scales

scales

Resident Slime
Oct 18, 2018
214
A while back I posted about how to talk to mental health professionals, specifically what to say to get out of a psychiatric hospital. I later noticed my advice being used where it would actually be harmful, and wanted to make a post explaining how to talk to mental health professionals to get what you want. For background, I have successfully accomplished my goals with mental health providers using these techniques, and have studied psychology and mental health in college, I can also provide some resources and explanations for my advice as needed, please feel free to ask questions if you want.


The first thing to consider is, what is your goal? I will talk about these scenarios:


  1. You want to recover.
  2. You want your friends and family to see your suffering and help you, take you seriously etc.
  3. You are 100% sure you want to ctb and are involuntarily seeing a mental health worker.

Before I talk about these scenarios I want to explain that my knowledge is mostly based in the US and other countries may be different. In addition a lot depends on the mental health care worker you end up with, just because something works for one person doesn't mean it will for another. Second, before going into each scenario it is worth discussing what mental health care workers look for.


What mental health care workers look for:


Those working in mental health rely on you to be honest with them. There are circumstances this isn't the case, it depends on your history with them, but this is an important piece.


Second, mental health workers will ask you about your desire to kill yourself. If you have suicidal thoughts this is actually considered fairly normal for the depressed individual and is called suicidal ideation. It is not in itself a cause for concern. It is highly unlikely a mental health care worker will notify your family or friends simply for having thoughts about suicide.


Mental health care workers assessing suicide risk will ask you if you have a plan for suicide, a method for suicide and a date. They also look for certain signs.


A plan for suicide is usually vague and can mean something as simple as "I want to hang myself" or "I think I will try drowning." Again, this isn't a giant red flag, depending on the rest of your interview with the worker, they may not take action, or they might.


A method means you have a way to do your plan. For example, if you have firearms at home or have gathered the materials for your suicide like a noose etc. this is a huge red flag and most mental health care workers will take action at this point because they believe you are a risk to yourself.


A date (say, this Saturday) means the worker is likely not going to let you leave and take you to a place for involuntary hospitalization, police may be called depending on the severity of the situation.


During your interview the mental health care provider will also be looking for other signs of suicide such as selling your things, saying goodbye to friends and family etc. basically things people do when they're particularly suicidal.


Now let's consider the different scenarios.

1. You want to recover.
In this scenario you want to be honest with your mental health care worker. Depending on your particular situation you should decide the best course of action for you. The amount of help you receive will depend largely on you. In order to maintain the most control you should tell the provider what you want for recovery, Even if you have a plan or method, tell them everything. If their actions don't suit you or don't help, and you decide you want to CTB after all, then go to scenario 3.


If you don't want to be hospitalized but really need help, you probably need more than you will get by telling them a little bit. You can ask for more help, but it's really down to them to decide. The more you're willing to work with them for recovery, the better your chances of getting recovery the way you want it.


Telling your mental health care worker you want to recover is actually a big deal because it means you don't want to die even if you're thinking about it and planning it, asking them to help you is actually really useful.


Also important note here, a lot of people on this site have terrible experience with mental health workers, but they aren't all out to get you or make you miserable. Everyone is different but most people can recover. Not everyone, but most. If you aren't sure where you fall yet, or haven't tried any form of recovery yet, it may be worth trying to work with mental health professionals the best you can. At worst they fail you and you decide to ctb after all, you can always change your mind and start lying later. But if you really want to recover, it's better to start here.


Also, don't think you're bound to your mental health worker. If your psychiatrist, therapist, whatever is not helping you or understanding, if you haven't improved, get a new one. Try something else. There are a lot of treatments for a lot of conditions, if you think you can be saved then you probably can be.

2. You want your friends and family to see your suffering and help you.

In this situation you are not truly suicidal, you are giving a cry for help and deserve the help you're asking for. However, something extreme like hospitalization will likely impede your control and have no benefits. In this situation I would recommend telling your friends and family about your suicidal thoughts directly but not any plan etc. Tell your mental health care worker about everything and how you feel you have so little help. In the worst case, it may be beneficial to try a non lethal suicide attempt. You should request intensive outpatient therapy or consider voluntary hospitalization where you tell them you're suicidal for now but don't mention any serious lethal method, don't mention research on the internet for serious harmful and lethal methods or a date of death, that will likely have consequences you didn't ask for and might make it worse.


