Discussion What happens if you tell professionals you have a 'plan'?

[PNKPNDA]

I'm in the UK and told my (private) psychotherapist my detailed plan. She told me that the NHS doesn't really have the recourses to help much at the moment and let me leave with weekly sessions booked.

oh god that is bad surely your private person could do something??? how much do you pay for the psychotherapist btw if you dont mind me asking??? i feel i would potentially benefit from psychotherapy but not sure i have the funds for it

 

[Nymph]

In the ward you go

 

[PNKPNDA]

In the ward you go

judging by the responses i feel this is definitely more the case in the USA, the UK maybe but it appears USA are tougher on it lol

 

[Cherrypea]

oh god that is bad surely your private person could do something??? how much do you pay for the psychotherapist btw if you dont mind me asking??? i feel i would potentially benefit from psychotherapy but not sure i have the funds for it

She is doing something by treating me I suppose. I wanted to be completely honest with her from the start. It's £75 for an hour once a week so not cheap but I've spent no money on anything else this year. I was seeing a counsellor which was as £60 but wanted to try if different treatments would help. We'll be doing hypnotherapy and the eye movement treatment.

 

[xLosthopex]

I've told my entire psych team that I have a clear and definite plan to ctb. But they can't do anything because I haven't given them specific details, such as date, method etc.

 

[PNKPNDA]

She is doing something by treating me I suppose. I wanted to be completely honest with her from the start. It's £75 for an hour once a week so not cheap but I've spent no money on anything else this year. I was seeing a counsellor which was as £60 but wanted to try if different treatments would help. We'll be doing hypnotherapy and the eye movement treatment.

yes that is pricey but if u feel its helping then deffo worth it!

I've told my entire psych team that I have a clear and definite plan to ctb. But they can't do anything because I haven't given them specific details, such as date, method etc.

fml thats shitty

 

[Bonkers]

She is doing something by treating me I suppose. I wanted to be completely honest with her from the start. It's £75 for an hour once a week so not cheap but I've spent no money on anything else this year. I was seeing a counsellor which was as £60 but wanted to try if different treatments would help. We'll be doing hypnotherapy and the eye movement treatment.

EMDR helped me. Had it twice for 2 separate incidents several years apart and it definitely took the edge off - eventually. Felt like absolute shit at the time, and takes a few weeks to complete. But it did dull flashbacks.

 

[k75]

All the ' professionals ' care about is their record, ie that they don't have a suicide on said record, and by you saying you don't have a plan you allow them to be able to claim you are not a risk, but also, who would say they had a plan if they did? One way ticket to the inpatient ward!

It's more than that. At least in the US. They are what's called mandated reporters. There are laws that force them to section you if they believe you are an imminent danger to yourself or others. That means they have to believe you will go right out and do something if you're allowed to leave. If they fail follow the law, they could lose their job/license and have big legal trouble.

Everytime i mention to professionals my thoughts on ctb they always ask if i have any plans. I am the sort of person who does not plan it- it is just always in my mind so my attempts have been rather 'spontaneous' but no solid plans for it so i always say no however I am wondering what do they actually do if you turn around and say yes I do have plans??? I do not have any experience with psych wards or inpatient stuff so I am just curious to know if they do anything or if it is just another standard procedure question with no real follow up???

So it's kind of up to the individual (some people freak out easier than others and are quicker to section), but there is a series of questions they ask to try to figure out how much of a risk you are.

Do you have thoughts? Do you have a plan? What is your plan? Do you intend to do it? Do you have access to things you can hurt yourself with? Stuff like that.

I've told every therapist I've seen that I'm suicidal, but I've never admitted to concrete plans. Never been sectioned. Thoughts are ok as long as you can assure them you don't intend to do it. I figure if I'm in therapy to try to not kill myself, they need to know I want to. There's no benefit to keeping that part a secret.

Obviously, if you're looking to definitely remain free to go home, you'll deny everything after just having thoughts. That's usually a good compromise.

But they also look at how you're acting and everything as well. If you're a sobbing, irrational mess, no amount of denying is going to convince anyone you're not a danger. And they have to send you to the hospital for further assessment. But if you seem just super upset at that moment but not motivated to go walk into traffic when you leave or something, they seem to prefer to just stay with you until the feelings have passed.

That's when I've had them just talk to me and come up with a compromise instead. They like to write up safety plans, which I think are dumb but apparently satisfy whoever is in charge. Basically it's just writing down emergency phone numbers you'll call if you start feeling like you might hurt yourself again, promising to contact them or someone else, making sure you know where to go, coping skills you can do, crap like that.

