Will I Be Committed to a Mental Hospital if I Tell a Therapist about my Suicidal Thoughts?

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Helsingør Psychiatric Hospital. Photo used with permission from JDS Architects.

You may be seriously considering suicide and yet not want to tell a therapist, because you fear landing in a mental hospital.

If you go to a therapist or psychiatrist and tell them you are seriously thinking of killing yourself, that does not necessarily mean you will be hospitalized. Hospitals are very strict these days about who they admit, and insurance companies are equally strict about covering a hospital stay. Some people joke that it is harder to get into a mental hospital than Harvard University.

Who Gets Hospitalized


Suicidal thoughts are not usually enough to warrant psychiatric hospitalization for adults. Instead, you would need to be in imminent danger (or in some states substantial danger) of trying to kill yourself. This generally means you are intent on acting very soon on your suicidal wishes. Perhaps you already have a plan on how you would kill yourself, you have whatever you need to carry out that plan, and you have some intent to follow through on that plan very soon.

If so, then yes, hospitalization would almost certainly be necessary. If you do not consent to be hospitalized (that is, you will not voluntarily admit yourself), then yes, a mental health professional would need to intervene to get you to a safe place. The reason for this is that serious suicidal intent is almost always temporary, as long as the person stays alive. Consider that even among people who attempt suicide and survive, more than 90% do not go on to die by suicide.

So, if you are thinking of killing yourself but do not intend to act on those thoughts any time soon, then a mental health professional most likely will not try to have you hospitalized. Instead, they will work to understand your reasons for wanting to die, to help you feel better, and to build up your coping skills.

If you a serious danger to yourself, however, then every effort will be made to keep you safe until the crisis passes and you are safe to be out on your own again.

Children and Adolescents

At many psychiatric hospitals, the standards for hospital admission tend to be more relaxed for children and adolescents. The younger a person is, the more alarming it can be that they would consider suicide. And children and adolescents are more impulsive than adults. So what I wrote above about strict criteria for hospitalization may not apply to young patients, because of the extra caution that they warrant. 

If You Do Need Hospitalization…

What are your fears of being hospitalized? Would you really rather die than go to a psychiatric hospital? If so, why?

Doctor In Discussion With Nurse At Nurses Station

Perhaps you fear being locked away for good, or at least for a long time. Most people do not stay in a mental hospital more than a few days, even if they come in with serious suicidal thoughts. Once upon a time, a great deal of patients did remain hospitalized for months and even years. Those days ended in the 1990s, when it became apparent that many hospitals were keeping patients longer than necessary for the sole purpose of collecting insurance money.

Perhaps you think mental hospitals are like that in One Flew Over the Cuckoo’s Nest or other Hollywood movies. But these days, hospitals do not use straitjackets on patients. In fact, they are not supposed to use restraints unless a patient is out of control and potentially violent. There are no bars on the windows unless it is a very old building. And nobody is forced to take “shock therapy,” more technically called electroconvulsive therapy (ECT). (Some people choose to receive ECT. It is a much safer, more humane procedure than it used to be, though it still can have dangerous side effects.)

If You are Admitted to a Psychiatric Hospital

Doctor psychiatric patient interviewThere are some important things to know about what happens in a psychiatric hospital. If you are admitted, a nurse or therapist will interview you about your problems, thoughts and feelings, and symptoms. You will be asked to turn over anything that could be used to try to hurt or kill yourself. This includes things like shoelaces, sharp items (called “sharps”), and belts. You will be evaluated to see if medication might help you. Depending on the hospital, you may participate in individual and group psychotherapy. You may have a room to yourself, or you may share.

There are definitely things that are scary about being in a psychiatric hospital. Staying with strangers, some of whom may have more serious problems than you, is frightening. Just as happens in any hospital, you do not have much privacy.

The unit is locked, and that can feel confining. You cannot come and go as you please. If you are very dangerous to yourself, you might have someone checking on you every 15 minutes or fewer, or even shadowing you.

All of these measures are to keep you safe from yourself. Suicides occur even in psychiatric hospitals, so every effort is made to protect you.

Someday, even if it is hard to imagine now, you may even be thankful that you were protected in this way.


© Copyright 2013 Stacey Freedenthal, PhD, LCSW, All Rights Reserved. Written for www.speakingofsuicide.com


Photos purchased from Fotolia.com


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  1. Tom says:

    The problem with myself is that I get too scared that I might commit suicide in the future, whether it be 10 or 20 years and I do NOT want to but there are situations that have made me feel very depressed based on events and the problem is that I can just simply stop my medication for blood pressure and insulin for diabetes which if I don’t take, it will have severe consequences or do what I did years ago which will be deadly for me. I have to encourage myself to think positive and not let people put me down. From reading other posts, I get scared that if I’m committed to a mental health unit and the way the users on here are making it sound how mental health units are hell, that if that happens to me, it might make me stop my life support meds. If a mental health unit treats me like crap, its basically like them saying to me… once you’re discharged, get rid of yourself with unspoken words.

    I have traveled all over the world, and try to do activities to keep me occupied, but sometimes, I do get depressed on the trips where I’ve even had thoughts but ya know, I do come around. I am currently on a antidepressant, but sometimes, someone can just push the wrong button on me and make my mind go a different direction to where I want to hurt myself. For example, I was threatened to be beat up just for defending myself. It made me feel so worthless, I really thought of hurting myself.

    A few years ago on a trip to Europe, while on a cruise ship, I got threatened by a passenger and it just frightened me so bad, It made me have those thoughts and I just wanted to get off in a country and poison myself, but the situation got better as the cruise ship followed the procedures on the threat and felt much better. I’m just to quick to act.

    Right now, I feel fine and NOT suicidal, but I do get the thoughts and I wish I wouldn’t.

