Emergencies
Call 911
If there is a chance of imminent physical harm, don’t take chances; call
911, and let them decide. In most places, dispatchers are fairly sophisticated
as to what their people can and cannot do. Calling 911 will send police or
emergency medical personnel. What they call imminent is someone need-
ing to be transported to hospital or jail, given lifesaving treatment, or imme-
diately stopped from doing something dangerous. If someone is hurt, or
you have any doubt as to whether an attack is panic or something more
dangerous, or if a family dispute gets physical or a suicidal person is bran-
dishing a gun, pills, or other means of bodily harm, call first and ask ques-
tions later.
In situations involving threat with no overt action, such as some-
one acting in a menacing way or just talking about suicide, 911 cannot
offer much help. They may still come in such situations, but the police
or emergency medical personnel might not have the legal authority to
do anything.
Emergency Rooms
Emergency rooms are for people who need immediate treatment. If some-
one is having a panic attack or is otherwise severely agitated, you may have
no choice, especially if the diagnosis is in question. Immediate treatment
for agitation is usually a stiff dose of benzodiazepines, which may not be
helpful in the long run. The second and third E.R. visits mean you should
be going somewhere else.
Emergency rooms in large cities usually have a mental health crisis
worker on call. Generally, it will take at least several hours to be seen. The
wait may be necessary if you have no other resources for a suicide threat,
or you think there might be a need for hospitalization. Many psychiatric
units admit through the E.R. if the patient doesn’t have an established
relationship with an inpatient psychiatrist.
Urgency Care Facilities
Urgency care is not a good source of treatment for the disorders dis-
cussed in this book. Crisis treatments with no follow-up make explosive
disorders worse.
272 ❧Explosions into Anger