What Really Happens When You Call 911?
While not popular to talk about, suicide is a sad reality in our society. The Centers for Disease Control estimated that more than 32,000 Americans died as a result of suicide in 2004. And contrary to some of our stereotypes about suicide, it occurs in all age groups, not just teenagers. Men, women, children, adults, older adults, and all ethnic and cultural groups can be at risk for developing suicidal thoughts or ideations, making it important for all health care practitioners and consumers, parents, teachers, children, and friends to know something about what to do when/if these thoughts come up.
I talk to folks in my practice on a regular basis about having a safety plan – i.e. what steps to take if they feel like they are in imminent danger of hurting or killing themselves. We discuss calling 911, or going directly to their nearest emergency room. The APA Help Center has more information about who to contact if you or someone you know is at a risk for suicide.
What I have realized over the years, is that often people are afraid to call 911 or go to the hospital (even when they really need to) because they don’t know what to expect. They are afraid they will be looked down on, chained to a bed, or made to feel “stupid” or “weak.” In fact, seeking immediate medical and psychological treatment is the most important thing you can do for yourself, and for most people is a positive, and helpful experience.
What generally happens is:
- If you or a concerned loved one calls 911, a police car, ambulance, and fire truck will likely arrive several minutes later. This is part of the protocol for 911 calls, so do not be alarmed that many first responders arrive.
- You are not a criminal, and should not be treated as one (i.e. no handcuffs used, Miranda Rights read, etc) – unless you are threatening to, or actually harming someone else. The first responders have been in situations like these before and will likely be understanding and kind as they escort you into one of their vehicles.
- You will be transported to the nearest emergency room.
- Once in the hospital you will likely be shown to an Emergency Department bed where you will wait for a nurse, aide, or other care provider to come in for an initial interview.
- Just as if you hurt your arm or were suffering chest pains, a medical professional will come speak to you (this can be done in private, or with a friend or loved one present – it will be up to you) about what has brought you in. It is important to be honest and open – even if it is embarrassing.
- After the initial interview, you will very likely have to wait for a period of time (hopefully not too long) to be evaluated by a mental health professional. You may speak with a psychiatrist, psychologist or a social worker. They will probably ask you similar questions to the first person who interviewed you, but in more depth. It is likely they will want to talk to you alone. Again, it is important to be open and honest with them about your mental state, your plans for suicide, as well as any medications you might have taken, or steps actually taken to harm yourself. They will also want to know about your mental health history as well as any mental health or psychiatric treatment you have had, or are participating in currently.
- After the interview, the psychologist – or other mental health professional – should be open with you about their ideas for your care. Will you be best served (and safest) in an inpatient psychiatric hospital, in an intensive outpatient program, by your current mental health practitioner?
- Whichever course of treatment is required, the psychologist will assist you (and your family if desired) in making necessary plans and arrangements. They will help you make appointments, find out about your insurance benefits, or arrange transportation to the nearest inpatient facility (many hospital do not have inpatient psychiatry/behavioral health departments, so if this level of care is needed then you will likely need to be transferred).
- As a health care consumer, you are entitled to ask as many questions as you need to, ask for reasons behind any decisions made, ask for a second opinion, and be involved in all decisions. It is important to be aware, that most states have laws requiring that people who are in imminent danger of harming themselves be hospitalized for a period of time in order to provide psychiatric treatment – even if they do not want to be hospitalized. In most states this hold period is 72 hours.
- The purpose of emergency mental health care is to ensure personal safety and establish psychiatric stability. These conditions should be met, a safety plan established, and solid, clear-cut plans for follow-up and/or continuing mental health care should be made before you are released from an emergency facility.
Photo by Paul Keleher.
Filed under: Being in Therapy, Stress, Uncategorized
[...] and I do not have a straightjacket in my closet. The only time I participate in a client being “locked up” is when they are a true danger to themselves or someone else. Not because they have broken up [...]
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Isidro
Thanks for your comments. Glad you found the information useful. And thanks for reading our blog!
This was very helpful in confirming what happened to my husband. He spoke of sucide (and I had noticed many changes in him in the previous few months) so, I called 911, the operator was very nice and kept me on the phone until the officers arrived. They were very respectful to my husband (he was non-agressive) he was taken in the back of the police car to the local mental health hospital, whereas he was then transferred to a private hospital because he has private insurance. He thinks that he still will be arrested when he leaves the hospital…..I am giving him this article. so that it may help him understand that he will not be arrested.. thank you for writing this.
Connie
Thank you so much for taking the time to write down your comments about this article. I am so pleased that you found it helpful, and I wish you and your husband well.
[...] Concerned about a family member or friend’s mental health? What really happens when you call 9… [SEO: If you or a loved one are a trauma survivor with suicidal tendencies, please print this [...]