    • Stacey Freedenthal, PhD, LCSW says:

      Tom, thanks for your insightful comment. It sounds like sometimes suicidal thoughts overtake you, unbidden, and they understandably frighten you. It is a good sign that you wish the thoughts would stop. If they come again, please consider calling the National Suicide Prevention Lifeline at 1.800.273.8255 (TALK).

      I found myself thinking of two things while reading your comment. One, I wonder if you have received any psychotherapy or even read many psychology-type books on healing depression, in addition to the medication you take. Because of your motivation to approach problems differently, you might really benefit from therapy or self-help. Both can result in long-lasting change.

      I also want to address the negative comments that others here make about psychiatric hospitals. Keep in mind that people who are happy with services, whether at a restaurant, hairdresser or a psychiatric hospital, are a lot less likely to comment if their experience is normal or even good.

      Keep in mind, too, that if somebody spent time in a psychiatric hospital, benefited from the treatment they received there, and moved to a place in their mind where they no longer felt suicidal, then they are not likely to come to a website for people dealing with issues related to suicide.

      I don’t mean to discount the negative comments here. People have raised serious and troubling issues about how psychiatric hospitalization, especially against one’s will, can be traumatic. And yes, it could be devastating to go to a psychiatric hospital and receive inferior care. Hospitalization can make some people feel worse.

      To me, this is like surgery to save a life. Sometimes surgery works, and the person recovers. Sometimes it produces greater injuries. Sometimes it doesn’t work. Still, millions of people choose surgery for life-threatening conditions.

      If someone is in serious danger of suicide – if a life is at stake – it seems worthwhile to work toward safety and recovery, even if (and especially if) at some point it becomes necessary to stay a brief time in a psychiatric hospital.

  2. Tom says:

    It’s always a blessing when a person is suicidal that they tell someone and that person either calls the cops and convinces them to get help because they care. If the person who is suicidal really wanted to carry on with their plan, they would just do it. I myself am a suicide survivor and had a near death experience and I regret doing what I did because it was over something very stupid and I rather not tell what I did, but I was in the hospital for 2 weeks in the ICU all because somebody called my house to tell them that they thought I was having a stroke. A Psychiatrist did talk to me and I told her that I am no longer suicidal and It was a terrible mistake I made and I did not have to be evaluated once she saw I was no longer suicidal.

    What I don’t understand about the mental health unit is that some do not care to help the patient and just warehouse them there. Do they realize that after the patient is discharged, that patient is more at risk of committing suicide because now, the mental health unit just upset the patient even more. Taking dangerous items away obviously makes sense, but what matters more is what happens after discharge. Does Medication necessarily help?

  3. Alex says:

    Once again, I get denied employment due to my past mental health issues. My 4.0 GPA. means nothing, My EMS skills are worthless because of a situation that happened YEARS ago. This makes me come to the realization that as important as seeking help is, when it’s needed, it comes with a price. So, my advice to any medical professionals is… Keep it under your hat, don’t talk to anyone if you are having issues if you want to keep your job, move forward or advance in your field. It’s not going to happen for you. The same for military, keep any PTSD issues covert. Your security clearance is over, sad but true.
    I don’t give this advice lightly. I know only too well the importance of seeking mental health help. And I know only too well the price that comes with it. I am saddened with this realization.

    • Stacey Freedenthal, PhD, LCSW says:

      Alex, I’m so sorry to hear about your continued struggles. Have you consulted an attorney? Employers in the U.S. are not allowed to ask about health conditions during the interview process. And if they do, you are allowed to decline to answer. If you are not being hired solely on the basis of past psychiatric treatment, the law is being violated. Please see http://www.eeoc.gov/facts/jobapplicant.html for more information.

      For the sake of others reading comments here, I want to challenge your sense that getting mental health treatment will stop everyone from getting a job or advancing in the field. That simply is not true. I know of a great many successful professionals in the medical field (and other fields, including the military) who received mental health treatment without any negative effects on their career. Of course there are exceptions, and you seem to be one of them. But the fact is, you can’t know just from looking at someone whether they have received mental health treatment. So you don’t know how many people out there have such treatment and are thriving.

      Again, I’m really sorry about your struggles and wish that you were not getting turned down by prospective employers. But…I think it does a disservice to tell somebody who is hurting so badly that they want to end their life that getting help will only hurt them. It can help. It often does.

      Alex, please do consider consulting an attorney. Employers should not be asking about your mental health history in an interview for an EMS position!

  4. TiredClinicalStudent says:

    I have been reading this article quite a bit lately and I have a question: what do you do if psychiatric care is what is making you suicidal?

    I ask because my partner recently got sectioned for the fourth time under particularly violent circumstances. she attended the ER with suicidal ideation and when the nurses saw her previous history she was wrestled to the floor made to strip and then forcibly medicated.

    so now she is in the hospital and the doctors are curious about her triggers. While she has anxieties about issues like work and family she told me that she particularly finds psychiatric treatment particularly troubling. medications are a big part of this as she suffers from serious side effects and finds the constant swapping of medications grueling and it played a significant role in her last two hospitalizations.

    so now we are in a catch-22. she won’t be released until she stops having suicidal ideations but the care she is receiving is encouraging her suicidal thoughts.

    • dave says:

      I know the feeling. I think the best option is for her to play the role of a recovered patient, even if she isn’t. That will both help her get discharged from hospital and also there will be the “fake it till you make it” effect which should actually help her recovery. Otherwise she will be controlled by the psychiatric system!

  5. Jon says:

    I’ve been reading the comments to this article and I find it a bit curious: why are so many people commenting on the fact that their involuntary stay was horrid? Is the fact that they are commenting at all actually a good sign? It means they did not go through with suicide after all.

