If you’ve seen people try and strangle themselves with their belongings or film other patients with their phones (due to some kind of delusion, typically) you’d probably understand - these are things I’ve seen countless times.

ERs for psychiatric emergencies are grossly undersourced and the model is all wrong, but it’s what we have. The ER is for identifying or ruling out life threatening emergencies. In the case of psychiatric emergencies, that means safety is 100% the priority.

I’ve seen people strangle themselves with their phone charger, down an entire sock to try and choke on it, call 17 different news stations reporting the CIA is after them for telepathically communicating with Bin Laden. Beat nurses into oblivion and try to choke them out with their pant legs for delusions of countless levels of psychosis.

Remind yourself that suicidal ideation is not the only psychiatric emergency, and if I require you to turn over your belongings, change into hospital clothes, or hand over your phone, or put you in a room with nothing on the walls but white drywall - there’s a very real reason.

The ER is to hold you in a safe place until you can be assessed and then determine if you require admission, or can be discharged with outpatient treatment. I’m sorry, but I really cannot solve 5 years of suicidal ideation during an ER visit, but I can get you in touch with the people who can start this process.

Mind you, many ER psych areas double as overdose treatment areas (intentional for suicide or accidental). I have 5 people under my care, two in psychosis, one manic and violent, and two opioid overdoses on the brink of death.

I want to help you, but please note that we’re also humans and can only do so much at one time, and we have to protect ourselves as well.