s**t, I'm sorry. I saw you are in the US, but didn't figure it out that the ER costs you guys money. Hmm. Do you have firm knowledge on what the costs are and how/when they're incurred? Could you, perhaps, go to the emergency room without any identification and still receive treatment without them having a way to know who you are and thus bill you? That's a little farfetched, I know. Call the help lines. Talk to somebody. That's what will happen at the ER most likely anyway. Find understanding, neutral people to talk to. Really, just keep talking. And also, if you feel like you could be in danger where you are, change your setting. Put yourself in a safe place. Self-harming is often impulsive and so it can be curbed by removing yourself from a setting in which your impulses could be satisfied. And of course, keep posting here. I went through what you're going through now just last week and the WP community was very supportive.