    The reason I’m looking at these topics is that I feel like I should visit a psychiatrist. I mainly want to go to find something to make me do things. I have an issue with never actually doing things and hating things such as work. It’s difficult to say whether it would interfere with my normal life, as my life hasn’t really been very unusual and different. It could be because of the same reasons. I’m a bit afraid that I might not want to be completely honest with the psychiatrist – I have some pretty unusual thoughts about the world and myself. I do not place much value in my own life, but I realize that instinctual reflexes will try to make me stay alive as much as possible. Anyways, I’m rambling, I’m afraid of telling everything to a psychiatrist because it’s a bit embarrassing (I can deal with that) and scary. It’s scary because there is such a thing as involuntary commitment.

    The problems comes from the fact that involuntary commitment is literally my greatest “rational fear”. What I mean by “rational fear” is that if I think of all the things I am afraid of the most in a logical sense, things I would not want happening to me, it would be involuntary commitment. Torture would be up there too, but it does not come close to #1. The reason for that is that torture is considered to be a bad thing. Society condemns torture, but it doesn’t do that to involuntary commitment. It is considered a good thing, yet I can easily see where it would be the same as torture.

    I realize that the likelihood of it happening are minuscule, but whether something seems dangerous to me isn’t based purely on the likelihood of happening. I have to also take into account the magnitude of the effect that such an event would have (eg the chance of winning the lottery is small, but the magnitude of the event is so large that to a lot of people it seems worth playing).

    The reason as to why I think involuntary commitment is bad is because it is involuntary. There is no other process which removes a person’s (my) rights without due process. You can argue that there is due process in involuntary commitment, but in reality it’s just the word of two physicians. Ones that often know each other or even agree with each other. There are cases where this is done in error, there are also cases where this is done maliciously – eg Gustl Mollath in Germany. Psychiatrists are just people, the likelihood that one of them could be annoyed and become vindictive exists. There is also the risk that what they (and other people) believe is right differs from what I believe. I, for instance, think suicide in certain cases (that aren’t extreme) is legitimate. Of course the reasoning should have sound logic, and the reasoning should probably be explained to someone and another person at another time (like a month later) just to make sure this isn’t a spur of the moment thing, but I do believe that it is legitimate. I do not know of any other person in real life who shares this belief with me. In fact, I would not want almost anybody that I know in real life making psychiatric decisions for me – I do not believe they would be thinking of what *I* would want, but rather what *they* would want.

    So all of this puts me in a conundrum: if I don’t ever contact a psychiatrist the chances of me ever being committed involuntarily are close to nil – probably many orders of magnitude lower than if I did. It is by far the biggest fear I have, because I am not exactly normal and don’t adhere to norms. I probably have a mountain of issues, just like everyone else, so this issue seems like a risk. Of course, my current plans do involve seeing a psychiatrist, but I still can’t shake the feeling that I am making a mistake with this. One that can never be taken back.

    How do I deal with the fear of a psychiatrist due to involuntary commitment? It’s not a fear I can just conquer because the likelihood of it ever happening is so low a trip or two there won’t really ease my fears. I also feel that bringing this up with a psychiatrist at any point in person is a very bad idea.

    Thank you for your time!

    Oh, one final thing: what about the 10% that did go on to commit suicide again? Wasn’t their freedom literally violated and they were forced to comply with threat of violence? Is that really an okay thing in our society?

    • Alex says:

      Why do you fear going to see a Psychiatrist? If you are having thoughts of self harm then go see a Dr., Call 911.Talk to a friend or family. If you think you are going to be IVC’ed. for having thoughts out side of the norm, don’t worry about it. Unless you are currently suicidal and have a plan of suicide you have a slim to none chance of being detained against your will. The only advice I can offer to you, not knowing you, is, seek help if you feel you need it. Peace. Alex

    • dave says:

      Ideally it sounds like you need to consult a professional with whom you can feel confident will act in your best interests to achieve the outcome you desire and that you remain in control. Addressing issues like motivation is not easy and if you want to try antidepressants, you will need to consult a doctor (family practitioner or psychiatrist). I suspect psychological techniques would be a good starting place though, so it may be that a psychologist or alternative practitioner would have something more useful to offer than a psychiatrist. Goal setting, planning, visualisation, small chunking, lifestyle improvement, time management, diet exercise etc if you haven’t already pursued these techniques. They are without side effects, may be more effective than medication, will boost your ego if you are successful and you can be confident you will remain in control to avoid admission.

    • Jon says:

      Alex, I explained the reasoning why I fear it – they simply hold too much power. There is no other aspect where it is legally possible for this kind of abuse (and misunderstanding) to occur. You say that I shouldn’t worry about it, but that’s what I’m literally asking about. What you just said is akin to “Hey, I have depressioon.” “Just get over it, stop being depressed.” I feel that the fear is completely rational and that many people just either don’t know the possibility and ease of such a process or trust law enforcement and doctors way too much to see this happening, or a combination of the two. And, again, it doesn’t matter that the likelihood is low – the magnitude of such actions is so vast that it simply ranks it at a high position in the list of worries.

      dave, the particular issues don’t matter here. I simply brought them up for background information. All the things you mentioned don’t work. They simply don’t work because to start doing them you actually need to put in the effort to start doing them and I simply don’t have such effort to give. But again, the exact details don’t matter.

      I’m interested in how to deal with this fear, rather than the other problems. This fear won’t go away regardless of any of these other issues, because to me it’s a completely rational fear – it is a complete oversight in the law and how human rights factor into it.

  6. name says:

    I heard these before, I believed it. But, now I know the reality: you are secluded, because of “procedure”. Intentionaly false diagnosis. yes, there are bars at windows. there are guards ready to seclude you if you are angry eaven you have a normal reason for it. Psychiatric drugs work like all drugs: they make you imposible to respond and they don’t resolve the symptom. antipsychotics are, in fact, tranquilizers. I realized soon that the only way to escape is to be “compliant” to admit that you have a serious mental illnes and the treatment is wonderful. find another way, never go to a psy.

