Help What NOT to say if I don't want to be involuntarily hospitalized?

[inprosperus]

I've been refusing treatment and rawdogging suicidality for years. However, I've run out of steam altogether, and my SI is too strong to let me kill myself, so I'm looking at options, and I feel very much lost.

I am medicated for the first time in 8 years, and I have an assessment appointment with a mental health clinic soon. I hate it all and I don't believe in it whatsoever, and a part of me says that I won't get better and that it's not worth it, but I feel so legitimately crazy and out of control that I'm willing to try it out. It won't do *enough*, but maybe it'll do *something*.

Honestly no I don't trust it at all LOL

In any case, I'm really stressed out about the assessment appointment. I'm scared of not saying enough and being directed to the wrong type of care (if I get sent to some bullshit surface-level breathing-exercises-and-journaling therapist I'm going to explode) or that I'll say way too much and end up forcibly hospitalized. I won't admit to recent past attempts, but what else is "too much"? Plans, suicide note, self-harm? I haven't talked to any sort of mental health specialist in too long. I don't know what's "acceptable" anymore.

TLDR: How do I balance properly conveying how fucked up I feel without being hospitalized/put into an inpatient program? My brain says "SAY NOTHING" but I know that's not logical (?). Is my hatred for mental health services biased or am I worried for good reasons? Any insight, experience?

 

[Trismegistus_13]

I'm really proud of you for having a health assessment in the future!! I hope they'll be able to help you! My advice would be to be as honrst about how you're feeling as possible. With thay said, I know that's not always exactly helpful. So...

Look up the SAFE-T risk assessment exam to get an idea of how they would evaluate you. Clinicians may send you for emergent psychiatric treatment if they believe you are an active threat to your own life. In other words, they are looking to see if you:

1. Are actively suicidal
2. Have a plan to commit suicide
3. Have the means to commit suicide
4. Have any protective factors from suicide

So if you go in there saying you are ready to die, and you are going to shoot yourself this Saturday with a gun you already own, they would hold you as you would fulfill all criteria above. If you tell them you're feeling suicidal but aren't really sure when you would want to, and you don't know how you would, and you know your parents would miss you, it would be unlikely they would hold you. Again, try to be as honest as you can. I wish you the best of luck!

 

[INYGTRMTFMO]

I'm really proud of you for having a health assessment in the future!! I hope they'll be able to help you! My advice would be to be as honrst about how you're feeling as possible. With thay said, I know that's not always exactly helpful. So...

Look up the SAFE-T risk assessment exam to get an idea of how they would evaluate you. Clinicians may send you for emergent psychiatric treatment if they believe you are an active threat to your own life. In other words, they are looking to see if you:

1. Are actively suicidal
2. Have a plan to commit suicide
3. Have the means to commit suicide
4. Have any protective factors from suicide

So if you go in there saying you are ready to die, and you are going to shoot yourself this Saturday with a gun you already own, they would hold you as you would fulfill all criteria above. If you tell them you're feeling suicidal but aren't really sure when you would want to, and you don't know how you would, and you know your parents would miss you, it would be unlikely they would hold you. Again, try to be as honest as you can. I wish you the best of luck!

Seconding this. I have literally told therapists the intent and intended method, but because I didn't have a date, they didn't need to hospitalize me.

Hell, I had a family member walk into a facility and ASK to be hospitalized for suicidal thoughts, and they turned him away. Beds are in short supply, at least where I live. You gotta be in ACTIVE, IMMINENT DANGER before they keep you.

In my experience, they try to increase those protective factors, ie if you are having suicidal thoughts, who can you reach out to, and what can you do to de-escalate yourself?

Hoping the assessment goes well and yields some positive results for you!

 

[Yuri440]

Aye as long as you are currently a danger to yourself is what my mental health team go by. I'm very much suicidal currently, and they're fully aware. I've not been hospitalised because I want to kill myself so bad but the actual chance I'll be able to do anything to harm myself at all is about 2/10 currently, so until that gets to a point where they think I'm actively going to harm myself, I'm alright.

Initial appointments will absolutely likely feel like generic therapy of journals and breathing exercises. The main thing to remember is that neither of you know each other yet, and they're still getting a feel. What's written on paper about your current struggles doesn't tell them how best to interact with you. For me, the whole being professional and such puts me off and into a defensive quiet mood, whereas a friendly casual approach helps me feel at ease and open up to them more about everything. There's lots of little things like that which take time before it'll be at a level that's great. It's taken mine about a year now to be at a point where I'm comfortable enough to talk openly.

Good luck friendo <3

 

[XiaroX]

I've said 'I have methods ready, but I'm not going to do it tonight.' A couple of times I said 'I want to die, but I promised my friend I wouldn't, and also he has health problems and needs me right now'.

 

[slowlydying2mrrw]

"Are you suicidal?"

You - "No"

That's the gist of it

I'm kinda being sarcastic but in reality, even according to licensed mental health practitioners and medical doctors (and even jails), if you are suicidal or they have belief you intend to harm yourself or others, they have an obligation to place you on a safety hold for 24-48 hours.

This sucks in a way, but it's the unfortunate reality. You can talk about your ideations just don't hint at anything that could suggest you would take action.

 

[XiaroX]

"Are you suicidal?"

You - "No"

That's the gist of it

I'm kinda being sarcastic but in reality, even according to licensed mental health practitioners and medical doctors (and even jails), if you are suicidal or they have belief you intend to harm yourself or others, they have an obligation to place you on a safety hold for 24-48 hours.

This sucks in a way, but it's the unfortunate reality. You can talk about your ideations just don't hint at anything that could suggest you would take action.

There is another scary factor, which I just remembered today, for people who live in places like the US. If people have certain types of medical insurance, there are 'health clinic' insurance scams, with employees who need few qualifications, and you might only need to say something like you were suicidal at one time. I don't know how accurate - but check out Steven Soderbergh's Unsane. It's a mental illness horror movie. The moral of that story is: don't sign anything without reading, even if you are pressured or told it's protocol and will hasten the process of your therapy.

The point is that they are trying to get money from insurance companies and force confinement and treatment on people that they don't need, and don't give them the treatments they are actually asking for.

Spoiler Alert: the woman in the movie had a restraining order on a guy who was stalking her, and eventually moved cities to escape him. She found she couldn't get over panic reactions, so she sought therapy, and because the clinic had few requirements for employees, her stalker was able to get a job there, and no one believed her.