Emergency Care and Hospitalization
If a person may cause harm to themselves or others, he or she must go to a hospital emergency room immediately. If the person is not willing, do not physically attempt to take him or her yourself. You may call 911 or Crisis Services (716-834-3131). See more on Emergency Services
If a person is in crisis but not a harm to him or herself or others, he or she may not need to go to the emergency room. A person may feel, however, the need for treatment before the next doctor appointment, or may not have a doctor. By going to a walk-in or same-day service provider, you will avoid a potentially long wait in an emergency room.
If you are unsure whether to go the Emergency Room or another medical facility, call your physician or Crisis Services at 716-834-3131.
Psychiatric Emergency Rooms
Please see Being Prepared for what you need to know about going to a psychiatric emergency room.
Niagara Falls Memorial Medical Center
621 10th St., Niagara Falls, NY 14302
Fees: Financial assistance based on ability to pay.
Hospitalization of persons with mental illness can be a very frightening, painful experience for both patients and families if they do not know what to expect. Though it is always difficult, it is best to be prepared. Link to Be Prepared.
When a person is admitted, a hospital stay is usually for just a few days up to 2 weeks. More thorough assessment and diagnosis will be done once the patient is admitted. An individual may leave at any time, unless involuntarily hospitalized (infrequent).
Hospitalization is for stabilization only and not for ongoing treatment. When discharged, the patient is referred to outpatient services. This reality may be very frustrating and concerning to family members for many reasons including the individual’s medication not yet taking effect yet, lack of adherence to treatment plan and lack of adequate housing. Family members or caregivers may advocate against discharge if they believe a person is not well enough.
Under certain circumstances, a person may be involuntarily hospitalized, or brought to a hospital for assessment, when less restrictive treatment is not possible and the person is a harm to themselves or others or is unable to live safely in the community. Very specific laws govern when this action is taken. See “Involuntary Hospitalization” below.
Article 9 of NYS Mental Hygiene law sets out seven procedures for involuntary inpatient psychiatric treatment. These procedures are commonly referred to by their section name (e.g., 9.45 or 9.27). The most frequently used sections are outlined below.
Section 9.27: Involuntary admission on medical certification by two physicians (referred to as “2 PC”).
A person may be involuntarily hospitalized if two physicians examine the patient no more than 10 days before the admission and certify that he or she is mentally ill and in need of involuntary care and treatment. The physicians certify that the person has a mental illness for which care and treatment in a hospital is essential to such person’s welfare and whose judgment is so impaired that he or she is unable to understand the need for such care and treatment. In addition to the two physician certifications (known as a “2 PC’), an application for involuntary admission must be completed and signed by any one of 11 categories of people, including immediate family members or nearest kin, roommates, a social services official, a hospital official when the patient has been admitted for medical care, the director of a facility providing substance abuse treatment, the director of the division for youth, or a psychiatrist treating the patient in a mental hygiene facility. Once an application is sent to ECMC along with the 2 PC, the person will be brought to ECMC and evaluated by a staff psychiatrist for possible admission.
Section 9.39: Emergency admissions for immediate care and treatment.
A staff physician of the designated mental hygiene facility (ECMC) may make the determination, confirmed by another staff physician, to retain for up to 15 days, people who are in need of hospitalization and dangerous to themselves or others. Once admitted, the patient may request a hearing, which must be scheduled within 5 days. If the patient after 15 days still needs hospitalization but will not stay voluntarily, procedures for admission upon medical certification can be instituted.
Section 9.41: Emergency admissions for immediate observation, care and treatment; powers of certain peace officers and police officers.
Any state or local police officer or sheriff ’s deputy may take into custody any person who appears to be mentally ill and is conducting himself in a manner likely to result in serious harm to him/herself others. The officer or deputy must personally witness the behavior. The person may be detained temporarily in a “safe and comfortable place” upon notice to the director of community services before being transported to ECMC as provided in Section 9.39.
Section 9.45: Emergency admissions for immediate observation, care and treatment; powers of directors of community services.
The director of community services (in Erie County, the Commissioner of Mental Health) or his/her designee may direct the removal of a person to a mental hygiene facility (ECMC) if the parent, spouse or child of the person, or a licensed physician, health officer, peace officer or police officer reports to him that the person has a history of mental illness for which immediate care in a hospital is appropriate per Section 9.39 above and which is likely to result in serious harm to him/herself or others. The Commissioner’s representatives in such cases are Crisis Services, which may call upon a peace officer or police officer to assist in transporting the person.
Other regulations are summarized below:
Section 9.55: Emergency admissions for immediate observation, care and treatment; powers of qualified psychiatrists.
Section 9.57: Emergency admissions for immediate observation, care and treatment; powers of emergency room physicians.
Section 9.43: Emergency admissions for immediate observation, care and treatment; powers of the courts (a/k/a Mental Health Warrants).
When a judge receives a sworn statement that a person has mental illness and is behaving in a manner that would be considered disorderly conduct in a person not mentally ill, or in a manner dangerous to himself or herself or others, the judge shall issue a warrant directing that the person be brought by the police department to his or her courtroom for a hearing. The judge may then issue an order directing that the person be taken to ECMC for examination and, if necessary, involuntary admission.
A family member should avoid using this regulation for a loved one since it is highly unlikely to provide immediate help and ultimately may only result in a mental health assessment by the hospital, not involuntary hospitalization. Furthermore, this course of action may inadvertently result in a civil action and potentially the criminalization of the person’s actions. Continue to call Crisis Services and/or the police whenever your loved one is in crisis.