If you go to the ER and are honest about your self-harm and suicidal thoughts you will probably be admitted to the psych ward but it could be voluntary. Going to the ER is a bit of a hassle. Here, they immediately put me in a consultation room but there is usually a long wait to see a doctor, breathelizer, urine test for drugs, change from your clothes to a gown, they take your belongings to be sure you don't have anything that you could hurt yourself with. Then there is usually a wait for a bed. I have been hospitalized many times and all but one time was positive.