You may be considering suicide and yet not want to tell a therapist, because you fear landing in a mental hospital.
If you go to a therapist or psychiatrist and tell them you’re seriously thinking of killing yourself, that doesn’t necessarily mean you’ll be hospitalized – even if you want to be admitted. Hospitals are pretty strict these days about who they admit, and insurance companies are equally strict about covering a hospital stay. Some therapists joke that it’s harder to get into a mental hospital than Harvard University.
Who Gets Admitted to a Psychiatric Hospital for Suicide Risk
Adults
Suicidal thoughts alone aren’t usually enough to warrant psychiatric hospitalization for adults. Instead, you’d need to be in significant and immediate danger of killing yourself. This generally means you’re intent on acting on your suicidal wishes very soon or you’re unable to control your suicidal urges. Perhaps you already have a plan for how you’d kill yourself, you have whatever you need to carry out that plan, and you have some intent to follow through on that plan very soon. And, on top of all that, you don’t want to try to stay safe.
If so, then yes, hospitalization would almost certainly be necessary. If you don’t consent to be hospitalized (that is, you won’t voluntarily admit yourself), then you might be committed to a hospital. This should an absolute last resort, but it can happen if someone’s suicide seems imminent.
People get admitted to a psychiatric hospital when suicidal danger is extreme because serious suicidal intent is almost always temporary. Consider that even among people who attempt suicide and survive, more than 90% do not go on to die by suicide.
So, if you’re thinking of killing yourself but don’t intend to act on those thoughts any time soon, then a mental health professional shouldn’t try to have you hospitalized. Instead, they should work to understand your reasons for wanting to die, to help you feel better, to increase your hope and reasons for living, and to build up your coping skills. (I say “should,” because unfortunately some therapists and doctors overreact. Here are ways to try to avoid a therapist who panics.)
Children and Adolescents
At many psychiatric hospitals, the standards for hospital admission tend to be more relaxed for children and adolescents. The younger a person is, the more alarming it can be that they consider suicide. And adolescents tend to be more impulsive than adults. So what I wrote above about strict criteria for hospitalization may not apply as much to young patients, because of the extra caution that they warrant.
If You Do Need Psychiatric Hospitalization for Suicide Risk…
What are your fears of being hospitalized? Would you really rather die than go to a psychiatric hospital? If so, why?
Perhaps you fear being locked away for a long time. It might help you to know that, on average, people admitted to a mental hospital with suicidal thoughts or behavior don’t stay more than a few days. Once upon a time, a great deal of patients did remain hospitalized for months and even years. Those days ended in the 1990s, when it became apparent that many hospitals were keeping patients longer than necessary for the sole purpose of collecting insurance money.
Perhaps you think mental hospitals are like the ones in One Flew Over the Cuckoo’s Nest or other Hollywood movies. But these days, hospitals don’t use straitjackets. In fact, they’re not supposed to use restraints at all unless a patient is out of control and potentially violent. There are no bars on the windows unless it is a very old building. And nobody is forced to take “shock therapy,” more technically called electroconvulsive therapy (ECT). (Some people choose to receive ECT. It is a much safer, more humane procedure than it used to be, though it still can have dangerous side effects.)
What Happens If You are Admitted to a Psychiatric Hospital for Suicide Risk
There are some important things to know about what happens in a psychiatric hospital. If you are admitted, a nurse or therapist will interview you about your problems, thoughts and feelings, and symptoms. You’ll be asked to turn over anything that you could use to try to hurt or kill yourself. This includes things like shoelaces, sharp items like razor blades (called “sharps”), and belts. You might be examined without your clothes on, to ensure you aren’t hiding any weapons or pills.
During your stay, you’ll likely be evaluated to see if medication might help you. Depending on the hospital, you may participate in individual and group psychotherapy. You may have a room to yourself, or you may share. You probably won’t be able to keep your phone with you at all times.
There are definitely things that are scary about being in a psychiatric hospital. I’m not going to sugarcoat it: Bad things can happen in psych hospitals. For some people, hospitalization appears to make them feel worse than they did before they were admitted.
Even if nothing outright awful happens to you in a psych hospital, everyday aspects can be hard to deal with. Staying with strangers, some of whom may have more serious problems than you, is frightening. Just as happens in any hospital, you don’t have much privacy. Being searched can be unsettling, even traumatic for somebody who’s been sexually abused in the past.
The unit is locked, and that can feel confining. You can’t come and go as you please. If you’re very dangerous to yourself, you might have someone who shadows you, watching you even when you’re using the bathroom.
All these measures, while unpleasant, are intended to keep you safe. Suicides occur even in psychiatric hospitals, so every effort is made to protect you from killing yourself.
Someday, even if it’s hard to imagine now, you may even be thankful that you were protected in this way.
*
Copyright 2013 Stacey Freedenthal, PhD, LCSW, All Rights Reserved. Written for Speaking of Suicide. Photos purchased from Fotolia.com, except where noted.
psychiatric wards are actually pretty traumatic , and “help” can actually make people worse sadly, especially when empathy is lacking in psych wards. They are not safe or good spaces, and they do still abuse patients. And yes, due to traumatic events that take place in these places, some people may actually feel like dying is a more logical option than being treated at one of these places.
Exactly
So very true. The last time I was hospitalized, I lied in order to get out and actually attempted suicide a few days later. I don’t know why the lie of hospitalization being helpful is perpetuated.
