Crisis & Acute Care

Acute psychotic break treatment in plain English: what happens in the ER, stabilization, the first 72 hours, and how to plan the next step in care.

The plan was supposed to be simple. Take a few days off work, lock the liquor cabinet, ride out the shakes with cold showers and ibuprofen. By the third night the room is spinning, the heart is racing at 140, and the family is trying to figure out whether the seizure was a one-off or … Read more

The 988 line is a real improvement over what came before it. The counsellors are trained, the wait times keep shrinking, and the safety planning approach actually saves lives. But anyone who has spent thirty minutes on the phone in the parking lot of a Walgreens at 1am, trying to talk down a sister whose … Read more

A Calmer Door Into the Crisis System For decades, the only doors into the mental health care crisis system in the United States were the psychiatric emergency room and the inpatient hospital. Both work, in the sense that they can keep people alive and stabilise the most acute episodes. Both also have well-documented downsides: long ER waits, … Read more

The car accident happened on a Tuesday afternoon in suburban Sacramento. By Thursday, Marcus couldn’t sleep more than two hours at a stretch. Every time he closed his eyes, he heard the screech and felt the airbag punch his chest. His wife found him standing in the kitchen at 3 a.m., staring at nothing. He … Read more

The text comes in at 9:47 pm. Your brother has been picked up by police on a 5150. You are not entirely sure what that means, what rights he has, what happens in the next 72 hours, or whether you should drive to the ER tonight or wait until morning. You are about to learn … Read more

Outpatient vs inpatient medical detox: when each is safe, ASAM levels of withdrawal management, costs, insurance coverage, and what comes after detox.

The phone call rarely comes at a convenient time. A sister overdoses on a Saturday night. A husband gets a DUI on the way home from work and finally asks for help. A college kid texts at 2am and says, “I think I need to go somewhere.” When that moment lands, the question that follows … Read more

Annika Beaumont gave birth to her son Felix at Northwestern Memorial Hospital in Chicago on a Tuesday in late October. By the following Sunday morning, her husband Pieter was sitting on the floor of their bedroom while Annika, who had not slept in three nights, calmly explained that the baby had been replaced by a … Read more

Cody Whitcomb walked into the Hennepin County emergency department in Minneapolis on a cold Tuesday morning in February, three days after his last hit of methamphetamine. He had not slept more than two hours total since arriving. He was crying, shaking, and convinced he should not be alive. The triage nurse logged him as “stimulant … Read more