5 Mental Health Problems You Should Go to A&E For

5 Mental Health Problems You Should Go to A&E For 

When it comes to mental health, ‘safety is the priority.’ While many people experience periods of low mood, anxiety, or stress, a mental health emergency occurs when a person’s thoughts or behaviors put their life—or the lives of others—at immediate risk.

Just as a physical wound needs urgent care, a psychological crisis can be fatal if not de-escalated by professionals. If you or someone else experiences these five ‘red flags,’ call 999 (UK), 911 (US), or go to your nearest A&E (Emergency Room) immediately.

1. Active Suicidal Ideation – Picture

This is more than a fleeting thought of ‘not wanting to be here.’ It involves a specific plan, the means to carry it out, and the immediate intent to die.

• The Warning: Expressing a sense of hopelessness, saying goodbye to loved ones, or giving away prized possessions.

• The Sensation: A feeling of being ‘trapped”‘or experiencing unbearable emotional pain that the individual believes can only be stopped by death.

• The Danger: Suicide is a permanent solution to a temporary (though agonizing) crisis. Immediate intervention can provide the ‘circuit breaker’ needed to save a life.

2. Acute Psychosis (Loss of Reality) – Picture

Psychosis occurs when a person loses touch with shared reality. This can be caused by underlying mental illness, severe sleep deprivation, or drug reactions.

• The Sensation: Experiencing hallucinations (seeing or hearing things others don’t) or delusions (strong beliefs that are not true, such as thinking someone is trying to kill them).

• Red Flag: ‘Command hallucinations,’ where voices tell the person to harm themselves or others, or “paranoia” that leads to erratic, dangerous behaviour.

• The Danger: Because the person’s ‘reality testing’ is broken, they may inadvertently put themselves in life-threatening situations (e.g. walking into traffic because they believe they are invincible).

3. Severe Self-Harm or Neglect – Picture

While not always an attempt to end life, self-injury can become a medical emergency if it is deep, uncontrolled, or involves the ingestion of toxic substances.

• Physical Signs: Wounds that won’t stop bleeding, the ingestion of any amount of poison/overdose, or physical collapse due to extreme calorie restriction (malnutrition).

• The Danger: In cases of severe eating disorders or self-neglect, the body’s electrolytes can shift (e.g. hyponatraemia, low sodium levels), leading to sudden cardiac arrest.

• The Warning: If someone is non-responsive or their physical health is failing due to a mental health struggle, they need medical stabilisation alongside psychiatric care.

4. Mania with Exhaustion or Aggression – Picture

A manic episode (often associated with Bipolar Disorder) involves a period of abnormally elevated energy and “high” mood that can spiral into a crisis.

• The Sensation: A “racing” mind, zero need for sleep for several days, and impulsive behaviors like spending life savings or engaging in risky sexual encounters.

• Red Flag: When mania turns into agitation or aggression. The person may become hostile or violent if their delusions are challenged.

• The Danger: Prolonged mania causes extreme strain on the heart and nervous system. Total lack of sleep can eventually trigger a secondary psychotic break.

5. Neuroleptic Malignant Syndrome (Medication Reaction) – Picture

This is a rare but life-threatening reaction to “neuroleptic” or antipsychotic medications. While it presents physically, it is a psychiatric-related emergency.

• The Classic Triad: High fever, “lead-pipe” muscle rigidity (stiffness), and altered mental status (confusion/delirium).

• Associated Signs: Fast heart rate and fluctuating blood pressure.

• The Danger: This is a medical emergency. If not treated with immediate medication cessation and intensive care, it can lead to kidney failure and death.

What to do while waiting for help

If you are supporting someone in a mental health crisis:

• Stay Calm and Low-Stimulation: Speak in a soft, steady voice. Turn down loud music or bright lights to avoid overstimulating a person who may already feel “under attack” by their senses.

• Ask Directly: Do not be afraid to ask, “Are you thinking about killing yourself?” Evidence shows that asking this does not “put the idea” in someone’s head; rather, it often provides a sense of relief.

• Remove Lethal Means: If safe to do so, remove access to medications, sharp objects, or ligatures while waiting for professionals to arrive.

• Do Not Use Physical Restraint: Unless absolutely necessary for immediate safety, avoid grabbing or pinning the person down, as this can escalate paranoia or lead to physical injury.