Same-day psychiatric crisis care (when available) — seen today, not in weeks

When you are in a mental-health crisis, you shouldn’t have to wait weeks for an appointment or spend hours in an emergency room. OhanaPsych offers same-day and this-week crisis appointments with a psychiatric provider — by secure telehealth anywhere in Hawaiʻi, or in office. As far as we know, we are one of very few psychiatric practices in Hawaiʻi offering same-day crisis appointments, and we accept Medicaid (QUEST) and most insurance.

If this is an emergency: If you or someone else is in immediate danger or having thoughts of suicide, call 911, go to your nearest emergency room, or call or text 988 (the 988 Suicide & Crisis Lifeline). An emergency room is the right place for a true, life-threatening emergency.

What is a true psychiatric emergency?

Some situations are true emergencies and belong in an emergency room or with 911 — not in a scheduled outpatient visit. Drawing on national guidance from the National Institute of Mental Health, the 988 Suicide & Crisis Lifeline, and emergency-psychiatry experts, signs that someone may need emergency care right away include:

• Thoughts of suicide with a plan or intent, or a suicide attempt
• Thoughts of harming or killing someone else, or threatening behavior toward others
• Feeling unable to keep yourself safe, or having the means and the urge to act
• A serious overdose or ingestion, or any medical instability (trouble breathing, chest pain, loss of consciousness, or a seizure)
• Severe confusion, or a break from reality such as hallucinations or delusions that put safety at risk
• Being unable to care for yourself or to stay safe on your own

The emergency room exists for exactly these moments: it provides immediate safety, around-the-clock access, and medical stabilization that an outpatient clinic cannot. If any of these apply, call 911, go to your nearest emergency room, or call or text 988 — right now.

Only you can decide

This is general education. It is not an exhaustive or complete list, and it is not medical advice. Every situation is different, and ultimately only you can decide whether you need to be seen in an emergency room. When in doubt, treat it as an emergency: call 911 or go to the nearest ER.

Please understand that if you call our office, our front-desk staff cannot and will not tell you over the phone whether you should go to the emergency room. That is not a lack of caring — it is the opposite. We have not seen, evaluated, or assessed you, and offering a medical opinion by phone without an evaluation would be inappropriate and unsafe. Our front-office staff are not clinicians and will not render that judgment. What they will always do is tell you to call 911 or 988, or go to the nearest emergency room, if you may be in danger.

Our goal is always your safety — handled with aloha and as much dignity as the situation allows.

A crisis is urgent — but often not a life-threatening emergency

Many mental-health crises are urgent without being life-threatening: a sudden worsening of depression or anxiety, a medication reaction, overwhelming distress. And in Hawaiʻi, getting a routine mental-health appointment commonly takes one to six months — and often longer on the neighbor islands — Hawaiʻi Island, Maui, Kauaʻi, Molokaʻi, Lānaʻi, and Niʻihau — or for people with Medicaid or Medicare, with some waits reported up to nine months (NAMI Hawaiʻi). A crisis cannot wait that long. Those situations don’t need a long ER wait — they need to be seen quickly by a psychiatric provider. We deliberately hold room in our schedule so we can see people in crisis today or this week.

How it works

Call us and tell us you need to be seen for a crisis. We get you in with a psychiatric provider same-day or next-day, by secure video anywhere in Hawaiʻi or in office. We accept Medicaid (QUEST) and most insurance, and language assistance is available. For everyone’s safety, controlled substances are not prescribed during crisis visits — crisis care is about stabilizing safely and building a plan, and controlled medications require an established, ongoing provider relationship.

Why we don’t write controlled substances in crisis visits

We want to be honest and clear, because this comes up often: we do not prescribe controlled substances — stimulants, benzodiazepines, or similar medications — during crisis visits. We understand how stressful it is to be out of a medication you depend on, and we say this gently: it is not that we doubt you, and it is not a punishment. It is that the evidence does not support starting or refilling these medications in a one-time, urgent encounter with a provider who does not yet know your full history.

