you can put in the text portion "emergency - need help" or some other text.
No. The point to the emergency beacon, as defined in the APRS protocol and implemented more or less in various equipment and software, is that it's handled differently. You wouldn't have to manually annotate it, and it would automatically be flagged/prioritized by receiving stations/nodes/servers. Example, FindU has a separate page for nothing but emergency beacons. Kenwood mobiles show a big "EMERGENCY" on the display.
In reading up on the topic it's poorly implemented and used, so I'm not looking to it as a foolproof solution. My interest is to find out how it *should* be set up and used if one had the desire or need. I do hike in the mountains and sometimes travel remotely. While I wouldn't consider APRS as a primary distress solution I think it could be part of one, and as such it would be useful to know how it should be set up correctly.
I see where you set the icon to the emergency identifier using the alternate symbol table and it only works using MIC-E, but beyond that I can't find any other detail.