Maybe you're in a bad situation but want to live, you want to get out of the bad situation. There is hope for you. Explain your specific situation to your mental health provider. There may be options available to you that you didn't know about.

3. You are 100% sure you want to CTB or are involuntarily stuck in a psychiatric hospital etc. or do not want help, do not want to recover, want to be left alone for sure.


This is the only situation under which I would recommend lying to your mental health provider. Lie like you're an actor and this is your job.


Here's some things that can help get you out of a psychiatric hospital, obviously it varies from person to person but I'm going to assume the common problem here is suicide.


Hospitals can keep you if they believe you're a harm to yourself or to others. So, act like you don't hate yourself or others. Talk about exciting things or hobbies you want to do. Talk about a future, suicidal people don't usually talk about a future because they don't perceive themselves as having one. So act like you have one, talk about friends, family, your favorite tv series or whatever. Don't talk about your own hatred. Try not to get angry, try to make eye contact, try to smile and move your hands as you speak. Depression often creates an image of someone shy, withdrawn, slow in their movements.


But don't be jittery or jumpy or too nervous either. Try to be relaxed. Practice some meditation if you have to, because it can help you maintain the relaxed composure you need to lie and get out. But don't act like your depression magically healed overnight or they will pick up on your lies. Talk about wanting to recover while living your life because you think it will help you more than the hospital. Say you think regular exercise, conversations with friends or making new friends or hobbies will help you overcome your depression or you think they might. Say you'd like to meet someone regularly for therapy and meds but don't think you need to be stuck where you are. Follow their advice and be easy to deal with, it might take more than one day.


Once you're out, know that you're given freedom but if you end up in the hospital again getting out will be harder than before. You have to be sure your next attempt is lethal and effective or move as far away as possible.
 
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weedoge

weedoge

Banned
Jul 12, 2018
1,525
Wow, that's a hell of a post, did you write that all for here specifically?

Just a little bit I'd like to say is that sometimes the issue is how the professional speaks to and treats the patient. Especially those with mood disorders, instability, dependance issues, etc etc, very stigmatised conditions. Professionals seem to love to act shady in these situations and make wild assumptions even when the patient is absolutely and completely honest.

Had some pretty awful experiences, pretty consistently. Only a few "professionals" out of the many I met were clearly in the job because they have an empathetic nature.
 
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scales

scales

Resident Slime
Oct 18, 2018
214
Wow, that's a hell of a post, did you write that all for here specifically?

Just a little bit I'd like to say is that sometimes the issue is how the professional speaks to and treats the patient. Especially those with mood disorders, instability, dependance issues, etc etc, very stigmatised conditions. Professionals seem to love to act shady in these situations and make wild assumptions even when the patient is absolutely and completely honest.

Had some pretty awful experiences, pretty consistently. Only a few "professionals" out of the many I met were clearly in the job because they have an empathetic nature.

I did write this for here actually! I felt super guilty when I saw my advice being rephrased in a different thread where I wasn't sure it was appropriate, and thought this might help a little.

I think your concerns and point is very valid. People who have stigmatized conditions and mood disorders or instability are definitely given the short end of the stick because oftentimes mental health workers don't have the proper training or ability to help. It sucks and I completely understand where you are coming from because I had a mental health worker give up on me for being too difficult and unstable. I've also had them come up with all sorts of inaccurate assumptions, which is something all humans do but you'd think mental health workers would at least train themselves to be a little bit less biased or a bit more empathetic.

Anyway, I assumed the honesty was about suicide specifically, I am not in any way advising on any other topic or assumption because well... honestly I don't think I have the knowledge or understanding to do that... it's hard to get the help you need in mental health as it is... honestly it's so frustrating I personally have given up, but I have also personally seen a lot of people recover and get better so I don't want to tell people not to try just because I failed.

I'm sorry your experience was bad, I understand how difficult it must be especially when you genuinely try.
 
