I had already told him not to call me first. It wasn’t that I didn’t want to know or that I didn’t want to help — of course I needed to know, and of course I needed to help. The problem was that they needed to call an ambulance first.

Asher had a history of doing this, and not just once or twice. He’d been hospitalized at least eight times in the past few years with the same exact story: he’d stop his medications, start using drugs, and would decompensate to the point where he hadn’t slept or eaten in a few days and needed emergency treatment. He wasn’t a bad kid or a violent menace, but when he was off of his treatment, all bets were off as well.

The problem was that no one knew anything about it. He’d joined the yeshivah just six weeks earlier. A brand-new and unfamiliar student, nobody had a clue that this poor kid was a ticking time bomb.

Until that day, when Asher disclosed to his rabbi that he was off his medications. They called me in, but by the time I got there to evaluate him, he wasn’t interested in speaking with a psychiatrist and made that clear by storming out of the beis midrash. We tried about a million ways to reach him, but he wasn’t hearing it.

So I did all I could do: I instructed the rosh yeshivah to call his parents back in London; they had to get on a plane to Israel as quickly as they could and come pick up their son. In the meantime, since Asher had made it clear that he wasn’t going to take any medications, I told the staff to call an ambulance if he got any worse or if anyone got scared. After that, they should call me.

Then I went back home to wait for the phone call. When it came a few hours later, I made sure they had called the ambulance, and then I headed back to speak with the yeshivah students and try to calm everyone down.

It’s called crisis intervention work. I remember it from my days back in the States, when I was the lone psychiatrist working in the downtown ER after Islamic terrorists bombed the Boston Marathon. I had walked around handing out coffee and doughnuts to the emergency responders who had seen the attack itself and the family members who were awaiting news of their loved ones. Surgical teams pulled shrapnel out of 30 or more patients in the ER that day while I did my part in offering reassurance, providing referrals, and being there for folks who wanted a shoulder to cry on.

Now I was doing the same thing at the yeshivah. Luckily no one had been hurt, but it was certainly traumatic for the four students who had been forced to restrain Asher after he took a swing at his roommate (who, he was apparently convinced, had joined the Mossad and was after him).