My thoughts exactly!! I had a terrifying experience, and I would rather die than go back to a mental hospital. If anyone only knew……
for context, i’m 16. i have attempted suicide three times within the past year, and have been self harming since i was 12. i have never told anybody about my problems only told my mom that i’m always “sad.” i have a doctors appointment in two weeks and am thinking about telling them about it. i have been struggling a lot and suicide specifically has been in my mind a lot the past month and i want it to stop and i want help. would telling my doctor about all of this maybe get me the help i need? will i be admitted?
Hey you are worth more then you know, suicide is only a way out of all the great things you can do in this world for other people maybe even be a counselor for suicidal people so don’t give up and do this because that would make the devil so happy which means he has you forever, show him your stronger than that and live on have babies get married and make yourself proud and make God proud of you then you will have hope forever. Don’t forget you are a good person and Gods child and worth everything and yes tell someone so you can get started on a brand new life. God bless you sweetie
Please tell them, sweetheart. Going to the ER and then a facility changed my life. The ER experience was so hard, but the facility I went to was a gift from God. And you may not even need to go ? you are not alone. Many of us are struggling. Reach out. Sending love
-a 24 year old version of you, who loves and cares about you.
Ps, tell your doctor. The support means everything.
I know this comment is years old now but to anyone reading this in the future who has the same question, the decision is entirely up to you. if you want to do it, do it. if you don’t want to do it, don’t. i hate it that other people are insisting on doing it like it’s the only rational option when it hasn’t worked for everyone. also, i know i might sound annoying for saying this but unless the person says they believe in god or a religion, please keep the responses secular, Barbara and Sami. it’s not respectful to assume that everyone shares your beliefs, or that your beliefs are right.
I have made 3 suicide attempts two recently on friday and saturday and I know that obviously I need help but I know my mothers reaction will be her trying to tell me that I dont have stress cos im 13. I started sh [self-harm] at 11. I stopped now roughly a month ago. I always struggled with my mental health as my mother wasnt the most comforting like at all when it came to emotions so I learned to bottle everything up and then I started exploding at people and myself and I couldnt eat properly and would just not eat. I just need advice on how I should ask for help from someone
Theone,
Thank you so much for reaching out here. You must be hurting badly or otherwise under a lot of stress. The thought of you having attempted suicide twice in the last few days and being all alone with that breaks my heart. I’m relieved to have the opportunity to urge you to PLEASE tell someone.
If you don’t want to talk with your mom and you’re in the U.S., you could call 988 to reach the National Suicide Prevention Lifeline. The counselor call call for emergency help for you or problem-solve with you about telling someone (or both).
Do you have any other adult in your life you could tell? Another parent, an aunt or uncle, a minister, a teacher, a school counselor, your family physician? A friend’s parent could help, too.
You also could call 911 and tell the operator you’re suicidal and need help, and the police and/or paramedics would come to take you somewhere. That might sound extreme, but if it’s your only option, please do it!
Another option is the Crisis Text Line at 741741 (just text HELLO or HELP or whatever you want). Unfortunately, I’ve heard from people that they’ve had to wait hours for a response, so if they can’t help you right away, please try somewhere else.
I list some other resources at http://www.speakingofsuicide.com/resources/#immediatehelp.
You need help, and you deserve not only to stay alive, but to have a life worth living. I hope you experience all of those. Please, tell someone who can help you stay safe and get help. Thanks again for writing here.
Theone,
I understand. When I was a little younger than you I asked my mother to put me in counseling. She signed herself up for counseling instead and said, “When I’m well, you’ll start to feel better.” A year later I got the nerve up to ask if I could see her counselor. During that meeting I tried to tell him that I was in pain. He proceeded to grill me on what type of pain? Shoulder? Stomach? Head? I didn’t have the words then so I said constant headaches. He told my mother that I was experiencing tension headaches and that I was “stressed out” from my home life (alcoholic father).
But today I know the pain was not stress. It was metal illness. It was not “tension headaches” but psychic pain caused by the struggle against suicidal ideation. When we self harm we get a slight relief from this pain because our brain is flooded with dopamine…but as those chemicals dissipate the psychic pain returns and more urgent. I wish I had the words and confidence I needed to get help then. Instead I held on by the skin of my teeth, fighting those thoughts and managed to survive until I got proper help years later.
I know how quickly our wills can crumble in the face of rejection so I suggest you bypass your mom just this once and talk to your best friends mom or an aunt. They are less likely to jump right to denial. And say these words: “I am a danger to myself. I keep have recurring thoughts of taking my own life. I’m afraid to tell my mother so will you be my voice? I need to see a doctor right away.”
If this seems too hard to say, write it down and give it to someone. I’m praying for you.
i’m suicidal, but knowing how my family would hurt keeps from going through. 2 questions
1. does it count as a suicide attempt if you talked yourself out of it?
2. ive felt this way for 3 years. how urgent or non essential is it to get help? should i wait for it to pass?
1. You are describing suicidal ideation. Though it is not an attempt it is very dangerous.
2. It is both essential and urgent that you get help. Anyone who has committed suicide has simply lost their battle fighting against these vicious ideas. You are correct it will pass but you CAN feel better and experience these thoughts less often with help. There are medicines that can reduce the cycling and therapies that can help you stay ahead of or if necessary, endure the wait time. Any doctor (but preferably a psychiatrist) can help you.
I honestly have the same feeling, I do belive that it wouldn’t count as an attempt if you talked yourself out of it.
A doctor gave me medicine that made me more depressed than I was before. I could not exercise and could not cook my meals and could not contact my sister and it was just horrible. The medicine was Citalopram and I told him I needed something to help me sleep. I have no friends and my sister will not speak to me. I am all alone and just have to do all the things that I did when I was a teenager. I was tested for my IQ and it was 189. I have 5 college degrees and 5 minor degrees. I am a minister who loves the Lord and trust that in the end all will be fine.