It can be scary going to the emergency room especially alone, here is the order in events in which you might get treatment if you present to the emergency room. Everyone’s different, and your reasons are unique to your circumstances. In general, thoughts of suicide can come up after a significant loss, or when you live with conditions like depression, bipolar disorder, or PTSD.

After contacting your support system and trying to follow a safety plan if you have one established, go to to the ER for immediate support if you are still feeling unsafe.

ER and hospital protocols for mental health crises vary from state to state.

When you arrive at the hospital and tell staff your having suicidal thoughts or a plan in place, they’ll call a mental health professional to determine the needed level of care.

Mental health evaluations generally start with a suicide assessment first, that helps determine the next steps.

One of the asssessment tools mental health professionals may use in the emergency room is the Columbia Protocol, also known as the Columbia Suicide Severity Rating Scale (C-SSRS) for short.

The Columbia Protocol is designed to identify how likely someone is to attempt suicide and gauge the level of support they need.

Some of the topics this assesment addresses include:

• whether and when you have thoughts about suicide
• what actions you have taken, if and when you think of suicide
• whether you have attempted suicide or began a suicide attempt that was either interrupted by another person or stopped by will
• Beyond routine assessments, a mental health professional may also spend time talking with you. They could ask you to brainstorm reasons you want to live. This is considered motivational interviewing, and it has been linked to reducing suicidal behaviors.

While outcomes to a suicidal assessment vary widely, you may sometimes get clearance to go home if professionals determine your chances of going through a suicide attempt have lowered.

In these cases, you are likely sent home with a safety plan. This plan could include returning to the hospital for outpatient visits or working with a therapist or psychiatrist.

• Hospitalization and care options for mental health and suicidal thoughts can be both voluntary and involuntary.
• You can decide if you need additional support managing your emotions and thoughts of suicide.
• In some instances, though, a health professional may decide for you if they determine your emotional state unhealthy enough to be released.
• If a mental health professional at the ER determines that you need additional support that cannot wait, you may be transferred to a higher level of care.
• Examples of this include a residential treatment program or a psychiatric hospital.

Although this may sound overwhelming or scary, the goal is to get you to a place specializing in what you’re going through.

Recommending one of these places is getting you the best care available for your specific needs.

Admission for inpatient psychiatric care likely will involve:

• treatment with medications and forms of therapy, depending on what you need
• higher levels of support so your care is constantly supervised by professionals
• creation of safer environments by removing any potential objects of harm

The length of time someone spends in an inpatient facility depends on the initial assessment, treatment progress and response, and existing treatment for contributing conditions.

A partial hospitalization program allows you to sleep at home while visiting a facility during the day.

This can be done at a hospital, behavioral health clinic, or mental health care center.

You can spend up to 6 days a week attending:

• group therapy sessions
• mental health education
• recreational activities
• one-on-one therapy sessions

Your health team will probably talk with you and ask you to take an assessment every week to determine your progress.

An intensive outpatient program lets you continue your typical work or school routine and stay at home while providing the maximum level of care during your time off.

The idea is that you see your mental health team as often as possible to work on your symptoms and suicidal thoughts without interrupting your daily responsibilities.