Urgent psychiatric care

Where can one go for a brief evaluation and med changes when one is acutely mentally ill with a serious mental illness but not sick enough to be admitted to a hospital? (When your doctor is unavailable or you are between doctors…)

Has anyone used an online/video psychiatrist for an acute exacerbation of a serious mental illness?

Has anyone gone to an ER or psych ER and gotten some new treatment and been sent home?

Is this voluntary? If the person is having a psychotic episode and is willing to go to the ER, that would be an option. Healthgrades.com lets you search for psychiatry → psychotic disorders. Or maybe the person’s personal physician can refer them to a psychiatrist.

Our experience with the ER is that a social worker therapist evaluates and talks on the phone to a psychiatrist who decides to admit it not. I do not think they do med changes because the psychiatrist isn’t actually seeing the person. We are hoping to prevent a hospitalization.

I don’t think the person would accept a voluntary hospitalization and is not currently meeting criteria for involuntary hospitalization.
Hospitalizations have been long (30 days) and very difficult for this person in the past.

Your local DSHS and their previous care provider should be able to send out notes. The DSHS will have some sort of emergency response team that will try fitting them in as soon as possible to the local clinic but you have to let them know AND get all of the medical records on hand. A PACT team or ACT team (rather than a DCR Direct Crisis Response Team) will be able to get them in sooner rather than later for basic care.

Relying on the ER when they are not acutely ill (or Urgent Care as that is not their purview, Mental Health) is definitely not recommended. They will treat you eventually but it’s more likely they will just refer you to community resources anyway and prescribe a sedative so that the immediate issues that occur with a SZ break are toned down. (i.e the person gets to sleep instead of wandering around wherever they please, if they are lucky.)

My son has had SZ for almost 10 years now. When he is really struggling, we have contacted the states ‘crisis’ line. Locally it is Sweetser. We have found that a CSU or Crisis Stabilization Unit has been instrumental as a ‘reboot’ along with a med change. It’s a safe place and the voices quiet.


The crisis team here comes with a police officer which does not work for my LO who is paranoid and has traumatic experiences w police despite never having committed a crime.

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