    • Anonymous says:

      I agree I will never go to another hell hole again talk to friend and family somebody who knows and has your best interests at heart

    • Stacey Freedenthal, PhD, LCSW says:

      “Anonymous,” I’m sorry that your experience was negative. It must have been pretty awful for you to consider the hospital a “hell hole.”

      Your suggestion to talk to friends and family is good, but it might not be enough if someone is in a highly dangerous suicidal state of mind. Keeping a dangerously suicidal person safe can be too big of a job for friends or family.

      How do friends and family their suicidal loved one from acting on suicidal thoughts? They can’t be expected to remove all potential suicide methods from a home, watch their loved one 24/7, physically overtake their loved one if the suicidal person decides to attempt suicide in their presence, keep the suicidal person from leaving the house, etc.

      I write about the limitations that people face when trying to help a suicidal person in this post: “You Can’t Do Everything: Limitations in Helping a Suicidal Person.”

      As I note in the post, even psychiatric hospitals cannot ensure the safety of a suicidal person. But, if the suicidal person truly is dangerously and imminently suicidal, hospitals have more resources to ensure the safety of suicidal people than lay people do. At least a hospital can keep its doors locked, have staff monitor the person 24/7, and keep the environment free of knives, shoelaces, razor blades, scissors, belts, scarves, blow dryers, hanging rods, and other commonplace instruments of death.

  7. Ben F says:

    I was at the hospital for 5 days, and it wasn’t an enjoyable stay, but I made it through OK. I’m very angry with the doctor who did it to me. And also, I have a story to tell about why I ended up there.
    Everyday in the summer, my grand-aunt took me to her house. We did everything together. Went everywhere. To stores, to restaurants, etc. And then, my world changed. She sold the house. The house I had spent my whole childhood at. So I cut myself many times, and had serious suicidal thoughts, so I was sent to the hospital.
    I had spent many years at that house, and she was forced to sell it. I know there are people out there with worse problems than me, but still, I am currently very sad.

  8. Mari says:

    Yes, I would rather die than be incarcerated without any rights. To be forced to take drugs, etc…yes. It is for this reason that I may cancel an appointment, I would really like to keep, to see a psychiatrist about PTSD. That which stops from getting help is the desire to continue to live. I came so close to killing myself about a week ago that I am still reeling, but at least I have some understanding of the trigger now…(PTSD).

    The PTSD is due strictly to those in the medical profession. One lie, on the part of any practioner and I am gone. Lock me up, and I will die. I cannot stand being locked in…I must always be allowed my freedom. I intend to die anyway. Have the means, the plan, just waiting for the right time, and in truth I would only go to this appointment because I need to stay alive for a few more months. Once my sons are alright…I can go.
    Not long now…No one is ever going to hurt me again, no one will ever have the opportunity, to lie, humiliate,degrade,and physically hurt me again…EVER

    As professionals you will always choose to believe other professionals, no matter how ridiculous it may be. I am working to place the business of medicine where it belongs…in the criminal courts. You are monsters of the highest degree. No compassion, no empathy, just arrogance, status-seeking, egoists,who care nothing at all for the patient…just yourselves and your peers. One day the power that you bear will come back to haunt you I guarantee it.

    • dave says:

      Please think why you have chosen to write these things. Clearly you are very angry with the medics but it sounds like you have turned this onto yourself. Would you be considering suicide for revenge? From your comments it sounds like it will have little impact on them, but the effect on your children would be enormous and life long. It must be horrible to be living in so much mental pain, but if you can keep on keeping on using non medical techniques such as meditation spiritual and exercise that will really show them.
      I pray you have the strength to keep going until you find the way to be more settled for you and all your family.

    • Stacey Freedenthal, PhD, LCSW says:

      Well said, Dave. Thank you for sharing your thoughtful comments in the service of helping out people in pain, not only the author of the above comment but also the many people who share similar thoughts and feelings.

    • Alex says:

      Hi Mari, I read your post. I too have PSTD. From an assault. My nightmares haunt me often. I would say that my hospital stay was not pleasant but it did help me to recover. I was put on medications that did more harm than help. However, I am here to respond to you because of that unpleasant stay. My original introduction to the mental health system was from being prescribed SSRI. meds from a simple broken arm. Later that year, I was beat up in NYC and left for dead. Back to the hospital again. All I can say is if you feel the need to seek help then do so. Its not a pleasant experience but, Its a better option than self-destruction or worse. I do feel empathy for your situation. Please take care of your self. Peace. Alex.

    • Stacey Freedenthal, PhD, LCSW says:

      Alex, thank you for reaching out to Mari and sharing your experience. I think you summed up well what many people have told me about their hospital experience: “It’s not a pleasant experience but it’s a better option than self destruction or worse.”

      No doubt hospitalization has been harmful to some people and helpful to others (and both helpful and harmful, too, to still others). I have known people who, like you, found that hospitalization did help them to recover, and I have known people who still struggle to recover from their hospital experiences.

      That said, I am happy to report that, of the people I know who have been in a psychiatric hospital, the majority were helped in some way by the experience.

  9. Anonymous says:

    What happens if you feel you will benefit from a psychiatric stay – even if briefly, but you do not have the money to do so? Will you be burdened with debt after your stay? Will you be denied access unless you are taken in as an involuntarily committed patient?

    • Stacey Freedenthal, PhD, LCSW says:

      “Anonymous,” those are good questions, and I can’t answer for every location. In the U.S., hospitals are not allowed to turn people away if they are experiencing a medical (including psychiatric) emergency. So a hospital would need to either provide you with the care you need or arrange for you to receive it elsewhere (and transfer you by ambulance), assuming that you need inpatient hospitalization due to a psychiatric emergency.