 

[UpandDownPrincess]

My doc did not worry too much until I said I had acquired means.

He knew I planned every thing in my life and was not impulsive, so a plan wasn't necessarily the end of the world.

Once I told him I had started to shop for means, we went to daily call-ins and safety contracts.

I was only sectioned once I was flagrantly suicidal and had lost all emotion about the act.

I should add, though, that this was a doc who knew me very well. Someone who doesn't know you well might feel the need act more cautiously.

 

[AutoTap]

Where I'm at they will try to put you into psych ward

 

[sadworld]

Everytime i mention to professionals my thoughts on ctb they always ask if i have any plans.

Same. I get this question soooo many times but I always say no and I would recommend to do the same or you might actually go to the psych ward...

 

[Gnip]

What if "mental illness" isn't the cause? I had a variety of diagnoses (ADHD, depression, anxiety, bipolar, etc.) and tried to manage them with meds and things like CBT and DBT, all of which were somewhat helpful in their own ways, but problems would eventually come back up. Turns out I wasn't "mentally ill," but had a history of unaddressed, long-term traumas that had at the time been overpowering and to which I'd tried to adapt in order to emotionally and physically survive. I had various forms of PTSD, to use another label which only covers so much. Finding and addressing the root causes via trauma-focused modalities like EMDR, Tapas Acupressure Technique, Emotional Freedom Technique, somatic interventions, etc. set me from the traumas and helped me to develop new ways of viewing, accepting, and managing difficulties without being overwhelmed by them if they aren't truly overwhelming, and to minimize their impacts if they are, and know that, if I can get free of such situations, I have the capacity to heal and experience resilience. I can even experience a measure of resilience asni experience them, which sets me up for a better recovery if they do end. Therapists who used trauma-informed frameworks and weren't stuck in the frameworks of psychiatric labels, patient-blaming, and the purely cognitive had lasting positive impacts for me. They supported me in healing and experiencing personal responsibility and capability, not in staying stuck and managing the impacts as if they were insurmountable. Unlike with true medicine, one cannot test for the vast majority of mental illnesses, and most practitioners don't send people for the brain scans that actually can diagnose things like schizophrenia, PTSD and sociopathy. Instead, they go by lists of criteria that overlap among diagnoses and try to prove the diagnosis by responses to medications, which do not cure such conditions and can lose efficacy over time. In fact, pharmaceuticals often drive psychiatry rather than being tools of psychiatry. So when a medicine stops helping, then one hopes for a more accurate diagnosis to be discovered, or to get rediagnosed, when meanwhile, the root cause of depression or mood swings may be because someone was abused or mindfucked or neglected throughout their developmental years, and that can be compounded by genetics, because one's ancestors experienced trauma, which can affect DNA, so if someone's family history is abuse through countless generations, there are long-reaching impacts as to how one experiences and manages trauma, which at some point nearly everyone will run into. Some people can be utterly changed by going through a trauma such as war, and for some people, childhood is physical or psychological war. The resulting depression isn't from an inherent "chemical imbalance" but from having been helpless and unprotected. I think the label of mental illness is a big ol' mindfuck and a red herring, and looks at someone as if they are somehow faulty, rather than looking for how such conditions arose and how to effectively address them and, if not totally free someone from the effects, to seriously mitigate them, and there are non-medicinal modalities that do this when a practitioner is willing to work in those frameworks and not the "mental illness" or extremely limited "cognitive" framework.

That's my soapbox. It comes from experience and study, and I humbly acknowledge it is incomplete and not universally applicable. My point is to caution against falling into the traps of theoretical frameworks and trusting people in positions of authority just because they have certain levels of knowledge and experience. Humans are wired to trust in and capitulate to authority and hierarchy, and such things do not always operate to serve our best interests. If interested, see the Milgram experiment and Robert Cialdini's writing on influence and persuasion for more information, I would never want someone to take my word for something just because I sound intelligent or emotionally convincing.

You have been somewhat fortunate. The creator of EFT, Gary Craig himself was not able to be of any help to me (and I have a letter from Craig admitting that). EMDR from a psychiatrist trained in Francine Shapiro's methodology also failed me completely, as did Roger Callahan in an hour and a half Thought Field Therapy session which I have preserved on audio cassettes from November 1996.

My personal experience has been that any positive results from these techniques is placebo based, and placebos do not work with me. As you noted, they are not universally applicable, but fortunately the quality of the results of these treatments can be quickly ascertained. In my case, I gave all these methods and the creators of two of them a fair chance to fail decisively. (Callahan came up with some good stuff, like the concept of psychological reversal and thoroughly articulated the clinical anxiety visual trigger of vertiginous lines of convergence which Alfred Hitchcock decades earlier made into a classic film in 1958 starring James Stewart and Kim Novak titled just that, "Vertigo").


