Mental Healthcare costs thousands of dollars and is hard to access? That's crazy!
Mental Healthcare costs thousands of dollars and is hard to access? That's crazy!
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27 comments
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CW self harm and suicidal ideation
Depending on where you are, please be honest with your therapist. Usually they can't (and don't want to) get you committed unless they're convinced you're in immediate danger of badly harming yourself or others. If that's the case, maybe going to the hospital isn't a bad idea. I've talked to my therapist about suicidal ideation, frequent dreams about suicide that I found pleasant, and about self harming, and she never even considered it. All she did was refer me to a psychiatrist, but I wasn't forced to see her, let alone committed to a hospital.
Do look up whether the rules are different in your country, though.
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As a therapist, I totally agree with what you’ve written above. However, I also have the unfortunate experience of working with mental health providers (mainly psychiatrists in pill-kiosk roles) who will send patients to the ER if they mention any suicidal ideation out of a paranoid fear of losing their license. Thankfully, ER doctors tend to actually assess the seriousness of said ideation and don’t admit people who aren’t seriously considering self-harm, but it’s still an ordeal.
So, I would simply add to your advice that if any mental health provider calls 911 at the mere mention of suicidal thoughts, get yourself a new provider immediately. That provider either hasn’t learned how to properly assess suicidality or is too chicken-shit to do it (far more likely, the latter).
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Thanks for the professional insight!
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Doesn’t make sense to send people to the ER? I’ve read too many tales of people going themselves or taking someone else and the ER kinda shrugs because they’re not equipped to really deal with whether or not to commit someone, or if they can hold someone, it’s usually only for very short periods of something like 24-48 hours.
If you have any insight that would be great.
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So, not all hospitals have inpatient psychiatric facilities, but most have emergency rooms. If they aren't equipped with an inpatient facility, obviously there's no place to admit them to and all they can do is either keep them in the ER for a few days for observation or send them to a facility that does have an inpatient psychiatric unit. Also, if they don't have any psychiatric units at all, I can see how their ER might lack a mental health provider who can adequately assess a person who comes in on reports that they reported suicidal ideation in a therapy session with their outpatient provider. However, any hospital with an inpatient psychiatric ward will usually have what's called a comprehensive psychiatric emergency program (CPEP), which is effectively a psychiatric emergency room (sometimes integrated into the actual ER, sometimes not), and they obviously will have psychiatrists to assess patients who come in during mental health crises.
My point was simply that outpatient therapists and psychiatrists are fully capable of assessing the seriousness of a patient's suicidal ideation and that a trip to the ER isn't always necessary. Patients should only be sent to the ER against their wills when the outpatient provider is not convinced that the patient won't harm themselves before their next session.
Sorry, I know that was wordy, but I hope I answered your question.
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That helps, thank you.
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27 comments