BACKGROUND Hate crimes against Asian American surged in the United States between 2019 and 2020. Those facing COVID-19 discrimination showed heightened psychological distress. We examined whether increased hate crimes against Asian Americans corresponds positively with psychiatric Emergency Department (ED) visits among Asian Americans in California. METHODS We obtained our outcome variable, psychiatric ED visits, from the University of California Health Data Warehouse (UCHDW) for the period from May 2012 to August 2022. We specified our exposure as a binary indicator for months in which hate crimes against Asian Americans were positive outliers, and we obtained this data from the State of California Department of Justice Criminal Justice Statistics Center. We employed Box-Jenkins time-series methods to control for monthly temporal patterns in ED visits. RESULTS Increased hate crimes against Asian Americans corresponds with a rise in psychiatric ED visits among this population. After accounting for autocorrelation and controlling for psychiatric ED visits among non-Hispanic whites, our outlier-adjusted analysis shows an increase of 14.13 more psychiatric ED visits per month than expected during high hate crime months (standard error [SE] = 2.81, p < 0.001). CONCLUSIONS Increased racial discrimination and hate crimes at times of conflict may provoke severe mental health crises that require emergency care. Enhancing mental health support systems and providing culturally competent care tailored to the unique experiences of racial minorities remain crucial during such conflicts.