SYNTHETIC DEMONSTRATION — no real student or patient. Not a medical device.

Urgent & emergency

When to Take Your Child to the ER for a Mental Health Crisis

Go to the ER or call 911 if your child has harmed themselves, has a plan or the means, or can't be kept safe at home. If unsure, call or text 988 — counselors can help you decide.

Go to the ER or call 911 now if…

Seek emergency care immediately if your child has already harmed themselves; has a suicide plan and access to the means (such as a firearm or medications); is threatening to harm themselves or someone else; or is so agitated, out of touch with reality, or distressed that you cannot keep them safe at home. These are medical emergencies. Putting distance between your child and lethal means is one of the most effective ways to prevent an attempt while you get help 2.

When 988 may be the right first call

If your child is having thoughts of suicide but is not in immediate danger — no plan, no means at hand, and able to stay safe with you — calling or texting 988 is often the right first step. The Suicide & Crisis Lifeline offers free, confidential support 24/7 through a national network of local crisis centers, and counselors can help you assess the situation, de-escalate, and decide whether an ER visit is needed 1. Many communities also have mobile crisis teams that 988 can connect you to.

What happens in the emergency department

In the ER, staff will keep your child safe and assess their risk, often using brief validated tools designed for youth — such as the Ask Suicide-Screening Questions (ASQ), which has high sensitivity for identifying suicide risk in young people 3. They may use a structured measure like the Columbia-Suicide Severity Rating Scale to understand the severity of thoughts or any plan 4. Based on that assessment, they will help create a safety plan and recommend next steps, which may range from outpatient follow-up to a brief hospital stay.

Keep your child safe while you decide and travel

Whatever path you take, stay with your child and do not leave them alone. Remove or lock away firearms, medications, and other means of harm 2. Speak calmly and let them know you are getting help together. If you are driving to the ER, have another adult sit with your child if possible. Trust your instincts — if it feels like an emergency, treat it as one.

Why professional assessment matters

A clinician can gauge risk in ways that worry alone cannot, using validated youth screening such as the ASQ 3 and structured severity tools like the C-SSRS 4, and can rule out medical causes for sudden changes. They build an evidence-based safety plan with you and your child for getting through the crisis and the days after 5, and they arrange follow-up care and, when relevant, coordinate with the school. Suicide is a leading cause of death among adolescents, and pediatric and mental-health clinicians are trained to identify and manage at-risk youth — which is why an in-person or hotline assessment is so valuable when you're unsure 6.

Common questions

I'm not sure it's serious enough for the ER. What should I do?

Call or text 988. Counselors are available free, 24/7, and can help you assess whether your child needs the ER tonight or whether a different next step is safer [1]. When you truly can't tell, err toward treating it as an emergency.

Will going to the ER make my child's situation go on their permanent record?

An ER visit for a mental-health crisis is medical care, like any other emergency. The priority is your child's safety. A crisis counselor on 988 can answer questions about what to expect and connect you to local resources [1].

Can I take my child somewhere other than a general ER?

Some areas have pediatric or psychiatric emergency services and mobile crisis teams. Calling 988 can help you find the most appropriate option near you [1]. If there's immediate danger, go to the nearest ER or call 911.

This may be an emergency

  • —Your child has already harmed themselves
  • —A suicide plan and access to the means (firearm, medications)
  • —Threatening to harm themselves or someone else
  • —Agitation, or being out of touch with reality, that you can't safely manage
  • —You cannot keep your child safe at home

Call or text 988 (Suicide & Crisis Lifeline) or text HOME to 741741 if unsure. If there is immediate danger, call 911 or go to the nearest ER.

This page is general educational information for an urgent situation and is not a substitute for professional emergency assessment; when in doubt, call 988 or 911.

References

  1. 1.Substance Abuse and Mental Health Services Administration (SAMHSA) (2024). 988 Suicide & Crisis Lifeline. SAMHSA (U.S. Department of Health and Human Services). link ✓988 provides free, confidential, 24/7 crisis support through local crisis centers and can help decide next steps.
  2. 2.Harvard T.H. Chan School of Public Health, Means Matter (2024). Lethal Means Counseling. Harvard T.H. Chan School of Public Health (Means Matter). link ✓Reducing access to lethal means, especially firearms, is an evidence-based way to prevent an attempt.
  3. 3.Horowitz LM, Bridge JA, Teach SJ, Ballard E, Klima J, Rosenstein DL, Wharff EA, Ginnis K, Cannon E, Joshi P, Pao M (2012). Ask Suicide-Screening Questions (ASQ): A Brief Instrument for the Pediatric Emergency Department. Archives of Pediatrics & Adolescent Medicine. doi:10.1001/archpediatrics.2012.1276 ✓The 4-item ASQ has high sensitivity for identifying suicide risk in youth in the pediatric ED.
  4. 4.Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S, Mann JJ (2011). The Columbia-Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings From Three Multisite Studies With Adolescents and Adults. American Journal of Psychiatry. doi:10.1176/appi.ajp.2011.10111704 ✓The C-SSRS is a validated measure of suicidal ideation severity and behavior in adolescents.
  5. 5.Stanley B, Brown GK (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cognitive and Behavioral Practice. doi:10.1016/j.cbpra.2011.01.001 ✓The Safety Planning Intervention is a brief, collaborative, evidence-informed best practice for an acute crisis.
  6. 6.Shain B; AAP Committee on Adolescence (2016). Suicide and Suicide Attempts in Adolescents. Pediatrics. doi:10.1542/peds.2016-1420 ✓Suicide is a leading cause of death among adolescents; clinicians should identify and manage at-risk youth.

6 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.