What you expressed about caution against theoretical frameworks and hierarchical "credentials" cannot be emphasized and reinforced enough. Blind trust is how suckers get screwed.

Genetics definitely can play a huge part. I have known four generations of a family where the great grandmother, grandmother, mother (my sister-in-law) and daughter (my niece) all had severe OCD.

Take away all my toxic exposure to school, and a criminally abusive and brain diseased father, the one issue which clearly remains is the obstructive sleep apnea I was born with. (The only meaningful value in being diagnosed with what is now termed AD/HD is the fact that the classic OTC sleep medication and antihistamine diphenhydramine revs me and others with biological AD/HD up rather than making us sleepy the way Benadryl makes non AD/HDers sleepy. My brain and body process certain medications and drugs paradoxically, so in that respect, getting diagnosed with what was originally called "Hypekinetic Reaction of Childhood at age seven has had some worthwhile benefit. But the instant that diagnosis was made, I should have been permanently withdrawn from school at age seven for homeschooling, never to return, an option which the law did not allow at the time.)


I did tell the neuropsychologist who evaluated me for Social Security Disability Income that I indeed had a plan, pulled out my copy of Final Exit, and told him my preference would be to fly to Hawaii and jump into an active volcanic lava filled caldera when he asked me if I had suicidal thoughts. He made a note of that, and the federal government approved my application for permanent disability in the minimum 13 months it takes to be approved on grounds of mental disability.

For all intents and purposes, I am immune from involuntary committals and psych holds because my psychiatrists know that the federal and state government have known about me for years and years, since I am a recipient of Medicare health coverage on these bases. I've already shown my psychiatrists copies of Final Exit and The Peaceful Pill Handbook. They know I possess that knowledge and they can do nothing about it. Nor can their licenses be revoked, because the state and federal governments also know. (Incidentally, they do not interfere in any way with my purchase and ownership of firearms, as they do not consider me to be a threat to public safety in any way. If I'd ever been involuntarily committed, that would be a different story, but they hold their own public school system responsible for originally disabling me. Their representatives have told me to consider my disability benefits to be reparations for the damage their school system inflicted by obligating me to attend via legislative fiat. The Social Security Administration and Health and Human Services have only treated me with utmost respect, far, far more respect than I usually got in demeaning workplaces.)

 

[Nymph]

judging by the responses i feel this is definitely more the case in the USA, the UK maybe but it appears USA are tougher on it lol

I'm not from the Us, I'm from Central Europe. It depends on the doctor I guess

 

[feast or famine]

In my experience, professionals in the mental health dept usually have to make some sort of disclaimer before they even talk with you at length that if they feel you are going to harm yourself or others based on information you've told them, they have to report it.

What happens when/if they report it is unbeknownst to me. I figure the person in question would likely be taken to a ward, although that could vary based on what country or even state you're in. I have never admitted anything of that sort to a mental health professional because I don't trust them.

 

[PNKPNDA]

It's more than that. At least in the US. They are what's called mandated reporters. There are laws that force them to section you if they believe you are an imminent danger to yourself or others. That means they have to believe you will go right out and do something if you're allowed to leave. If they fail follow the law, they could lose their job/license and have big legal trouble.



So it's kind of up to the individual (some people freak out easier than others and are quicker to section), but there is a series of questions they ask to try to figure out how much of a risk you are.

Do you have thoughts? Do you have a plan? What is your plan? Do you intend to do it? Do you have access to things you can hurt yourself with? Stuff like that.

I've told every therapist I've seen that I'm suicidal, but I've never admitted to concrete plans. Never been sectioned. Thoughts are ok as long as you can assure them you don't intend to do it. I figure if I'm in therapy to try to not kill myself, they need to know I want to. There's no benefit to keeping that part a secret.

Obviously, if you're looking to definitely remain free to go home, you'll deny everything after just having thoughts. That's usually a good compromise.

But they also look at how you're acting and everything as well. If you're a sobbing, irrational mess, no amount of denying is going to convince anyone you're not a danger. And they have to send you to the hospital for further assessment. But if you seem just super upset at that moment but not motivated to go walk into traffic when you leave or something, they seem to prefer to just stay with you until the feelings have passed.

That's when I've had them just talk to me and come up with a compromise instead. They like to write up safety plans, which I think are dumb but apparently satisfy whoever is in charge. Basically it's just writing down emergency phone numbers you'll call if you start feeling like you might hurt yourself again, promising to contact them or someone else, making sure you know where to go, coping skills you can do, crap like that.

