What happens if you tell your therapist you're suicidal?
TALKING ABOUT IT IS THE FIRST STEP TO STAYING SAFE
Estimated read time: 5 minutes
By Jackie Menjivar
(Marcus Dall Col / Unsplash)
Warning: Content discussed addresses suicide.
Suicidal ideation (thinking about suicide or ending your life) is more common than you might think. Millions of people experience it at some point in their lives.
It isn’t a moral or personal failure to have these kinds of thoughts. They may even be a symptom of a larger mental health condition. Yet, for a lot of people, there’s still a lot of apprehension around disclosing your suicidal thoughts — especially to professionals. You might worry about being involuntarily hospitalized if you mention suicide in your therapy session.
Just because you talk to your therapist about suicide doesn’t mean that you’ll be hospitalized. There are several other interventions that they can try first. So let’s clear the air about talking to your therapist about suicide.
Should I tell my therapist that I have suicidal thoughts?
Yes! Talking about suicide in a session may feel uncomfortable or scary, but your therapist is there to support you — not punish you.
“While therapists are mental health professionals equipped to handle these conversations, they are also deeply human. Your therapist understands how difficult, uncomfortable, taboo it may be to have these conversations surrounding suicidality and mental health,” says Kathryn Lee, a psychotherapist in private practice in New York City. “You may find that your therapist may meet you where you are with empathy and compassion; some of us have also experienced suicidality, trauma, mental health disorders, etc. We are here with and for you.”
You can’t fix the problem if you don’t even acknowledge that it’s there. Suicidal thoughts are a symptom, and you need to talk about your symptoms to get proper care. You’d tell your primary care doctor if you had a runny nose or sore throat, right? Mental health works the same way. Trust that your therapist will act with compassion and work with you to figure out what’s going to be most helpful for you.
How do I talk to my therapist about suicide?
Be straightforward and honest. Dancing around the topic or avoiding questions about it might actually make your therapist more concerned about you and your safety (because they don’t have enough clarity to tell otherwise). Talk openly about what you feel, how often it happens, and how intensely you feel it.
It’s also totally okay to talk to them about your concerns too. If hospitalization is something you’re worried about, let them know. Ask questions about confidentiality and treatment options. Remember that therapy isn’t something that happens to you. You’re a part of this process too, and your therapist is there to walk you through all of it.
What will my therapist do if I tell them I have suicidal thoughts?
They’ll probably ask you some questions about it. There’s a wide spectrum for suicidal thoughts, and your therapist will want to understand what you’re personally experiencing.
For example, there’s a difference between sometimes wishing you were dead and having a plan to attempt suicide. Your therapist will need the specifics to find the best treatment option for you.
“They may ask if you have a plan, timeline, access to medications, weapons etc,” says Kathryn. “If your therapist has not already asked you, they may ask about how frequently you experience these thoughts and if you have experienced suicidal ideation in the past.”
When your therapist asks you these things, they’re also assessing your risk of hurting yourself. Each therapist has their own standards for what they consider high- or low-risk. In general, if you already have a plan in mind and a way to carry out that plan, they’ll need to escalate the situation to keep you safe.
Just remember that your therapist isn’t interrogating you for some kind of wrongdoing. When they ask questions, it comes from a place of curiosity and empathy. They can’t help you unless they know exactly what’s going on.
Will my therapist report me or hospitalize me if I tell them I have suicidal thoughts?
Therapists are ethically and legally required to report if a person is a danger to themselves or other people. Again, that usually means you have a plan to end your life, and you have the means to do it — but every therapist assesses risk differently!
Who they report to depends on state and local laws, but it’s usually some kind of public health authority with the power to enforce involuntary treatment. If you’re under 18 and your therapist thinks you’re at serious risk of hurting yourself, your parents will probably be notified.
Keep in mind that this usually only happens when there’s a really high level of danger. Your therapist probably isn’t going to jump into emergency-mode at the first mention of suicidal thoughts. Fear of escalation shouldn’t keep you from reaching out and getting the help you need.
How can my therapist help me if I tell them I have suicidal thoughts?
Hospitalization isn’t the only way to respond to suicidal ideation — and in most cases, it isn’t necessary. It’ll depend on your specific situation and therapist, but here are a few potential treatment options:
More frequent sessions. You may need to meet more frequently with your therapist, potentially multiple times a week. In your sessions, they can help you address the reasons behind your thoughts and build up your coping skills.
Developing a safety plan. Your therapist can help you put together a plan to help you manage your suicidal thoughts and stay safe. You may work together to identify your triggers, coping strategies, people to reach out to, and other resources for crisis care.
Medication. If they suspect a chemical imbalance is contributing to your thoughts, your therapist may recommend that you start on medication. If you’re already on medication, you may need to change medications or adjust your dosage.
And, yes, hospitalization may be necessary if other interventions aren’t helping. Learn about how hospital treatment works, and read the experiences of people who have been hospitalized for their mental health.
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You don’t have to deal with these thoughts alone. Opening up about them is an important step in your recovery, and it shows an incredible amount of courage and strength.
If you’re struggling with suicidal thoughts, the 988 Suicide and Crisis Lifeline can provide free and confidential support and connect you to other resources. Or text IDM to 741741 to get connected with a crisis counselor from the Crisis Text Line, available 24/7.