Psychiatric Emergencies: Suicidal Crisis, Severe Mania and Acute Psychosis
Guidance for recognising and responding to psychiatric emergencies, including suicidal crisis, acute psychosis, severe mania, and delirium.
Certain psychiatric presentations constitute emergencies requiring immediate evaluation and intervention, rather than a routine outpatient appointment. Recognising these situations and knowing how to respond quickly can be life-saving.
This page outlines the situations that require urgent attention and the steps to take. It is not a substitute for immediate emergency care when a crisis is occurring right now.
Situations Requiring Immediate Emergency Care
- Suicidal crisis — thoughts of suicide accompanied by a plan or intent, or a suicide attempt
- Severe agitation with risk of harm to self or others
- Acute psychosis with disorganised, dangerous, or unpredictable behaviour
- Severe manic episode involving reckless, dangerous behaviour or complete loss of judgement
- Delirium — sudden confusion, disorientation, or fluctuating consciousness, often with a medical cause
- Postpartum psychosis — a rare but serious emergency requiring immediate assessment
What to Do in a Crisis
- If there is immediate danger to life, go to the nearest emergency department or call emergency services without delay
- Do not leave someone in crisis alone if there is a risk of self-harm
- Remove access to means of self-harm where safely possible
- Contact a psychiatrist or crisis service for urgent guidance if the situation is escalating but not yet at the point of calling emergency services
Emergency Referral and Safety Planning
Following an acute crisis, urgent psychiatric assessment establishes the underlying cause, immediate treatment needs, and a collaborative safety plan for the period ahead, alongside close follow-up during the highest-risk time.
Supporting a Family Member in Crisis
Family members play a critical role in recognising warning signs and supporting safety. Clear communication with the treating team, without judgement toward the person in crisis, supports better outcomes.
Frequently Asked Questions
Frequently Asked Questions
When should I call emergency services rather than book an appointment?
Any situation involving immediate risk to life — an active suicide attempt, severe agitation with danger to self or others, or acute confusion — requires emergency services or the nearest emergency department immediately, not a scheduled appointment.
Is postpartum psychosis really an emergency?
Yes. Postpartum psychosis is a rare but serious psychiatric emergency requiring immediate assessment and, in most cases, hospitalisation, due to risk to both mother and baby.
What happens after an emergency assessment?
Following stabilisation, ongoing psychiatric care is arranged, including a clear safety plan, appropriate medication, and close follow-up during the recovery period.
Expert Care
Dr. Muhammad Shoaib Zafar provides guidance on recognising and responding to psychiatric emergencies as part of comprehensive care.
If you or someone you know is in immediate danger, please go to the nearest emergency department or call emergency services right now. This page is educational and does not replace emergency care.
Common signs & symptoms
- Suicidal thoughts with intent or a plan
- Severe agitation or risk of violence to self or others
- Acute psychosis with disorganised or dangerous behaviour
- Severe manic episode with reckless or dangerous behaviour
- Sudden confusion or disorientation (possible delirium)
- Postpartum psychosis or severe postpartum mood disturbance
Treatment approach
- → Immediate emergency evaluation
- → Safety planning and, where necessary, hospitalisation
- → Urgent medication initiation where indicated
- → Coordination with emergency medical services
- → Family involvement in safety planning
Frequently asked questions
When should I call emergency services rather than book an appointment?
Any situation involving immediate risk to life — an active suicide attempt, severe agitation with danger to self or others, or acute confusion — requires emergency services or the nearest emergency department immediately, not a scheduled appointment.
Is postpartum psychosis really an emergency?
Yes. Postpartum psychosis is a rare but serious psychiatric emergency requiring immediate assessment and, in most cases, hospitalisation, due to risk to both mother and baby.
What happens after an emergency assessment?
Following stabilisation, ongoing psychiatric care is arranged, including a clear safety plan, appropriate medication, and close follow-up during the recovery period.