Under which circumstances is it appropriate to call 911 or send a client to the ER?

When there is an active plan and/or intent for suicide or harm, it is crucial to call 911 or send the client to the emergency room. This response is based on the immediate risk to the client's safety and the necessity for urgent intervention. An active plan indicates that the person has thought through the steps they might take to cause harm to themselves or others, which amplifies the danger significantly.

In situations where suicidal ideation is passive or the client is simply upset, although these may warrant attention and support, they do not represent an immediate crisis that requires emergency intervention. Likewise, while a client's request for a hospital referral could signify distress, it does not inherently indicate that they are in a life-threatening situation that necessitates emergency services. Thus, the presence of a concrete plan or intent for self-harm distinctly indicates the need for urgent, specialized help to ensure safety.