Introduction: Emergency responders face an increasing number of calls involving people with behavioral and mental crisis issue. They must be able to recognize signs of mental distress, apply proven techniques for dangerous situations and referrals for them to obtain mental health care. 
	Objective: To study the situation, characteristics, issues, and accessibility to the emergency medical services (EMS) and appropriate treatment for patients with a mental crisis in Thailand.
	Methodology: A mixed method research design. The sample included 26,511 mental crisis patients using EMS from the Information Technology for Emergency Medical System between 2014-2016 and stakeholders from four provinces distributed regionally using focus group and in-depth interview. The data were analyzed using descriptive statistics and content analysis.
	Results: The number of emergency patients with mental crisis accessing emergency medical services were increasing for the past 5 years. Most patients are male in working age from the Northeastern during the raining and cold season, especially between September and October. During a mental crisis, assistance will be requested from the police and the emergency units. The response depends on the experience and community capability. The operation teams have insufficient knowledge and skills. Emergency rooms in most hospitals lack specific caring unit. Psychiatric hospitals have different criteria for admitting patients. Most hospitals did not have fast-track system and even refuse admittance. Cooperation among the mental health hotline (1323), the police (191), and the emergency unit (1669) is still a challenge. Also, the development of a fast-track network connecting the community to hospitals will ensure patients’ confidence in supporting resources.
	Conclusion: The number of mental crisis patients with EMS were rising. However, accessibility to appropriate service centers was still an issue. Most hospitals lack prioritized access and most staffs had insufficient knowledge and skills. Cooperation among the police, emergency operation team and the psychiatric team is still a challenge.

Emergency Patients with Mental Crisis Accessing Emergency Medical Services in Thailand