The author offers information to help clinicians identify which patients require emergency treatment. Clinicians are advised: to pay attention to immediate signals from the first-time patient that he or she may be at risk for homicide or suicide & for signs of acute depression; to proceed with caution when a patient insists they can remain stable as an outpatient even though they are feeling suicidal; & to watch for risk factors in familiar patients. Clinicians are also advised to negotiate levels of contact & to encourage family & friend’s to monitor the patient’s behaviour & provide emotional support to the degree they are able.