Controlled substances are safest and most effective when they are managed within a continuous, ongoing relationship — with a thorough evaluation, a shared treatment plan, monitoring over time, and clear guardrails. National clinical guidance reflects this across every class of these medications: the CDC’s opioid-prescribing guideline stresses continuity of care and structured treatment plans rather than episodic prescribing; the American Society of Addiction Medicine’s stimulant guidance calls for comprehensive assessment and ongoing monitoring; and the joint benzodiazepine guidance emphasizes careful, longitudinal management and tapering. A crisis appointment — by design a brief, urgent visit — is exactly the setting these guidelines caution against for controlled-substance prescribing.

So here is our promise instead: we will see you quickly, help you stabilize safely, and — if a controlled medication is genuinely part of your care — connect you with one of the providers on our panel for the ongoing, established relationship that safe prescribing requires. We treat every client with aloha; choosing not to write controlled substances in a crisis visit is part of how we keep you safe, not a door closing on your care.

A better option than the ER — when it’s not an emergency

The emergency room is essential for true emergencies, and you should always use it when life is at risk. But for an urgent mental-health concern that isn’t life-threatening, the ER is often not the best setting: psychiatric patients frequently “board” in emergency departments for many hours or longer waiting for care, and those delays can worsen symptoms. National crisis-care guidance from the Substance Abuse and Mental Health Services Administration emphasizes that timely, appropriate crisis services — not the ED — are the right response for most behavioral-health crises. Being seen the same day by a psychiatric provider means care without the wait, the cost, and the environment of an ER.

How long are those waits, really? Studies of adults in psychiatric crisis find they remain in the emergency department roughly three times longer than other ED patients, with reported average boarding times ranging from about 7 hours to more than 24 hours — far beyond the four-hour disposition window many emergency departments aim for. For keiki and teens it is often worse: a national study of pediatric mental-health ED visits from 2018–2022 found that about one in three young people who needed admission or transfer boarded in the emergency department for more than 12 hours, and some wait days for an appropriate placement — a stretch of time that is hard on any child and family. Being seen the same day by a psychiatric provider can spare many families that ordeal entirely.

How we show up for you

We start from lōkahi — balance across the connected parts of your life — and we meet you with aloha (compassion and presence) in a hard moment, treating you as part of an ‘ohana, not a number in a waiting room. Our goal is to help you feel safe, stabilize what’s happening, and leave with a clear next step.

Lasting access by telehealth

As we complete the final stages of becoming a Rural Health Clinic (RHC), telehealth for mental-health care is here to stay with us. Under Medicare’s rural-health rules, RHCs are permanently authorized to provide behavioral and mental-health care by telehealth — including into your home, anywhere in Hawaiʻi — not under the temporary flexibilities that expire and must be renewed. (Prescribing of controlled medications still follows the separate Ryan Haight Act and DEA rules.)

Wherever you live, OhanaPsych is your statewide practice. We provide care across the entire state of Hawaiʻi by telehealth, reaching every island — Hawaiʻi Island, Maui, Oʻahu, Kauaʻi, Molokaʻi, Lānaʻi, and Niʻihau. If you would rather be seen in person, you have that option at our offices in Hilo and Honolulu.

Need to be seen today?

Call (808) 777-9460 and tell us it’s a crisis, or start your request online. If it is a life-threatening emergency, please use 911, the ER, or 988 first.

If you or someone you love is thinking about suicide or self-harm, get help right away. Call or text the 988 Suicide & Crisis Lifeline (call or text 988, or chat at 988lifeline.org). In Hawaiʻi, Hawaiʻi CARES is available by calling or texting 988, or at 808-832-3100 / 800-753-6879. In a life-threatening emergency, call 911.

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Medically reviewed by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner, OhanaPsych / Ohana Care Clinic.
Last reviewed: June 28, 2026. Citations verified: June 28, 2026.

This page is general health education from OhanaPsych. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you are in crisis, reach out to us or another licensed provider. In a life-threatening emergency, call 911.

References

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Honolulu Civil Beat. (2026, February). The human cost of waiting for mental health care in Hawai‘i. https://www.civilbeat.org/2026/02/the-human-cost-of-waiting-for-mental-health-care-in-hawaii/

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988 Suicide & Crisis Lifeline. (n.d.). 988 Suicide & Crisis Lifeline. https://988lifeline.org

Substance Abuse and Mental Health Services Administration. (2020). National guidelines for behavioral health crisis care: Best practice toolkit. https://www.samhsa.gov/find-help/implementing-behavioral-health-crisis-care