Many individuals with intellectual disabilities who live with their families experience mental health problems and ensuing psychiatric emergencies. During periods of crisis, families may require additional services, including going to the emergency department (ED). The goal of this study was to elucidate demographic, clinical, and crisis features associated with ED use in 192 individuals who lived with family and experienced a psychiatric crisis. The presence of psychiatric symptoms; a mild (vs. moderate/severe) level of intellectual disability; a history of behavior problems, psychiatric hospitalization, and ED use; and a recent history of negative life events were related to ED use. Learning about the factors that distinguish groups is needed to make sure we develop proactive community-based resources for such people to prevent visits to the ED from occurring when possible. (Contains 4 tables.)