I can relate to the safety plans and numbers to ring - despite never confirming i have solid plans they do still drill into me about numbers to call bcos i guess they are very aware of how impulsive I can be lol but as most people have said it all depends on the individual and the country and what not.

 

[k75]

I can relate to the safety plans and numbers to ring - despite never confirming i have solid plans they do still drill into me about numbers to call bcos i guess they are very aware of how impulsive I can be lol but as most people have said it all depends on the individual and the country and what not.

I do think it's a good thing to have a list of that stuff for like a cheat sheet in a crisis, because (at least for me), your mind goes blank the more upset you get. But the whole concept of a safety plan somehow making you safe is just weird to me. I guess it's playing on obligation? Like you will feel bad hurting yourself because you're accountable? I don't know. I'm probably not going to think at the last minute, "Oh no, but I wrote a safety plan!" and back out. LoL

Edit: I'm now laughing over here thinking about people finding my safety plans after I'm gone and being all, "But she had this and everything! Whyyyy?"

What's wrong with me? LoL

 

[Sherri]

I mentioned it to mine a couple of times, he was quite understanding and no threats or mental health crisis were called. Maybe I was lucky. But I do openly talk to the doc about it sometimes.

 

[Konjac]

In my experiences, just saying you're suicidal will result in safety plan after safety plan. Annoying, but nothing major.

Saying you're actively planning is tricky- it depends on your circumstances and diagnoses. For some, it's an instant section. For some, it's just being on lockdown at home, maybe a referral to some sort of crisis/home treatment team. You never really know for certain what'll happen until you find out firsthand, unfortunately.

 

[Death22]

All the ' professionals ' care about is their record, ie that they don't have a suicide on said record, and by you saying you don't have a plan you allow them to be able to claim you are not a risk, but also, who would say they had a plan if they did? One way ticket to the inpatient ward!

This - and also to make sure of the safety of others. That's all.

You as the individual is not important. The harsh truth,

What's important is their responsibility, their record and others (the group aka society) and last but not least - M O N E Y

 

[Raminiki]

I've been asked many times whether I have a plan by doctors and psychiatrists, even by disability assessors who decide my income. I'm always honest and say yes. They ask me to detail said plan. I respectfully refuse lest any efforts be made to sabotage me. It usually gets left at that. I was, however, forced to disclose the full details of my plan to the disability assessors to prove my suicidal thoughts are 'authentic'. I had to do so in front of a friend and my partner. It was barbaric and traumatic for all involved.

I've never been approached or detained. I've spoken to NHS24 about being suicidal, nada. I've been questioned about ligature marks on my neck and confessed to trying to harm myself, nope. I've filled in their questionnaires about how frequently I feel suicidal, they're not bothered even if it's every day. They do bugger all about anything. I've broken down sobbing that I need help to my doctor and they recommended useless online CBT courses.

Mental health services are ineffectual and underdeveloped in the UK. I'm of the opinion that nothing short of deliberately making a huge attention-seeking attempt and causing significant harm to myself would get me any degree of help. Even then, likely I'd just be bungled off to hospital for a few days, then thrown out due to lack of resources. I was once shipped off to hospital by a concerned parent, but refused to talk much or to stay there. They let me go home and never bothered to help me hence. It can be several months between psychiatric appointments, even if you're desperate.

All the people closest to me are aware I'm suicidal, some have seen me at my lowest, some know my main method. They do nothing to restrict me because they respect my autonomy and thus I trust them with my darkest thoughts. And I have warned that I will respond very negatively should they betray me.

The people less close to me are vaguely aware I'm suicidal and don't know my main method, and I work to censor my feelings from them. They cannot be trusted not to sabotage or blackmail me.

 

[TheLostCause]

Well im about to find out Monday. Im in the UK so im not really expecting anything but my SI is kicking in telling me I need to stay alive even though being alive is just hell, so i intend to be brutally honest at my psychiatrist appointment as my last ditch attempt at getting help. Im going to tell them i have a plan but theres no way im detailing it.
Ive made previous attempts but ive always said they were just self harm and not suicide attempts. I got sectioned once a few months back, I wasn't actively suicidal at the time of them sectioning me, they even did a re assessment a couple days later while i was in general hospital waiting for a bed and they still accepted it was the best course of action. I was absolutely terrified, never left my room, refused to eat. They discharged me a week and a half later with a BPD diagnosis and after realising it was the wrong move and was doing more harm than good. So im hoping even if im honest I should avoid hospital as it really isn't the best thing for me.