      Would you be burdened with debt? It depends on several things – whether you are admitted to a public or private hospital, whether the private hospital you’re admitted to has a charity program that covers some hospitalizations, whether you have any insurance, Medicaid, Medicare, etc.

      I know costs are a huge concern, and debt is no small thing. Even so, your life and your mental health are more valuable than money. I hope you will do what is needed for you to stay safe and to recover!

  10. I told my therapist and he threw me away. Ill never pay back the $3000+ the hospital charged me. Worst of all they could have cared less about me when I was there. All they did was write in note books. BE WARNED MENTAL HOSPITALS ARE MENTAL PRISONS!!!!

    • Stacey Freedenthal, PhD, LCSW says:

      Matthew, I’m sorry your experience wasn’t helpful. As I’ve said elsewhere on this site, hospitalization has helped some people, hurt others, and both helped and hurt still others. I suppose it’s like many medical procedures. Even the most effective medical procedures do not help everyone and harm some people.

      On top of that, some hospitals are better than others. Some merely provide a locked environment with medical supervision, while others provide individual therapy, group therapy, 12-step groups, and more.

  11. JJ says:


    I just had a question. If I tell my therapist that I’m suicidal and that I have a plan, is there any way to get treated without being hospitalized, or will they have me admitted because of the plan and intent?



    • Stacey Freedenthal, PhD, LCSW says:

      J.J., I don’t know the specifics of your situation so I will answer generally. And, generally, suicidal thoughts and a plan are not sufficient, by themselves, to warrant hospitalization. There also needs to be the intent to act soon, in fact quite soon, on those thoughts and plan.

      Of course, when anyone speaks in generalities, there are many situations that don’t apply. Someone with suicidal thoughts and a plan, but without the intent to act soon, might still warrant hospitalization if other factors are present, such as psychosis or inability to function.

      I have had quite a few clients who had suicidal thoughts and very detailed planning around how they would die by suicide, yet who did not need to be hospitalized. They did not have the intention to immediately carry out their plan (it was more like, “This is what I can do when and if the time comes….”) and they were able to collaborate with me on how to stay safe.

      Keep in mind that criteria for involuntary commitment tend to be quite stringent. The same applies, in many cities, to voluntary admission. Even people who are suicidal and want to be admitted to a hospital often are turned away. So I hope that fears of hospitalization will not stop you from seeking help.

      My best to you, and I am sorry you are dealing with suicidal thoughts! I hope other posts on this site can be of help to you, as well. Also please keep in mind the number of the National Suicide Prevention Hotline, which is open 24/7. The number is 800.273.TALK (8255).

  12. doc dave says:

    But there’s not good evidence that hospital admission saves lives. As a doctor I believe it’s more about showing care to avoid litigation. Despite suicide watch and removal of dangerous items / ligature points, a determined person will have little difficulty with suicide or more commonly act well to get discharged and then peform the deed. Starting medication, ect and or intense psychotherapy seem legitimate reasons for admission, but inpatient suicides still occur.

    • Stacey Freedenthal, PhD, LCSW says:

      Doc Dave, you are absolutely right about the limitations of hospitals. I address this briefly in my post about limitations in helping suicide people, which you can find here. Specifically, I write:

      “Even inside locked psychiatric hospital units, even when patients are under constant supervision, some patients die by suicide. That is staggering. It is also illuminating. If mental health professionals and psychiatric hospitals cannot prevent all suicides, then how can friends and family be expected to do so?”

      And I agree with you about hospitalization often serving solely to protect the mental health professional from liability. In fact, I think many professionals (and clients, family, friends, etc.) place excess hope in hospitalization, as if it will cure suicidality in 3 days or less.

      Finally, I don’t think there’s *any* evidence that hospitalization saves lives, but I am not entirely sure. There definitely is not, as you said, good evidence. The problem is, how does one really study this? We can’t randomize dangerously suicidal people into a no-treatment group, or even into an uncontrolled environment.

      These are all points I intend, at some point, to write about more in the future. Thank you for sharing your thoughts and adding to the discussion.

  13. Jes says:

    i’ve been feeling very Suicidal lately and my parents know that i have been cutting and stuff but i’m just really sick of crying so much over school problems and personal problems i really just want to tell my mum that i want to go to hospital and get help because i don’t feel safe at home anymore due to recent things that i have experianced. I hate being at home i really do all i can think about is family fights and something else i do not feel like saying i just really want to leave or run away but i know it would be better going to hospital insted of killing myself/running away but i just don’t know how to tell my mum or how she would react, she is amazing and helpful but when she found out about me cutting she started crying so me telling her that i want to kill myself and that i have recently tried it and that i need help i’m scared because i don’t know how she would react someone please help and give advice please! i really don’t want to seem attention seeking but i just don’t know what to do anymore.

    • Stacey Freedenthal, PhD, LCSW says:

      Jes, PLEASE tell your mother! Even if she gets upset, that’s a small price to pay for you to stay alive and get better.

      My advice is to show her this comment that you posted. That way, you don’t need to build up the courage to tell directly.

      It also might be helpful for your mom to read this post, 10 Reasons Teens Avoid Telling Parents about Suicidal Thoughts. That post also links to other posts with information about how parents can best respond to a suicidal child.

      Again, please tell your mom. She needs to be able to get you the help you need, but she can’t do that if she doesn’t know how much you need the help.

  14. JeanPaul says:

    Having worked with many mental health professionals over the years, my advice is:
    1. do seek help
    2. Be VERY careful who you seek it from.

    I have worked with wonderful therapists who I credit with saving my life. I have also worked with psychiatrists who were verbally abusive, dishonest and negligent. My experience has generally been that psychiatrists range from contemptuous to abusive, while most psychologists range from from good natured but stupid to wonderful. I would say that if you need help, find a psychiatrist to get medication and then talk to them as little as possible, find a therapist and let them heal you.

