, board-certified psychiatrists can provide real-time evaluations, consult with on-site clinical staff, and help determine the appropriate course of treatment from afar. Psychiatric assessment time is cut significantly, allowing more patients access to specialist care.

This has been one of the most meaningful and pragmatic advancements in mental health crisis care.

The Different Types of Emergency Mental Health Support

The ER is not the only option during a mental health crisis.

Actually, it's often not even the best option. Emergency mental health care has come a long way. From 2022 to 2023, mobile crisis services saw a 21% increase in consumers served. Here's a breakdown of the available options:

• Emergency Departments (EDs) Door number 1. Useful for threats to immediate safety, active suicidal behaviors, or severe psychosis where the patient is putting themselves at risk of physical harm.

• Mobile Crisis Teams Certified mental health specialists dispatched directly to the person in distress. Less institutional than an ER, typically much more effective for de-escalation in the home.

• Crisis Stabilization Units A short-term stay residential facility aimed at stabilization without needing full inpatient admittance. A legitimate middle ground between the ER and seeing someone as an outpatient.

• Inpatient Psychiatric Programs Suited for cases needing 24-hour supervision. Hospital units where someone can be watched, medicated if necessary, and stabilized for a few days.

• 988 Suicide & Crisis Lifeline Free, confidential, and available anytime. 988 has logged close to 16 million contacts from across the country since it launched in 2022.

Every option is there for a different level of requirement. It's knowing which one fits the need at hand.

What Therapy Clients Need to Know Right Now

This is where it gets critical for anyone currently in therapy...

Mental health crisis doesn't always present itself dramatically. Sometimes it creeps up over weeks. Sometimes it snags you when you least expect it, even during productive periods of treatment.

Here's what every therapy client should understand:

• Getting crisis care does not mean treatment has failed. Accessing emergency services while in treatment means the system is functioning — intervening before things get any worse.

• Have a crisis plan ready before it's needed. A competent therapist will help develop this. It should consist of step-by-step instructions, emergency numbers, and the location of nearest available resources.

• Tell the therapist about warning signs as soon as possible. The sooner triggers are known, the better prepared everyone will be.

• Emergency care stabilizes. Therapy heals. Both are necessary — and neither can substitute for the other.

Putting It All Together

There's one reason mental health crisis care exists: nobody should have to weather a psychiatric emergency alone.

Emergency rooms, mobile crisis teams, telepsychiatry and crisis stabilization units are all parts of a continuum. They exist to catch people when things escalate.

To quickly recap:

• Mental health crises affect nearly 1 in 10 adults every single year

• EDs see millions of psychiatric patients every year — but are often not the right setting

• Hospital telepsychiatry is rapidly expanding specialist access in emergency settings

• Multiple levels of support exist between outpatient therapy and inpatient admission

• Every client should have a crisis plan before they ever need one

Understanding how the system works doesn't just alleviate fear. It enables faster, simpler and much less traumatic access to help.