My intention in writing this blog is to share the experiences that I went through with my son, starting with the first manifestation of his illness and our journey through numerous subsequent episodes, and also to provide commentary as a parent and psychiatrist on issues that these experiences bring up, such as how the diagnostic process works in mental health, how to work with treatment providers, and medication issues. My hope is that reading this may be helpful for people with mental health issues and also their families and friends.

The essence of an emergency room evaluation should be to arrive at a diagnosis, especially if one is not already known, and to get expert help with treatment and resources. Emergency rooms sometimes don’t have psychiatrists located in the ER but usually have consultation available for psychiatric evaluations. Patients may be brought in by the police for disruptive behavior, although more often mentally ill individuals are brought to jail and then are sent for evaluation at the request of the criminal justice system.

When I saw Bill in jail, he sat behind bars looking forlorn and scared. The jail staff told me that if I took him to the emergency room, they would release him immediately and wouldn’t ask me to post bail. I called a friend to meet me outside the emergency room to make sure that Bill was calm enough for me to manage him by myself. The sergeant released him, saying, “Bill, I hope you feel better.”

We rode together to the ER. I asked him what had happened, but he didn’t respond. I asked him if he had done drugs; he shook his head. I explained that in the emergency room they would ask him questions about his life and........

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