What Happens If You Tell Your Therapist You’re Suicidal?
Therapy, for many people, is a central component of recovery from mental health conditions such as depression, anxiety, OCD, PTSD, and many other diagnoses.
Even if you don’t have a diagnosed mental health condition, therapy can be a useful space for processing your thoughts and feelings in your everyday life.
After all, therapy is a confidential place to talk to a professional about both your internal and external life.
However, there are some circumstances in which a therapist may be forced to break confidentiality, and one of those instances is where a client informs their therapist that they are suicidal.
If you are having suicidal thoughts, feelings, or plans, it is important to be honest with your therapist so that you can get the help you need.
It often helps to know what will happen when you divulge this information to your therapist beforehand so that you can be prepared and take the next steps on your mental health journey armed with knowledge.
Read on to find out what happens if you tell your therapist you’re suicidal, and why doing so is important.
Why Should I Tell My Therapist I’m Suicidal?
Understandably, many people experiencing suicidal thoughts or feelings are reluctant to share this with their therapist. This could be due to the remaining societal stigma of suicide or for fear of what will happen if they do.
However, it is very important to let your therapist know if you are having thoughts of suicide. It is especially crucial that you tell your therapist if you have made any plans to act on these thoughts.
If you have made any suicide attempts in the past, this is also information that your therapist should know.
If you are feeling suicidal, it is essential that you receive the right help to keep you safe. This can’t happen if you don’t tell your therapist how you are feeling.
Many clients are scared that if they tell their therapist they are suicidal, they will immediately be sectioned against their will.
However, this only happens in rare, extreme situations where a therapist believes that their client is in danger of immediate harm to themselves or others.
Therapists approach situations like these with sensitivity, following a step-by-step process to determine what kind of help you need and how to get it for you.
Remember: your therapist is here to work with you, not against you, and your safety is their priority.
What Happens Next?
1. Assessing Your Suicidal Thoughts
The first thing your therapist will do when you tell them you are suicidal is to ask you further questions to assess the nature of your suicidal thoughts and feelings.
Contrary to popular belief, discussing suicidal thoughts does not necessarily mean that a person will act on them. Suicidal ideation is different from suicidal intent.
However, it does indicate that they should receive help and support.
Questions your therapist might ask include how long the suicidal thoughts have been going on for, what kinds of thoughts you are having, what typically triggers these thoughts, and whether you have any plans to act on them.
You might also be asked whether you have any firearms in your home, whether you are taking any medications, and what your living situation is like.
This might be an uncomfortable conversation, but it’s important to answer these questions as honestly as possible so that your therapist can take the necessary steps to keep you safe.
2. Making A Safety Plan
If you don’t have any immediate plans to harm yourself, your therapist may decide that the next appropriate step is to work with you to create a safety plan.
A safety plan is a helpful document that will guide you through the process of managing your depression symptoms and suicidal thoughts as well as seeking help if you ever do feel that you are at risk of suicide.
Typically, a safety plan for suicide will include the following elements:
- Triggering situations and how to navigate/avoid them
This is about recognizing when your suicidal thoughts tend to occur and how you can either exit or stay calm when your suicidal ideation is triggered by a specific situation.
- Distractions for when suicidal thoughts arise
When you feel suicidal, it can be difficult to think of things to soothe and distract you. A list of distracting activities can be really helpful.
- Mental health tools to use when feeling suicidal
This will be a list of tools and techniques you have learned or are learning in therapy to ground and calm yourself when you feel suicidal. Meditation, CBT techniques, and grounding exercises may be included.
- Instructions for creating a safe environment
When you notice warning signs of suicidal thinking, you should immediately try to create a safe space for yourself. This includes removing (or having someone else remove) any potentially harmful objects or medications from your vicinity. Your therapist will outline ways to achieve this in your plan.
- Reasons not to act on the thoughts and feelings
Life can seem very bleak in the midst of suicidal thinking. Preemptively writing down reasons to stay alive while you are in a better headspace means you don’t have to search for them while you’re in crisis.
- Contact information for your support system
This should basically be a list of people you trust and can talk to about how you’re feeling, along with their contact details. Easily accessible contact information will make it easier to reach out when you’re struggling.
- Professional contact details
Sometimes, when suicidal thoughts take over, following a safety plan can be overwhelming.
If you feel at risk for suicide and don’t feel able to follow your safety plan, this is an emergency situation, so you should have all relevant medical and emergency contact numbers in your safety plan.
2. Contacting Your GP
If your therapist is concerned about your suicidal thoughts, they might decide to contact your GP.
They will ask for your permission to do so first, but they may need to break confidentiality if you are deemed to be at risk for suicide and refuse to involve your GP.
Your GP can help by referring you to other appropriate mental health providers or services, and discussing things like antidepressants and anti-anxiety medication with you.
3. Referring You To Hospital
Your therapist will only refer you to the hospital as a last resort.
For example, if you have made a plan to end your life, have everything you need to carry out the plan, and informed your therapist that you are going to act on them imminently, hospitalization may be the safest option for you.
Ideally, a client will agree to go into hospital and get help, but if they refuse to do so and all of the above applies, the therapist may need to break patient confidentiality and contact the authorities.
Sectioning may be the next step from here, but again, it is a last resort.
Being hospitalized for your mental health may be a frightening experience, but try to remember that the doctors and your therapist (who will work with the hospital to get you the best care) have your best interest at heart and want you to feel better.
Telling your therapist that you are suicidal can feel scary, but it’s important to do so.
Disclosing suicidal thoughts to your therapist will not automatically result in hospitalization, and most often, your therapist will help you to make a safety plan.
If you need additional treatments or referrals, they may involve your GP, ideally with your permission.
If you are at immediate risk for suicide, you may need to be treated in hospital, but this will always be a last resort.