Psychosis becomes a medical emergency when it poses immediate risk of harm to self or others, or when the person can no longer care for basic needs. Seek 911 or emergency psychiatric services without delay if:
- Suicidal or homicidal behavior
- Expresses intent to die ("I’m going to end it tonight")
- Plans or attempts suicide (e.g., stockpiling pills, standing on a ledge)
- Threatens to kill or seriously injure someone with means and intent
- Dangerous impulsivity
- Wandering into traffic, jumping from heights, or self-injury due to delusions/hallucinations
- Command hallucinations ordering harm (e.g., "voices tell me to cut myself")
- Severe functional collapse
- Refuses food/water for days, risking dehydration or starvation
- Catatonia (unresponsive, rigid, or mute)
- Inability to recognize danger (e.g., walking naked in freezing weather)
- Aggression with inability to de-escalate
- Physically attacking others while believing they’re a threat (delusional self-defense)
- Weapon use or credible threats
Non-emergencies (still need urgent care within 24–48 hours):
- First-episode psychosis without imminent danger
- Worsening delusions/hallucinations but person is cooperative, eating, and safe
What to do in an emergency:
- Call 911 and specify "psychiatric emergency" – request Crisis Intervention Team (CIT) officers if available.
- Do not argue with delusions; stay calm, reduce stimuli, ensure safety.
- Mobile crisis teams or psychiatric ERs can assess for involuntary hold (e.g., 72-hour evaluation).
Early intervention prevents tragedy. If unsure, err on the side of caution when in doubt, treat as an emergency.