During assessments, I will at some point ask, "Do you have a wish to be dead or thoughts of hurting yourself?" It can be very disconcerting to see a patient hesitate to answer. I've seen this reaction numerous times, and what I hear is, "I'm afraid to tell you because I know you will send me to the hospital.
"Yes it is true that as licensed professionals we are mandated to report if we suspect that someone is at risk to hurt themselves or someone else, but as a trained professional I know that thoughts alone are not an indicator of a potential suicide threat. There are risks and protective factors. I have no trouble or hesitation in taking the steps to have someone hospitalized if it is necessary, but I find that If I am working with a client who is honest and willing to work on and adhere to a safety plan, I can usually treat that person without having to hospitalize them.
What is a Safety Plan?
A safety plan is a plan that collaboration between a therapist and the client that results in a kind of personalized instruction sheet that the client can use when they are approaching a potential crisis. It empowers the patient to recognize signs that a crisis might be coming ( Intrusive thoughts, Isolation, heart palpitations for example), coping strategies that you can use, people or resources that you can reach out to , ways to make your environment safe, and reminders of what you have worth living for. Safety plans work because they build on the individual's strengths and empowers them to cope with the situation.
If you find that you have feelings of hopelessness and thoughts of hurting yourself, please reach out to a qualified professional and work on finding your hope again. Listed below are helplines if you are feeling suicidal.
Free 24/7 support at your fingertips US and Canada: text 741741