 

[Lostandlooking]

Another thing that can happen; not being accepted for treatment because you disclose you have a plan. I've had this happen two times the last couple of months.

When they asked if I had a plan they almost immediately told me that they needed to check with the team and consult regulations about this, they might not be able to help me.

A couple of hours after the conversation they called me back saying they could not provide the help I needed. (Which could be true, I'm looking for someone who is specialized in autism and trauma) But I suspect that the fact that I have a plan could play a part as well.

I've had therapy before and never had such trouble getting help. It often took forever but I would not be refused. I didn't have a plan back then. And that's where the conversation ended when it came to suicide. As long as I didn't have a plan it was fine. (at least it feels that way)

 

[TheLostCause]

Another thing that can happen; not being accepted for treatment because you disclose you have a plan. I've had this happen two times the last couple of months

I had a therapist at the start of the year, i told her i was suicidal and had been struggling not to act on it. She left the room then came back and said she could no longer continue our sessions and referred me for an assessment in which they did nothing at all. So all i got was my therapy cancelled.

 

[Darknessallaround]

Mental health services are ineffectual and underdeveloped in the UK. I'm of the opinion that nothing short of deliberately making a huge attention-seeking attempt and causing significant harm to myself would get me any degree of help. Even then, likely I'd just be bungled off to hospital for a few days, then thrown out due to lack of resources. I was once shipped off to hospital by a concerned parent, but refused to talk much or to stay there. They let me go home and never bothered to help me hence. It can be several months between psychiatric appointments, even if you're desperate.

Sounds about right unfortunately.
I've been 'threatened' with the prospect of the Crisis Team coming to my house, but it never actually happened. My MH team know I live with suicidal ideation and that there are various triggers. But I would have to be at immediate risk for them to actually do anything, and then as @Joxalldaita said, it would probably result in a short stay in a MH unit (assuming there were any beds that is), then a discharge back home with little if any follow up.
The MH system is completely broken in the UK. No wonder people don't even try reaching out for help.

 

[Shades of Grey]

It depends on your location, age, provider, and history... but you will not necessarily be sectioned for admitting that you have a plan. Particularly if you have a plan sans intent.

I have been chronically suicidal for the past two decades, and have multiple high lethality plans. I also have easy access to and familiarity with methods many do not due to my line of work. Once the plans are there and deeply entrenched, one can't very well just forget them. I'll always know how I would off myself given the chance.

I've been hospitalized once. It was voluntary. I had the means and intent. (Checked myself in because I felt that I needed to stay alive a bit longer for someone, and I was no longer capable of doing so.) I am not, by nature, an impulsive person. At all. I'm sure that has factored into the decisions that have been made.

But a plan does not necessarily= hospitalization.

 

[Kramer]

Why would you even ask this? What do you think happens?

 

[Shades of Grey]

Why would you even ask this? What do you think happens?

I know that there are members here who have been involuntarily committed for less, and there are some very real (and sometimes valid) fears about that.

I think it is important to acknowledge that talking about ideation (even when significant and persistent) does not necessarily have to mean loss of autonomy, because those fears keep some people from accessing resources that they might actually benefit from.

 

[PNKPNDA]

Why would you even ask this? What do you think happens?

lool can one not ask questions and be curious??? as the replies have shown the responses from professionals can vary very much so thank u very much for ur input xx

 

[elfgyoza]

Another thing that can happen; not being accepted for treatment because you disclose you have a plan. I've had this happen two times the last couple of months.

Yes, this is a huge problem and I always forget about it.
I've been told countless times how there's nothing they can do at the moment, except look at meds, because I'm still suicidal. They're clearly not used to chronic suicidal thoughts, I've been 'in the system' for over one and a half years and I've still not even been put on a waiting list for any kind of therapy. They just kind of expect you to just deal with it yourself.

 

[LongNight]

Everytime i mention to professionals my thoughts on ctb they always ask if i have any plans. I am the sort of person who does not plan it- it is just always in my mind so my attempts have been rather 'spontaneous' but no solid plans for it so i always say no however I am wondering what do they actually do if you turn around and say yes I do have plans??? I do not have any experience with psych wards or inpatient stuff so I am just curious to know if they do anything or if it is just another standard procedure question with no real follow up???

I'm in the US. What they're wanting to know is if you're going to kill yourself in the near future. If you have a plan, meaning do you have the means and opportunity, that means you've taken action already, which means they have to intervene. Where I live, you would go to the emergency room after that, then the psych ward for at least 72 hours. You should have people from the psych ward or mental health following up with you after that, but the professional you started with assumes the ER handled it and your situation is fine now.