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LifeSick

LifeSick

Eat the rich or die!
Sep 20, 2018
167
I might create another account just to like this post twice. Just saying.
 
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S

Schopenhauer

Enlightened
Oct 3, 2018
1,133
That's great advice. Except for the fact that I'd avoid the "professionals" even if I wanted to recover. So lying is the best policy for me. I'll never support thugs who can get me involuntarily committed.
 
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TAW122

TAW122

Emissary of the right to die.
Aug 30, 2018
6,843
Scenarios 1 and 2 are definitely out of the question for me since I've made up my mind. Therefore, I will definitely be going with scenario 3. While I am not ctb'ing anytime soon (though depending on circumstances that could easily change), I am still going to be ctb'ing the future. Something I'd like to know would be how to avoid raising suspicions with people around you IRL whether it's family, friends, strangers, acquaintances, etc. I just believe that it is better to not fall into the situation in the first place as prevention is the first line of defense before mitigation, though your advice for scenario 3 is really good should I or anyone ever end up involuntarily having to see a mental health professional.

So with that said, I am wondering what's your strategy of not raising suspicions with people IRL (friends, family, acquaintances, strangers, etc.)?
 
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S

Shewaitsforme

Arcanist
Sep 23, 2018
493
3 was me all over. Managed to get myself discharged in 5 weeks, in August i was put on a section 2 for 20days and discharged. Was re-admitted in September on a section 2 (did the full 28days) then they put me on a section 3 but i appealed, told them id have help outside, i wasnt diagnosed with a mental health issue (just adjustment disorder) told them i needed to be out as i work for the NHS, told them i needed to sort my flat. So yes, although i never once said id changed my mind about suicide i was able to pull them up on a few things so they couldnt hold me any longer. Oh and my continuos using of Coke, Crack and pills sure helped them boot me out. Since being home ive managed to get discharged from home visits so basically have no help just like i wanted. I dont want to live anymore, ive done life and its too painful. Why would i want to start again, ive done that 5 times already in different cities, im tired
 
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scales

scales

Resident Slime
Oct 18, 2018
214
That's great advice. Except for the fact that I'd avoid the "professionals" even if I wanted to recover. So lying is the best policy for me. I'll never support thugs who can get me involuntarily committed.

The good thing is you have a choice and only you know what's best for you. I also feared involuntarily commitment. Having control over one's life is a basic human right and I think it's dehumanizing to force anyone to do anything.
 
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scales

scales

Resident Slime
Oct 18, 2018
214
3 was me all over. Managed to get myself discharged in 5 weeks, in August i was put on a section 2 for 20days and discharged. Was re-admitted in September on a section 2 (did the full 28days) then they put me on a section 3 but i appealed, told them id have help outside, i wasnt diagnosed with a mental health issue (just adjustment disorder) told them i needed to be out as i work for the NHS, told them i needed to sort my flat. So yes, although i never once said id changed my mind about suicide i was able to pull them up on a few things so they couldnt hold me any longer. Oh and my continuos using of Coke, Crack and pills sure helped them boot me out. Since being home ive managed to get discharged from home visits so basically have no help just like i wanted. I dont want to live anymore, ive done life and its too painful. Why would i want to start again, ive done that 5 times already in different cities, im tired

I'm sorry for the difficulty you have suffered, that all sounds awful! I am glad you managed to convince them their help wasn't needed and were able to take control of your life and your death.
 
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S

Schopenhauer

Enlightened
Oct 3, 2018
1,133
The good thing is you have a choice and only you know what's best for you. I also feared involuntarily commitment. Having control over one's life is a basic human right and I think it's dehumanizing to force anyone to do anything.

And that's why I avoid the medical-industrial establishment. They have the legal right to commit you (albeit temporarily) for something you might do (and only harm yourself, at that).

Imagine throwing a person in prison preemptively because they might rob a store. Nobody would accept this. Nonetheless, people are enthusiastic when a potentially suicidal person is locked away.
 