    And don’t wait until you are already suicidal to get help. I waited too long for support and landed in a hospital. That got me well (though I relapsed), but it was traumatic. It’s better than dying, but really not a good time.

    Get help NOW! Before it’s too late.

    Another warning for those seeking help… There is no quick fix. Depression isn’t like the flu. You don’t get better. It’s more like diabetes. You can manage it and live a full successful life, but it will never go away.

    • Alex Jude says:

      Hi Jean. Very true whom you speak to in regarded to mental health. Emergency department doctors are great for a broken bone or stitches but they should not write a prescription for SSRI medications. Or, your walk in mental health community center is over worked,under staffed,under paid and to be honest an entry level career position. I have found that a friend, teacher,or clergy is a better starting point. This web site is a better option then most community mental health facilities have to offer. Some people really need medication but talk therapy is often more helpful.Anyway, Im not an expert on the topic but I’ve had my up’s and downs. Right now im on a downward curve. Peace, Alex.

    • Stacey Freedenthal, PhD, LCSW says:

      Jean Paul, you make very good points. Mental health providers range on a continuum, from the very bad to very good. I wish the “very bad” were not out there, but every profession has them, including, sadly, the helping professions.

      I feel sad when I hear someone say, “I went to a therapist once and he/she was awful, so I’ll never try that again.”

      For those reading this who have had a bad experience with a therapist, psychiatrist, psychiatric hospital, or psychiatric medication, if you are suicidal or otherwise in need of help, please try again. As Jean Paul said, the earlier you get help, the better.

      I promise you, there are good mental health treatments and providers out there, even amid the bad.

    • Stacey Freedenthal, PhD, LCSW says:

      P.S. Jean Paul, I agree with you that, for many people, depression is a chronic illness that can be managed but not cured. But there are some very fortunate people out there who have had depression and who got better without ever relapsing. And there are people who go many, many years before relapsing.

      For those who do struggle with depression repeatedly, it definitely is possible to still live a full, successful life, as you put it. The keys seem to be healthy living (good sleep hygiene and regular exercise, in particular) and, for some people, a consistent regimen of antidepressants, even after the depressive episode has ended.

  15. Alex Jude says:

    Hi: I never had any mental health issues until I was put on psychotropic drugs for pain management, for a broken arm. Given the problems with opioids, it seemed like a good idea as I didn’t want to deal with any dependency problems. I didn’t do well on them,I complained to my Dr. only to be told that my body would get used to them. I didn’t. I started having major mood swings, It got to the point that I was hospitalized in behavioral health. I did sign my self in under the threat of being IVC. I was over medicated while inside and my actions were thought to be suicidal so I was put into seclusion. Your right when you say they don’t use straitjackets anymore. They use chemical restraints. A week or so later, I was discharged but still prescribed benzodiazepines. This caused more problems to the point of psychosis and suicidal ideation. Back to behavioral health. I was fortunate enough to find a good Psychiatrist . He took me off of the benzodiazepines and now, I am back to my old self. However, this history of hospitalization haunts me. I have a 3.5 GPA. in Human service and EMS. It is all but useless as any job I apply for with the state rejects me for my psychiatric. record. I don’t like to say it but I have come to the conclusion that it is better to not even talk about your own mental health issues. It seems no different than a criminal record. I would love to hear any feed back you may have on this situation. Alex.

    • Stacey Freedenthal, PhD, LCSW says:

      Hello Alex, I am so sorry to hear about your experience. It sounds traumatic on many different levels. How fortunate that you found a good psychiatrist who was able to recognize and relieve the side effects you were experiencing.

      I am confused about your mental health treatment history preventing you from getting job offers. Such information is confidential, protected health information. No employer has the right to know of any of your health treatment, psychiatric or otherwise. And no one is supposed to be able to discriminate on the basis of a health condition, regardless. There may be exceptions (such as airline pilots, who need to demonstrate they are mentally fit for the job) but these are very rare.

      Confidentiality in the U.S. is protected by HIPAA, among other statutes. What you describe above violates the law on multiple counts, both in terms of robbing you of privacy and of discriminating against you. I suggest you consult a lawyer!

    • Alex Jude says:

      Thanks for the response. The problem I am having is with the application questions about mental health history. If I don’t answer truthfully, I am omitting information. If i do answer truthfully i get passed over. I thought HIPAA laws would cover me but it doesn’t seem to. It is a background clearance issue. I do feel that seeking psychiatric help when needed is a good and healthy thing to do but, in the real world, some things are best left covert. Still confused, Alex.

    • Stacey Freedenthal, PhD, LCSW says:

      Hi Alex, I am really sorry to hear that you are being discriminated against in this way. I know some professions do have a justification for checking mental health history. (I suspect, for example, the Secret Service would be one.)

      It is already hard enough for people with mental health problems to get the help they need. The threat of job discrimination just makes it harder.

  16. jess says:

    I feel that I need “help” or therapy. I’ve attempted suicide multiple times throughout my life and I’m only 14. I’ve thought about death starting from a young age. My best friend is always telling me I should seek therapy but my parents don’t think it’s necessary and they say I’m not allowed to talk about death or think suicidal thoughts. I want help but my parents won’t allow me to get any

    • Stacey Freedenthal, PhD, LCSW says:

      Jess, it is painful to read that your parents won’t allow you to get professional help or to talk about death or to think of suicide. From your comment, it’s clear that you want help. And people can’t usually just “turn off” suicidal thoughts. (If only it were that easy!) We can’t control what thoughts visit us or intrude, only how we respond to them.

