What happens if you tell a doctor that you're suicidal?

[ToadsJustFellFromTheSky]

Just that really.

When a doctor asks you whether you've had thoughts about actually hurting yourself or if you've made any plans to and you tell them you have, what (if anything) do they do?

There have been times in the past when I've wanted to talk about how I really feel but am always scared about what will happen.

Sorry to hear you are feeling so low, it's a horrible place to be

From personal experience, they ask you if you are serious, decide you arn't (regardless) offer you anti-D's, or a change of drugs, or a higher dose and tell you to come back in a fortnight. You leave slightly reeling and wonder how the hell you will make it through a fortnight.

Close friend makes frequent suicide attempts and very serious self harm, they just patch her up and send her on her way to do it all again.

Is there anyone irl you can talk to? Or just chat on here

Really?

So if someone said that they were going to overdose on something on x day at x time they wouldn't actually do anything about it?

Makes you wonder why they even ask that question...

They prescribe drugs and send you to counselling.

depends on the GP I expect

Mine would say 'well I'm not going to give you ABs for that' and give me a furious look for wasting her time on my trivial whingeings, and mutter something about it being normal at my age and have I thought about losing weight and it being something I'll just have to live with. Or not.

Judging on every other time I've seen her about anything, which is why I keep it to myself.

If I really wanted to talk to someone, I would find a counsellor before I spoke with my GP. Actually I would change GP, I'm thinking about it.

If you feel you can talk to your GP and they would be sympathetic, maybe start with asking to see a counsellor but be warned, the waiting list could be long. If you can afford it, seek a private counsellor and go from there, they might be able to help you broach the subject with your GP. At least that's what I would do - I'm not qualified in anything at all and this post is based entirely on having fragile mental health and a fucking awful GP.

My experience seems quite different. My local Mental Health Team would swoop into action immediately, I'd have a Crisis team assessment same day, then either go under Home Treatment Team (daily visits at home) or be admitted to hospital.

Either way I'd see the psychiatrist within a day or so for medication review. As a parent, they'd also do a referral to Social Services.

I live in Northamptonshire.

Fuck all. Utterly pointless ime.

Jesus, I was sent home from the hospital after 2 suicide attempts with nothing. First one a referral to my Comminity Psychiatric Nurse and a long wait to see a psychologist, second one nothing. But I wasn't a mum then, I was a severely depressed young lady with no support system (imo a high risk). I would like to think that they'd do more now but I did go back to my Drs with depression, not suicidal, when I was a mum he gave me more tablets and told me to do a CBT course online. I know they put a lot of money into advertising talking about mental health, I kind of wish they'd use that for helping people at risk.

I think it quite often depends on your history. if you've got no history of mental health problems then you'd probably be offered anti-ds, possibly counselling and sent on your way.

If you're known to the mental health team then they tend to be a bit more proactive - same day appt at the CMHT, same day appt with the crisis team or even hospital depending on your history. That kind of intervention comes from being "in the system" for years though IME.

Oh and I'm a mum and have not had any social services involvement ever.

The thing is, someone saying, "I'm suicidal" can mean very different things, depending on the person's personality, history and circumstances.

So any medic who hears that will be doing a basic mental state assessment to try and get an idea of how serious you are and your level of risk - some people will be prone to dramatic moodswings and emotional statements but don't present any real risk, whereas others can be very understated and non-dramatic, but be very urgently at risk.

They are looking for:
Degree of suicidal intent
Presence of a plan and likely lethality
Access to means to carry out the plan

They will want to be as certain as they can be that you are safe, whether that involves a chat with you, referral to a psychiatrist, CMHT or crisis team, emergency PRN medication, or immediate admission to hospital. Obviously they won't get it right all of the time, but that's the kind of decision-making process that will be going on.

I have had mental health problems for well over twenty years, so have a long history. I have turned up at my gp's hysterical, sobbing, desperate, pleading for help before I do something.

They have referred me to counselling with 12 month waiting lists

I have never had access to the crisis team from the GP or from A&E, only on discharge from hospital as an in-patient or through a team while being seen as an outpatient.

Very varied responses from the different medics involved then . As has been well said by other posters it really boils down to an assessment of how you are presenting, your support network and the opinion of the medics concerned.

Thoughts about suicide are quite common so I would not be afraid of discussing them with my GP (or psychiatrist). Sometimes these thoughts start to become like the elephant in the room. I get quite obsessive about them if I don't share, and they are like a rock round my neck dragging me down.

Fortunately, I have a great GP who recognizes that a lot of depressives have suicidal thoughts (and plans) but don't act on them. I certainly do and, for the (most) part, my suicidal thoughts are more of a potential, future escape route (which I find comforting to have) rather than something I am going to do right now.

Toad are you asking because you are afraid you might be hospitalized, or are afraid because you won't be and deep down that is what you want?