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scales

scales

Resident Slime
Oct 18, 2018
214
Scenarios 1 and 2 are definitely out of the question for me since I've made up my mind. Therefore, I will definitely be going with scenario 3. While I am not ctb'ing anytime soon (though depending on circumstances that could easily change), I am still going to be ctb'ing the future. Something I'd like to know would be how to avoid raising suspicions with people around you IRL whether it's family, friends, strangers, acquaintances, etc. I just believe that it is better to not fall into the situation in the first place as prevention is the first line of defense before mitigation, though your advice for scenario 3 is really good should I or anyone ever end up involuntarily having to see a mental health professional.

So with that said, I am wondering what's your strategy of not raising suspicions with people IRL (friends, family, acquaintances, strangers, etc.)?

This depends on your specific situation. Are there any things you want to do before you die? Are you planning to sell all your things etc.? What sorts of things are you planning to do that might raise concerns?

For example, if you're selling your things and saying goodbye you can tell your family and friends you're moving for a job to another country and because you wanted a change of pace. You could sell all your things, have a fantastic goodbye etc. without raising concerns.

If you are talking to friends about suicide on the other hand and want to avoid them telling anyone... it may be best not give them too many details. It also depends on your age, for example if you live with family and need excuses to hide your things, and whether you have the money to say, get a storage unit or PO box to hide and receive your suicide materials.
 
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Misanthrope

Misanthrope

Mage
Oct 23, 2018
557
That was really well written Scales. It is just such a shame mental health provision does not have parity of esteem with physical issues. Or works on a preventative model, instead, seeming to wait till the person is truly broken and probably doesn't want help any more even if before they were asking for it. I also found it quite disturbing the difference in how clients of mine were treated if they had a borderline personality diagnosis vs having bipolar disorder. In the UK at least the borderline label has some pretty nasty negative connotations associated with it. My clients were routinely dismissed because of it. Getting them any semblance of help was like pulling teeth. I even had a member of the home treatment team tell me once. "We don't really come out to people with BPD as it can make them worse." Sometimes I have no words for the cruelty inherent in the systems that are designed to help.
 
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scales

scales

Resident Slime
Oct 18, 2018
214
That was really well written Scales. It is just such a shame mental health provision does not have parity of esteem with physical issues. Or works on a preventative model, instead, seeming to wait till the person is truly broken and probably doesn't want help any more even if before they were asking for it. I also found it quite disturbing the difference in how clients of mine were treated if they had a borderline personality diagnosis vs having bipolar disorder. In the UK at least the borderline label has some pretty nasty negative connotations associated with it. My clients were routinely dismissed because of it. Getting them any semblance of help was like pulling teeth. I even had a member of the home treatment team tell me once. "We don't really come out to people with BPD as it can make them worse." Sometimes I have no words for the cruelty inherent in the systems that are designed to help.

That's awful and yet... it doesn't surprise me. I can see this exact thing happening where I live. I've come to realize mental health workers are as human as others and fall for the same mistakes, biases and problems that the rest of us do. So often they aren't equipped to deal with problems common in more complex cases or anything even slightly out of the norm.

Too often mental health professionals can be judgemental, difficult or even emotional. The worst is dealing with one who hasn't been given proper training or probably doesn't even want to work in the field.
 
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TAW122

TAW122

Emissary of the right to die.
Aug 30, 2018
6,843
And that's why I avoid the medical-industrial establishment. They have the legal right to commit you (albeit temporarily) for something you might do (and only harm yourself, at that).

Imagine throwing a person in prison preemptively because they might rob a store. Nobody would accept this. Nonetheless, people are enthusiastic when a potentially suicidal person is locked away.

The last few sentences proves the hypocrisy of the people. They are appalled at people being treated like criminals before said person actually committed a crime (due to "due process"). Though when it comes to a potentially suicidal person it's treated like a great thing, the person should be grateful for an (unconstitutional) violation of their freedom (no "due process" for the suicidal). How sicking and hypocritical these people are.

Anyways, yes the mental health system is really fucked.
 
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The Blackangel

The Blackangel

Nyiach des uti nesi deh ahy.
Nov 3, 2018
212
I learned long ago that unless you want to be warehoused like a fucking car tire, lie your ass off.
 
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