      So please, get help! Tell a teacher that you are thinking of suicide and want professional help. Tell a school counselor. Tell a friend’s parent. Tell a minister or other religious leader. Tell anyone you can who might be able to get you help.

      If you are in the U.S., I encourage you to call a hotline. The National Suicide Prevention Hopeline can be reached at 1.800.273.TALK (8255). There are other hotlines, too; please see various resources listed on this site at http://www.speakingofsuicide.com/resources/#immediatehelp

      Here’s the deal, Jess. If someone calls a hotline while actively suicidal, a hotline is likely to call the police. Often, the police will take the person to an emergency room for an evaluation. Depending on whether other adults are able to connect you with mental health services, this may be the only way that you can get connected with professional help.

      You are doing an excellent job reaching out for help by posting here. I hope that you will receive such help soon!

  17. Anonymous says:

    Im not suicidal but I feel if you are a certain age you should be able to take your own life if there are major reasons for it

    • Stacey Freedenthal, PhD, LCSW says:

      Permitting suicide, whether among older adults or people with terminal or painful physical illness, definitely is a much-discussed and controversial topic. Many support allowing people to end their lives, whether under the guise of “assisted suicide,” “hastened death,” “aid in dying,” or something else. This is something I intend to write more about…eventually!

    • Mari says:

      One thing you must realize when taking your own life. It is the people you leave behind who must live without you, the grief, the horror, and guilt…could I have done something else, should I have been there then, would such-and-such have stopped them…and betrayal, such a terrible sense of betrayal. My older brother was the only one who ever seemed to care about me…when he shot himself I felt completely abandoned, and questioned all those years that he, at least, tried to be there for me…suicide must always be done with others in mind. Unless an obvious illness, or disease is at play, it should always be done as though by accident. May sound tough, but if you think about…and I don’t walking in front of a car or train…please do no traumatize others. When you choose to die, plan carefully….

    • Stacey Freedenthal, PhD, LCSW says:

      Mari, you rightly say that others are affected by a loved one’s suicide. Your solution is to camouflage the suicide so that loved ones don’t have to blame themselves or feel abandoned. These are important points.

      But your solution might not be a solution, after all. As Cara Anna writes on her excellent blog, talkingaboutsuicide.com, no method is foolproof. She writes of “botched suicide attempts”:

      “Some people _ how many? _ go into their suicide attempt assuming it will work and instead emerge with a body that is long or permanently damaged. People have been paralyzed. They have damaged their livers with pills. They have faced months or years of reconstructive surgery or physical rehabilitation. Hospital bills alone have reshaped their lives.” (Click here for the full post.)

      It is not possible to protect loved ones by attempting or dying by suicide. They will be hurt no matter what. My hope for those who are suicidal is that they be able to protect themselves.

  18. Justin says:

    I’m 18 and I’m having suicidal thoughts more and more often and am having a stronger urge to act on them. What will happen if I say that I’m feeling this way. My friend was about to attempt suicide a year ago when he was 17 but stopped and called the suicide hotline and then the police since he was in danger. Well he was put in a bahvioral complex for two weeks and then put in a safety plan and antidepressants. I was wondering what happens since I’m no longer an adolescent.

    • Stacey Freedenthal, PhD, LCSW says:

      Hi Justin, I’m sorry you’re having not only suicidal thoughts, but also urges to act on them. Whether you would be committed to a hospital depends on how severe your suicidal thinking is. Generally speaking, you’d need to say that you intend to attempt suicide within a short period of time. It depends where you live, but many states permit involuntary commitment only when a person be in imminent danger of suicide or harm to others.

      That said, you didn’t make clear whether you want to enter a psychiatric hospital. The admissions criteria for voluntary admission tend to be more lax than those for involuntary commitment, because with commitment, a person’s civil rights are suspended and the person is deprived of liberty against his or her will. Still, admissions criteria vary by hospital.

      I hope that information is helpful. I will add that admissions criteria for adolescents and adults aren’t really different from each other, but some hospitals appear to be more liberal in admitting adolescents, because the impulsivity of that age group makes them more vulnerable to acting on suicidal thoughts.

      Good luck to you!

    • Mari says:

      Please beware that most places can have you committed without your consent…if this is done, not only can you not leave, but they can force you to take drugs you do not want, and often do not need.

    • Stacey Freedenthal, PhD, LCSW says:

      This is true, but with some qualifiers. People who are involuntarily committed to a psychiatric hospital cannot leave on their own accord, but there are protections built into the system to protect patients from being hospitalized longer than necessary. These protections vary by state in the U.S. To learn more, you can do a Google search with these terms: involuntary commitment “patient rights”. Results come up for different states. You can also insert your state’s name into the search for more specific information.

      As for forced medication, laws exist to protect patients from taking medications against their will except in emergency situations. What is an emergency to one person might not be an emergency to another, but in general, emergency medication is considered necessary if a person will immediately hurt himself or herself, or others, without medication. Otherwise, in most if not all states, a court order is necessary to force someone to take medication against his or her will. You can learn more by doing a Google search with these terms: involuntary commitment “emergency medication”.

  19. thomsen says:

    same with me I want to commit suicide I have a good life I’m just tired of life and find no reason to go on

  20. Atra says:

    Don’t seek therapy. If you’re forced to see a mental health professional, don’t tell them the truth. They can and do commit you, and while I can’t speak for every “looney bin,” my experience in them can be summed up as “torture chamber” – at least 100 times worse than anything I saw on TV. I will never seek help again. I will suffer in silence until I finally just fall off. It’s better than going back to one of those places. From that day forward, I will only tell lies to medical professionals who ask about my mental state, because I can’t trust them.

    • Stacey Freedenthal, PhD, LCSW says:

      Very sad response, Atra. I’m sorry you have had such negative experiences. This is precisely why I hate when a therapist overreacts – people who need help are less likely, if likely at all, to seek help again.

