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A great number of people visited in the Emergency Department have a psychiatric problem and often this is not recognized or not properly treated because of many reasons. The unrecognized mental disorders are a major problem for the well-being of patients, for the burden of relatives, and a great cost for the Public Health System. That’s why a good policy is needed to organize an efficient emergency system, with shared principles (i.e. on admission and discharge criteria, compulsory treatments, pharmacological approach etc.) and acceptable standard of care. Psychiatric emergencies need a quick intervention in order to insure an effective evaluation and clinical management of the situation with a good standard of risk management and safety for everybody. Behavioral emergencies are critical and need a complex approach based on de-escalation techniques and also on a safe and effective pharmacological therapy.