“When are emergency consultations needed?”

We screen for suicidal ideation/attempts, as well as determine if you are able to function and care for your own needs. If that screen is Ok, we send you out to see a psychiatrist/counsellor on the outside.

So, if you are not on the verge of harming yourself or someone else, you probably should see your doctor and go from there.

If you ever feel as if you are going to or want to hurt yourself, or someone else or if you are seeing things that aren't there or if you are so preoccupied with your thoughts that you can't function, then you should go to an emergency department immediately. If your depression is becoming overwhelming, make an appointment with a psychologist or psychiatrist ASAP.

If you feel like you may hurt yourself or someone else, you should definitely get an emergency consultation

You should discuss this with your therapist / prescriber, as what is unbearable torture for one person can be an unpleasant distraction for another. In general, it is better to be in a safe space (like the ER) than not if you are decompensating or contemplating injuring yourself or someone else, however short of that, you should have some ground rules or options in place--if I drift down to feeling like "x" then I (we agree), I should page my therapist for a phone triage. If I lose more altitude to "y," then I should page my prescriber to see if an additional dose or phone-in prescription is warranted...and if I am 'scraping the treetops ("z"), then I need to go to the ER...knowing that it is a very busy place and I will be there for several hours, but am likely to come away (eventually) in a better place, with any adjustments they may have considered reasonable, and an outpatient follow up plan made with my providers.