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Mental health issues have increased substantially since the onset of the COVID-19 pandemic. However, health policymakers do not have adequate data and tools to predict mental health demand, especially amid a crisis. Using time-series data collected in Singapore, this study examines if and how algorithmically measured emotion indicators from Twitter posts can help forecast emergency mental health needs. We measured the mental health needs during 549 days from 1 July 2020 to 31 December 2021 using the public's daily visits to the emergency room of the country's largest psychiatric hospital and the number of users with "crisis" state assessed through a government-initiated online mental health self-help portal. Pairwise Granger-causality tests covering lag length from 1 day to 5 days indicated that forecast models using Twitter joy, anger and sadness emotions as predictors perform significantly better than baseline models using past mental health needs data alone (e.g., Joy Intensity on IMH Visits, χ2 = 14·9, P < ·001***; Sadness Count on Mindline Crisis, χ2 = 4·6, P = ·031*, with a one-day lag length). The findings highlight the potential of new early indicators for tracking emerging public mental health needs., (© 2024. The Author(s).)