      For you and for others who read your comment, I will say this: There ARE mental health professionals who use hospitalization as an absolute last resort; some do not ever commit someone to a hospital involuntarily, for precisely the reasons you described.

      I will also go out on a limb and say, for those who do want hospitalization or end up hospitalized, there are hospitals that are not torture chambers. Each is different. I know people who have been greatly helped by hospitalization. Sadly, I also know people who have been greatly hurt.

      Sometimes when someone is making the ultimate life or death decision, they feel a profound need to talk about it. They might talk with friends, and they might be fortunate to have friends who can truly listen without judgment or pat advice. They might, on the other hand, have friends who react in ways that are hurtful: “How could you want to die? Don’t you know how selfish you are to hurt people like that?” “You just want attention.” “You need to get over this.”

      A mental health professional who is skilled at working with suicidal individuals – and who does NOT overreact, freak out, or otherwise resort to hospitalization unnecessarily – can be helpful to a person who is dealing with suicidal urges.

      The professional can listen and empathize without judgment or alarm, help the client go over pros and cons of suicide (yes, there clearly are benefits to explore), and explore with the client his or her ambivalence. Those are first steps. The clinician can also work toward helping the client to heal the wounds or illness that make suicide appealing, to rediscover meaning and value in life, to want to live again, and to come up with coping methods for safety and growth.

      None of this can happen if therapists have made people too afraid to seek their help.

      So please, if you are a therapist reading this, consider the great harm that can come from seeking commitment for a client without it being absolutely necessary – and keep in mind that it is absolutely necessary very, very rarely!

    • Atra says:

      Yes. I went seeking therapy after I spent years with rape-related PTSD symptoms that made maintaining a romantic relationship difficult, which then led to depression. Everyone I knew encouraged me to seek therapy, which I thought to be laughable – I always considered therapy to be a pseudoscience that does nothing for people with an IQ higher than their shoe size. But I wasn’t getting better on my own, so I thought, “What’s the worst that can happen?” When they asked if I’d thought of suicide, I answer truthfully, yes. When they asked how I would do it, I told them. When they asked if I wanted to do die, I again answered truthfully, yes, but I was too much of a wimp to actually do it. Their next response was to have four men force me into a vehicle against my will, take me someplace I didn’t want to be, and then have four more men strip search me before locking me away in a tiny stinking dirty cigarette-smoke-filled prison with no warmth, no food, none of my prescription medication for back pain, violent patients, violent night staff, no access to a phone despite signs posted all over saying I have that right, and sedatives waiting to go up my rectum if I got loud, like they did with everyone else. I don’t know which class taught these psychiatrists to have rape victims strip searched by four men and then forced into a hostile environment and kept in line under threat of anal violation, but I do know that I’m never being truthful to anyone with the authority to have me committed ever again. I might have been too much of a wuss to commit suicide before, but now knowing what it’s like is all the motivation I need to carry it out. If I ever find myself in that position again, I will bash my face into the ground until I’m dead or unable to know I exist anymore. I would rather die than go back to one. I don’t know if these psychiatrists/therapists know what the nuthouses are like they send patients to, but they’re outrageously negligent if they don’t, and outrageously stupid if they do. When it comes to mental health, honesty is the enemy. Best to just live with it until I can’t, and then I won’t.

    • Stacey Freedenthal, PhD, LCSW says:

      Hi Atra, thank you for sharing your experience. It is heartbreaking. You went to a therapist for help and received the opposite: loss of liberty, fear, further abuse. Your experience at the hospital sounds horrifying. Please be assured that most hospitals do not operate that way.

      If ever you do need help again for suicidal thoughts, I hope you will consider that many therapists encourage hospitalization only when absolutely necessary to maintain safety, and that, even when hospitalization is necessary, it can, in many instances, be a helpful experience. I am so sorry that your experience was harmful instead.

      EDITED: Dec. 26, 2014

    • Mari says:

      As to your reply Stacey…you call it sad. I call it criminal, and by knowing these things are happening you are as criminal as they are, and as abusive.

    • Stacey Freedenthal, PhD, LCSW says:

      Mari, I think you misunderstand my position. I am deeply pained by the injustices that occur at (some) psychiatric hospitals. I do not advocate involuntary commitment to a psychiatric hospital unless it is necessary to protect someone who is in imminent danger of dying by suicide or killing another person (or people).

  21. YVONNE says:

    i tried to commit suicide last month. i still want to commit suicide i am so tired with my life, i hate myself, i hate going anywhere, i hate dealing with the public but i still have to work to pay for my medicle insurance, i use to work full time with the public but now i am down to 3 day’s a week…and it is so hard for me to do that. i just want to be alone, no one around me. and not have to go anywhere that has a crowd… it suck’s i dont know what to do, i can no longer handle working and dealing with the public, or anything or anyone, but i cant stop working, because i have to pay my medicle insurance to go to my doctor’s. without them to talk to and get medication to help me with my bipolar nos, with severe depression and anixity and pannic attack’s. so i dont try and commit suicide again, but i think about it all the time, but this time i want to make sure it work’s.

    • Stacey Freedenthal, PhD, LCSW says:

      Yvonne, I am so sorry you are hurting so badly. I hope that you continue to get help. Also, if you are in the U.S., you no longer need to get health insurance through your job. Because of the Affordable Care Act (Obamacare), you can get insurance on the exchange. This liberates a lot of people who had been shackled to their job purely to avoid losing their insurance.

      I have published a list of resources for people who are thinking about suicide here. It contains resources for getting help via hotlines, email, chat rooms online, and other websites. Please check them out. You never know what or who might help turn things around for you.

      p.s. I edited your comment to avoid giving graphic details about your attempt method and its aftermath. This material can trigger others who are seriously considering suicide or have already made an attempt.