Beyond Blue

Beyond Blue

Should I Make My Wife Go to the Hospital?

The NAMI Maryland publication, “Connections,” published this question awhile back. It is one I am often asked:

I was recently faced with the dilemma of whether or not my wife was a danger to herself and others, and whether or not to take her to the emergency room as a psychiatric emergency. Are there any guidelines or suggestions as to when its best to take a loved one to the hospital?


Dr. Mark Komrad, M.D. responded:

This is one of the challenging issues in all of psychiatry–both practically and ethically. So I can only attempt to address it in a most preliminary fashion in this article. The easy answer is: call your wife’s psychiatrist. I believe that all physicians should have a system to be available in the case of possible emergency. That is a fundamental ethical principle we are taught in medical school. Every patient and family should be familiar with how to contact the psychiatrist in the case of emergency.

One of the most common reasons psychiatrists are reached in an emergency is to consult on just this situation–whether or not a person should go to an emergency room (ER). As a part of residence training, all psychiatrists have extensive experience with this scenario.


What if the doctor can’t be reached or if there is no psychiatrist on the case … yet? The primary concern is safety–hers and yours. If there is any question that your wife is unable to control her behavior to maintain safety, it is reason enough to have an evaluation in the ER. Safety includes considerations of violence to self and others, as well as other kinds of safety such as fire safety, fall risk, or medical risk. A diabetic who is refusing to eat, a person with unstable hypertension who is highly agitated, a person who has fallen into an unmoving catatonia and isn’t acting to take care of his basic needs, a person who environment has deteriorated to a fire or health hazard: these are all examples of various cases from my own clinical experience that have been appropriately brought to the ER. So, if the doctor says go–go. If you feel there is a risk of harm afoot -go.

A final consideration in your decision: if someone has never been in for treatment, an ER evaluation can open the door to mental health treatment, and is sometimes the only first step a person is willing to take.

  • http://AddaURLtothiscomment john

    You begin by saying that you weren’t sure if your wife was a threat to ‘herself or others,’ and I want to ask you if you really needed to put the ‘or others’ in there. Too often people that are depressed and suicidal are also assumed to be homicidal, and in the vast majority of cases this is just not so. The danger inherent in this statement is that depressives are automatically viewed with fear rather than compassion. Unless your wife has shown violent behavior toward others (and she very well might have), you should be careful not to label so.

  • http://AddaURLtothiscomment Rita

    I too have nothing but horror stories to tell about both emergency rooms and psyche wards. Never again!!! Twice I almost died because, as soon as the ER staff find out you have a mental illness (which they can figure out by what meds you tell them you’re on) they automatically blame any physical symptoms you are having on your ‘anxiety’ or whatever. Too bad they attributed by pain and trouble breathing to ‘anxiety’. Turned out it was a dangerously inflamed gallbladder, an ulcer, and a growth in my lung almost as big as my little finger. Idiots! Spent a week on a psyche ward in agony and almost died while they kept telling me to ‘think happy thoughts.’

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