Refugees are at increased risk of mental health challenges, encounter many social issues such as homelessness and food insecurity, and experience barriers to accessing culturally appropriate outpatient care. As such, many refugees who experience a mental health crisis present to emergency departments (EDs) to seek mental health care and support for physical needs. To investigate gaps and barriers in care, this project integrates literature on ED treatment of suicidality and an applied case example of a homeless, US-settled Somali refugee with PTSD, polysubstance abuse, and chronic suicidal ideation seeking ED care.