What happens if you tell your therapist you’re suicidal?

In this blog, we will discuss what are the possible things that could happen if you tell your therapist that you are suicidal. 

We will also discuss what is the best way you can discuss suicidal ideation with your therapist.

What happens if you tell your therapist you’re suicidal?

When you tell your therapist that you are suicidal, here are the possible things that could happen:

Individual and unique responses

Every therapist will respond differently to your disclosure of suicidal ideation and even attempts in the past.

Each therapist will have a unique response but it is very likely that your therapist will ask you more questions regarding your suicidal thoughts. They will ask some more question about your suicidal ideation and thoughts or past attempt history.

Some of the questions they might ask could include:

• How often are you having these thoughts? 
• How long do those thoughts and feelings last? 

Assess severity

An ethical therapist is someone who will ask you more questions and probe you for more context and information about your suicidal ideation and intent. 

By asking these types of questions, your therapist is trying to determine how intense those thoughts and feelings are and how much at risk you are for actual suicide attempts. 

They make effort to understand if you have any intention of dying because in most cases, suicidal individuals don’t actually want to die– they want to escape the pain and struggle they are facing. 

Understanding where you stand is important information for your therapist to know if the thoughts and feelings start lasting longer or feeling more severe. 

Uncomfortable conversations.

One of the major reasons as to why your therapist will probe and ask you a lot of questions is because they want to keep you safe. 

This means that they will be engaging you in some uncomfortable questions and conversations as well such as your personal schedule, if you have any means to suicide like guns and other weapons. 

They will also ask you about your family situation and the possibility of contacting them for your safety, if you family memeber can help assist you in keeping safe by locking the fire arm, separating you from any weapons etc.

Your therapist will also discuss your medications that you’re taking, if you’ve been saving any pills for a planned attempt, and if those medications could be locked up and monitored by someone else in your family. 

This is all in an effort to create a safety plan for you and while it could be uncomfortable to get other people involved, this effort to make a circle of trust is for your safety.

Reporting to authorities

Therapists are ethically and legally required to report if a person is a danger to themselves or other people. 

This also includes suicidal ideation and intention and if you have the means to, they might report to authorities depending on state and local laws.

If you’re under 18 and your therapist thinks you’re at serious risk of hurting yourself, your parents will be notified. 

Notifying parents and other authorities usually happens when there’s a really high level of danger. This means that your therapist will not report at the first and only mention of suicidal thoughts rather, if there is an escalation or they have reason to believe that you are in immediate danger- they will report the situation. 

Licensed psychotherapists generally also have a legal and ethical duty to protect their patient’s privacy. However, the law’s interest in preserving life overpowers the right to confidentiality trust they are mandated to report. 

It is understandable if you do not want your therapist to report your case however, when they do not report they can face legal issues themselves.

Issues related to reporting should be explained to you during the first meeting itself and should not come as a surprise to you, they will also discuss it during the session when you talk about suicide. 

Coping strategies

It is likely that your therapist will also help you make a plan and develop coping strategies that you can apply to help you deal with thoughts about suicide.

According to writers at PsychologyToday, some of the strategies they could use includes:

• More frequent sessions where you may be required to meet more frequently with your therapist. Depending on the severity and intensition it could be more an twice or thrice a week.
• They will help you in developing a safety plan which you and your therapist will work together to form a step by step plan to help you manage your suicidal thoughts and stay safe.
• One of the first strategy is to Identify the warning signs such as thoughts, feelings, behaviors, or situations that increases the risk of suicide and suicide ideation such as identifying suicidal thoughts such as “I wanna die” or “I should just off myself”.
• You can also use strategies that does not need other people, rather allows you to spend time doing things that calm you down such as listening to relaxing music, painting, drawing, or exercising. 
• If these strategies that you can do alone are not working, you can choose to contact people who can provide distraction and relief. Now, contacting people does not mean that you tell them everything but rather people that you love, that you feel comfortable with, and also people that you enjoys spending time with. 
• You can also engage in activities that will give you a sort of distraction and relief such as going shopping, watching a movie in the theatre, or going out for snacks and ice cream etc. 
• If the situation is intense, contact a friend or family member specifically to ask for help by disclosing one’s thoughts of suicide. The names and contact information of these people that you trust enough to disclose information to should also be provided to your therapist. 
• The final strategy that you can apply is to contact professionals or agencies, including your therapist or other emergency services in the case that your situation is dire and an emergency. 