Can you please help my son. My son has suffered from ADHD, OCD, and bi-polar disorder throughout his life. He has lived through his father’s, who also had bi-polar disorder, suicide on his 6th birthday and when he was 16, the death of his baby brother. He doesn’t deserve to be going through what he is dealing with now. He did not have a well paying job and could not afford his medication. He tried to make his medication last till he would get his paycheck on June 25, 2010 by skipping days. This led to him becoming severely depressed. While working on his truck everything that could go wrong did. He just lost it. He became severely suicidal. He went through his fiancé’s house breaking everything. He got out her rifle, tried to shoot himself in the head three times. Luckily the gun did not work. He became more and more agitated. He begged his fiancé to call 911 he could not control himself. She called, explaining he was suicidal, tried to commit suicide with her rifle that would not work. When they arrived, she again told them what had been going on and that he had a rifle that did not work. They entered the house, saw him on the couch with the gun. They immediately ran out of the house and drawled their weapons. He got up, went to the door, opened it with the butt of the rifle, began waiving it around and said, “Shoot me you MF”. Without another word spoken, not even saying drop your weapon or we will shoot, or trying to talk him down, one officer fired two shots. One bullet hitting him in the head. He fell back onto the floor, they ran up to him rolled him over and handcuffed him.
He was life flighted to Columbia University. He remained there for four days. During which time they would not give me or anyone information on his medical condition. We knew he was alive, but we didn’t know if he was brain dead or all right. They kept him handcuffed to the bed with an armed guard inside and outside his room. They charged him with several different crimes. He was then transferred to Montgomery County jail. He was still extremely depressed and suicidal. After a few days they finally gave him some of his medication. After a day or so they committed him to a psychiatric hospital in St. Louis. After 20 days he was transferred back to the jail. They have been giving him two of his medicines, but refused to give him his Klonopin, which he desperately needs. They said it was not allowed in the jail. His bail was set at ridiculous $500,000 cash.
Several weeks later, after complaining of severe headaches, something changed in his medical condition. He told them for days that something is wrong, there was puss coming from his wound. One officer told him “your head isn’t going to fall off”. Finally on the third day of this, an officer looked at it. There was something coming out. He was taken to an emergency room where it was discovered the hospital had left a tube in his head. He could have developed a life threatening infection in his brain.
After that they did treat him better. He was made pod chief, which allowed him a little more privileges. They refused to make him a trustee, which would have allowed him to call his fiancé without the ridiculous cost of about $9.00 a call. Several times when the minister from their church came to visit him, they would not allow him to visit my son.
He had a forensic psychiatric evaluation done in which the Psychologist wrote several quoted statements that he said my son made. My son says he never said some of the things quoted. He is having a private psychiatric evaluation done now. He was given another bond hearing. His bond was lowered to $100,000 cash bond. They may as well have denied bail. Who could possibly be able to post that? They did grant a change of venue. He has been transferred to the jail there.
It seems to me that his only crime is having a psychiatric disorder. Would they have shot then charged a person who had heart disease and called 911 because he was having a heart attack?
Can anyone please help. This just isn’t right.
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I know this article is old but I just read it for the first time yesterday and it really struck me when you said no handcuffs are used. It’s interesting because I was (and still am) going through severe PPD and my husband was angry that I wouldn’t open the bedroom door for him and our neighbor (i’d been crying all day and was a total mess. I didn’t feel like talking to my neighbor about it!) so he called the cops. They came and I was using the bathroom in the master bedroom and the officer came in and stood there and watched me pee, even after I asked him to please wait outside while I finished. He became hostile and screamed at me to stand up or I’d be arrested (let me say that I wasn’t making threats to anyone, or threatening to harm myself. I was just crying.) I stood up, washed my hands and came out to the living room where my husband, neighbor and 3 kids (ages 3 1/2, 15 months, 2 months) and another officer were sitting there. They asked me what was going on and I said I was having a bad day. I was told I was being taken to the hospital for observation and to stand up, that I was being handcuffed. In front of my children and ALL my neighbors who were standing outside wondering why there were police cars at my house. I was shoved in the back of the police cruiser and taken to the emergency room.
When I got there (with snot all over my face from crying) the officer announced right in the middle of the ER “Where do I take the suicide risk?”
It was mortifying. I had no clue who had my kids. I wasn’t allowed to call my mother to come be with me at the hospital. I had to sit and stare at a security guard while he talked to his wife (or girlfriend) about watching a “psycho until the social worker gets here”
It made the whole ordeal worse and has led to divorce for my husband and myself because of what he did to me. I was humiliated. I was treated like a criminal. I was treated like an animal.
It’s bad to say, but if someone out there is planning on suicide, i’d recommend they finish the job the first time so they don’t have to go through that.
Nikki
What a horrendous ordeal you have been through. I am sorry to hear that your experiences with the emergency responders and other care providers at the hospital were such negative ones. I am hopeful that you are now receiving follow up care by mental health professionals that are caring and responsive to your needs.
Thank you for the reply. I have tried to speak with my family doctor about increasing my dosage of my antidepressant. He asked that I call him “in 3 weeks” to discuss how I’m feeling. I’ve called 4 times and even told his MA (via voicemail because she doesn’t answer the phone) that I’m having suicidal thoughts and the dosage needs to be changed ASAP. No return call. I also made an appointment with a therapist (the first one I went to told me I was “weird and paranoid”) but an hour before my appointment our water heater broke and my husband couldn’t wait until I got back to get a new one, so I had to stay home with the kids. I’ve discontinued the AD because it’s not working and the side effects are horrible.
There is NO help out there. No one seems to care. All healthcare professionals I’ve tried to talk to about this have swept the condition and myself under the rug.
It’s really sad that in this day and age it’s still so ignored.