When I first went to the GP and said I couldn't stop thinking about killing myself, he took me very seriously. He prescribed a small amount of diazepam to help and made a referral to the local crisis team. They called me that day and asked if I could keep myself safe. I said I could that day, so I had an appointment with them the following day where they assessed me and put in visits and help till I was over the worst.

NotAJammyDodger I actually don't feel suicidal right now. However I have done in the past but I have always been too scared to admit it to anyone in case I'm hospitalized.

On the other hand when I have felt really suicidal I have wanted to talk to someone about it but have always been too scared to. When my GP would ask me if I had any thoughts about hurting myself I would always downplay it so it didn't sound as bad as what it was.

It's the same with all the counsellors I've had. Everyone I've seen has made me sign a form that says that confidentiality will be broken if you admit to being actively suicidal (not those exact words obviously). So I've always been scared to tell them when it happens so just like with my GP, I downplay it.

Toads - you have to work quite hard to be hospitalised, and even harder to be admitted against your will.

Suicidal thoughts are really not uncommon, GPs and other MH professionals will not overreact to you saying you feel suicidal, but it is important that people know how you feel in order to get you the best help.

IME they work really hard to involve you in discussions about what you need - the scenario where people pile in and make choices for you against your will is really not the reality. They can break confidentiality, but again they will not IME do it behind your back or without discussing it with you. Obviously it will depend whether you are talking about having occasional intrusive thoughts about suicide but no specific plan, or whether you are actively suicidal and have access to means and the intention to carry it out.

Breaking confidentiality in practice should mean having a long discussion with you about how they need to keep you safe, making appointments for the crisis team to visit you at home, giving you PRN medication, phoning your GP to put a flag on your notes to ensure that you can get an apointment any time you need one, possibly asking to speak to other family members if appropriate to ensure that you're safe.

Reading other people's experiences I may have been lucky, but I would liken it to interventions in childbirth - you may not have started out wanting a ventouse or epidural or whatever, but there may come a point where you need these things, and as long as it's explained to you and you feel respected and consulted, it doesn't have to be an overwhelmingly bad experience.

You wouldn't be admitted s mhse Maytree foundation are a good source of support if you are in a genuinely suicidal crisis, or preferably before. Google and phone them.
Best wishes to you.

So if they ask you if you've had any thoughts about hurting yourself and you answer "yes" they won't then have you hospitalised.

Good to know.

No they won't. With as few beds as there are you have to be very, very unwell before hospital is recommended. Having thoughts of suicide generally doesn't fall into that category.

"So if they ask you if you've had any thoughts about hurting yourself and you answer "yes" they won't then have you hospitalised."

No, really really not. Assuming you have a vaguely competent MH professional, answering 'yes' to this question will lead into a conversation in which they tactfully try to establish the nature of your thoughts, what triggers them, whether you have any plans to act on them, and generally try to assess how much of a risk you present.

Obviously if you are sitting there saying that you have made detailed plans, have access to XYZ lethal means of killing yourself and are intending to leave the consultation and put the plans into practice then there will probably come a point where the options you are being offered are pretty much limited to 'come with me to A&E now' or 'wait here with a cup of tea until we can take you directly to the crisis team for urgent assessment'.

Crisis Team and A&E assessments also generally take the form of people talking to you for a long time, rather than anything more dramatic. Cups of tea will also be involved. It's all very British, and generally at some point in the process you do start to feel somewhat less appalling.

Don't let fear of dramatic consequences put you off getting the help you need, it really isn't like that.

I feel hard done by now as I've never been offered a cup of tea!

Depends if your high risk. If your likely to carry it out expect intervention. If you just feel like you really could then hopefully support, empathy and a follow up appointment.

To be fair there's not a lot anyone can do with a 10 min appointment max!

I have an amazing GP who at my lowest called me the next few days just a minute or so to see how I was doing. It made all the difference to me.

You should definitely talk about it.
You will not be hospitalised automatically
It might help a lot to talk about it.

It is a really common experience to have suicidal thoughts when depressed. It could vary from thinking that life is not worthwhile and wishing to be out of it sometimes but recognising things that would stop you to having a formulated plan that you will carry out to feeling really desperate and acting without much thought.

The Dr should explore your feelings sensitively with you including how you could keep yourself safe and a crisis plan if you feel you cannot.

The plan could vary from just having regular support from the GP, meds, counselling, CMHT, crisis team or admission as a last resort. It really depends on the whole situation. It is not one size fits all.

Hi Toads totally agree with recent comments from other posters. You need to talk about it. It is really common to have suicidal thoughts. Sharing your pain will help. Keeping it bottled up inside will only increase your anxiety. Best wishes

It is important to discuss it, but you need the right person to listen

I feel short changed! I've never had a cup of tea!

But yes, pretty undramatic in the main. Even if you do end up in A&E, you have to sit and wait for hours and hours, to then have a 5 min chat with someone to tell you you should go home and have a nap.