Pharmacological treatment 

In the case that your suicidal ideation is due to a hormonal imbalance, your therapist will likely recommend you medication and pharmacological treatment or change medication or adjust your dosage since suicidal ideation is also a side effect of antidepressants and other drugs.

Hospitalisation

Another thing that could happen when you tell your therapist that you are suicidal is that they might report you and hospitalise you. 

However, Hospitalization is the therapist’s final option for dealing with suicide and will only bring up this when they suspect that you will attempt suicide upon leaving your appointment, or if you cannot agree on a safety plan, of if you have the means of attempting.

If you need to be hospitalized, your therapist will be infromed and they will receive updates on your care, and work with you to transition back to your normal life eventually.

Hospitalisation is only to keep you safe for the time being when there is no other means possible or if the coping strategies have all failed or they are not agreed on. 

While it could be scary to think that you will be hospitalised, it is only for your own safety and because your therapist is highly invested in keeping you alive. 

How do I talk to my therapist about suicide?

If you are wondering about how to tell your therapist about you being suicidal, the best way is to be straightforward and honest. 

Confidentiality is an important aspect of therapeutic care considering that trust is necessary for clients since most of what is shared is often something they would like to conceal from others or at times, the problem tends to be the parents themsleves. 

While a therapist must keep things confidential and it is part of their ethics to maintain confidentiality, there are limits to this confidentiality since therapists are bound by the ethical guidelines of their state license.

For your own safety, there are some exceptions to the rule when it comes to confidentiality in therapy. Generally, these rules have to do with the well-being of the patient or people in the patient’s life.

For example, therapists are required to report if a patient is a threat to themselves or others. This may mean the patient has threatened suicide, is repeatedly harming themselves, or has threatened to harm another person. In this case, a therapist may recommend hospitalization so the patient can be monitored. 

Once the patient is deemed stable, the therapist may then work with close friends or family members to develop a support plan for the patient in order to maintain that sense of stability.

You can bring it up in your session as it starts, avoid bringing it up at the end of the session. Doing so does not help you nor the therapist to be able to make efforts to help you. 

You have to remember that your sessions with your therapist are for you and dancing around the topic or avoiding questions does not do anyone good. 

Instead it might actually make your therapist more concerned about you and your safety. Giving your therapist good clarity by openly talking about what you feel, how often it happens, and how intensely you feel it is the best option for you.

Conclusion

In this blog, we have discussed what are the possible things that could happen if you tell your therapist that you are suicidal. 

We have also discussed what is the best way you can discuss suicidal ideation with your therapist.

FAQ related to What happens if you tell your therapist youre suicidal

What to do if you have a suicidal client?

Here are a few things you can do if your therapist is suicidal:

• Constantly monitor their suicidal thoughts 
• Be available, supportive and empathetic. 
• Be realistic
• Get positive support structure in place (familiy and friends)
• Make sessions more frequent 
• Make sure that ways and weapons for suicide is removed 

What questions to ask if someone is suicidal?

Some important questions to ask someone if they are suicidal includes:

• Have you wished you were dead or wished you could go to sleep and not wake up?
• Have you actually had any thoughts about killing yourself? 
• Have you thought about how you might do this?
• How often are you having these thoughts? 
• How long do those thoughts and feelings last? 

References

What Happens When You Mention Suicide in Therapy? PsychologyToday. https://www.psychologytoday.com/us/blog/think-act-be/201809/what-happens-when-you-mention-suicide-in-therapy

Should I tell my therapist I’m suicidal? Aspire. https://aspirecounselingmo.com/blog/should-i-tell-my-therapist-im-suicidal

Does A Therapist Have To Report Me As Suicidal If I Tell Her I Self Injure? MentalhelpNet. https://www.mentalhelp.net/advice/does-a-therapist-have-to-report-me-as-suicidal-if-i-tell-her-i-self-injure/

What happens when you talk to your therapist about suicide? I Don’t Mind. https://idontmind.com/journal/what-happens-when-you-talk-to-your-therapist-about-suicide