Emergency Room Tips for Caregivers

The Situation Requires an ER Visit

When a mental health emergency strikes, the path to care can feel overwhelming, chaotic, and isolating—not only for your loved one, but for you as the caregiver. The world can feel like it is moving both too fast and not fast enough.

Stepping into the ER to support your loved one through a medical emergency is a brave step. Very often, when our loved ones have reached this crisis point, they are too unwell to seek treatment alone.

As a caregiver, you are not a mere bystander; you are a vital part of the care team. Your support and active presence will make a huge difference in the outcome of the experience.

NSMoms know firsthand how challenging it is to navigate a mental health crisis. We want you to feel empowered to face the situation with courage.

This guide is designed to provide actionable tips to help you stay grounded—speaking up for your loved one’s needs and managing the logistics of the situation so you can focus on what matters most: getting your loved one the help they deserve.

First Visit

Always be prepared. Mental health emergencies can occur at any time. Even though the situation is stressful, it is advisable to present yourself to staff in a calm and respectful manner.

• Bring a one-page story and a file card with the most important jot-note information: diagnosis, medications, safety risks, current psychiatrist, and recent symptoms. Specific descriptions with dates and times are very helpful.
• Carry a printed photo of your loved one when he or she was well. The difference now that your loved one is unwell should be obvious to staff.
• Notify as many support people as possible, including family and friends, to send collateral information for you to share at the ER. The more people who can provide information, the better the chance of admission if necessary.

First Visit Continued

• If your loved one goes to the ER and leaves before being seen by the Mental Health Team, request that an Alert of Possible Patient Risk form be initiated by the Community Treatment Team. This form will be received by Emergency Psychiatry Services and the Mobile Crisis Team and should be in effect for two weeks.
• If the ER recommends that your loved one be discharged and you agree that it is safe, ask for a copy of the discharge instructions.
• If you feel it is unsafe, ensure your safety concerns are documented and record the criteria that were used to decide against admission. Ask if a psychiatric assessment was completed.
• If you are asked to take your loved one home with you, ask for a copy of the discharge plan. Say that you need time to prepare to receive your loved one.

Subsequent Visits

• Bring the most recent hand-written copy of the Relapse Plan with you. Present all items noted above to staff. Add the number of hospitalizations with dates, and ask that it be added to the medical record.
• Ask the triage nurse to bring up the current Special Care Plan on the electronic health records system. If your loved one has a clinician or clinical team, it should have been entered.

Subsequent Visits Continued

• Nova Scotia Health strongly encourages all clinicians to create a Special Care Plan with patients. If you are listed on your loved one’s Circle of Support, you can ask to be involved in its creation.
• The Special Care Plan is required to be updated annually. Trusted caregivers are permitted to send collateral information for the Health Records even if there is no consent.

If Your Loved One Refuses Your Involvement at the ER

• Without consent, hospital staff may be legally prevented from sharing some information with you. There is absolutely no law preventing you from sharing information with them. Be sure to provide the one-page story, the file card, and the Relapse Plan to the triage nurse or attending psychiatrist.
• If your loved one does not want you to be in the room during assessment, ask to speak with the psychiatrist or social worker separately. Let them know that you have vital collateral information regarding the patient’s health that your loved one may not have the capacity to share.
• If your loved one is excluding you due to symptoms like paranoia, delusions, and lack of insight, state this clearly to staff.

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If Your Loved One Refuses Your Involvement Continued

• If you have previously been identified in the Special Care Plan as the Primary Caregiver or Substitute Decision Maker, remind staff of this. Even if your loved one is currently refusing your presence, those pre-existing roles may give you the legal right to be consulted.
• If you are not permitted to be in the treatment room, stay in the hospital. Clinicians can sometimes encourage patients to consent to you being involved and the medical team may need to reach you quickly.
• If the situation becomes volatile due to your presence, notify staff that you are going to a different part of the hospital to wait and hand them your collateral information.

Some Emergency Contacts