Urgent- suicidal friend

[aliasname]

My friend has been messaging me today saying how she wants to end her life. She is currently sectioned (for about 6 months now) and she has told her psychiatrist about being suicidal, hence they are refusing to discharge her.

The way she talks is quite scary, very matter-of-fact and genuine. I'm assuming since she's an in-patient in the mental hospital (I don't actually know which one, but can take a good guess) and under a psychiatric team, they will already know about this & keep her safe?

I'm reluctant to phone and warn them, as it may get back to her & then she no longer trusts me as a safe friend.

She just keeps saying she wants to get out and 'do what she has to do'. She's also refusing the medication prescribed.

Do I just keep talking, or do I go behind her back and alert someone (to something they almost certainly already know) ?

So she just dropped in the name of her psychiatrist, and I can't help wondering if it's because she wants me to get involved (fwiw we haven't spoken in months, every time I messaged her I got no response so this is the first conversation since February)

I would tell them. They won't be able to discuss her condition with you but you can give them information. If you are concerned about it getting back to your friend you can make it clear that you wish them to keep this information confidential.

I'm sorry you are in this position, it's really hard to know what to do for the best but I think for your own peace of mind you should talk to them.

The advantage to reporting your concerns is that if she does take her own life you know you did what you could to help her.

Clearly she is very unwell and it’s good to hear that she is not being discharged.

Very sad 😞

I’m so sorry you are in this situation. I think you should tell them, I’m sure they would keep it confidential and not let on that you’ve been in touch.

That must be very distressing for you and your friend, it may be helpful to let the ward know, however, I work on an accute psychiatric ward so please be reassured if a patient has suicide ideation and are considered at any risk to themselves they will be under supervision. There are also lots of protocols in place to prevent anything happening, she should be in a safe place and I hope your friend recovers soon

She’s in a safe place.

They will more than likely be very aware of her risks, hence their decision not to discharge (but one does wonder, if 6 months of admission hasn’t helped, what the team think keeping her in any longer is going to do…)

it’s distressing for you to receive those kind of messages but ultimately she is safe. Try and move the conversation to something like if she is allowed visitors, etc and see if you can make a plan to go and visitor (if you want to).

*visit her

You are being a safe friend if you tell them. It shows that you care about her and want to help. It might be difficult for her to understand that when she is unwell. But she will appreciate it when she gets better.
Hopefully the staff in the unit will be aware and will be working to try and keep her from harm,. But if anything happened and you hadn’t passed on the information you had how would you feel then. You are helping her most by telling them.
Its also unfair for you to have this responsibility and you need to have clear boundaries with your friend.

What is your gut telling you to do? You have a duty of care to yourself as well as your friend, it is very likely that her team know where she is at, and that still might not be enough to stop her from following the path she wants to, but you may be left never knowing if you could have made a difference and that's a hard thing to hold. As others have said a simple disclosure to her team will alleviate that burden for you, it's so unlikely they are unaware but you can't know, and any mental health professionals worth their training will not go in and say your friend called us, especially if you specifically ask them not to. Be kind to yourself, you are being a good friend but this isn't yours to hold, share it and continue supporting your friend in the ways you can with the knowledge you've ensured you are not the only one holding this information

Only if the patient is sharing that information with the staff.
And ‘protocols’ will only be in place if she is a known suicide risk.

@aliasname do share your concerns with the ward if you can find out where she is. It’s great that she feels able to talk to you but it’s a hard secret to carry.

Ring the ward and let them know. It's too much of a burden for you to do alone.
They'll probably already know, but it'll be helpful.

(but one does wonder, if 6 months of admission hasn’t helped, what the team think keeping her in any longer is going to do…)

Keep her alive. Some people are in those places years.

I would phone and tell them. If anything happens then it won’t always have you wondering. She does sound very ill having been in that long. They won’t say “Alias has phoned up” they’ll just check on her more often/up her watch etc. They won’t betray your trust.

I'd phone and tell them too. But just to say, as someone with mh problems myself, although never been sectioned, she obviously thinks a lot of yoI and that you're a safe person.

Is she under section and can't voluntarily leave? How does she have a phone? (As I said I don't know about mental health units)

I would tell her doctor, show evidence and I think they'd be skilled to not name names and hopefully chat anyway and help.

as pp said, you love her and want the best for her, and this is the best thing.

@Harrystylestutu many units/wards allow mobile phones (depending on type of ward/individual risk).

Thank you all for the quick responses. As I said, she has told her psychiatrist about her suicidal plans (or so she says ~ I guess I have no way of knowing if she's telling the truth) which is why, along with refusing to take medication, she hasn't been discharged.

Interestingly, when she talks about suicide its always in the future "when I get out of here" etc which reassures me she's not planning anything imminent.

I was also concerned that if staff found out about our conversation, they might take her phone away ~ leaving her feeling even more isolated.

For some reason I feel the need to tell you about her.

Although we lost touch after university, she's always held a special place in my heart ~ because she is such an individual who never seemed to care what other people thought & taught me to be the same.

She had a great sense of humour, never took anything seriously.... we were the first people in our town to visit the newly opened Body Shop (I bought an apricot lip balm) I'm talking in the past tense, because I don't see any of that personality in her recently.

She taught my husband how to juggle. She wore giraffe earrings, and played pranks, and loved animals.

She used to call herself 'Mad Denise' (and then so did everyone else) and it was almost like she was trying to pre-empt people saying she wasn't normal. Even when we were teenagers, she felt different to other people. We didn't talk about it then, because let's face it all teenagers are trying to fit in - but I think she struggled more than most.

That was over 30 years ago. All this time, she's been trying to be "normal" it breaks my heart, because she is the most genuine, caring, sincere person I've ever met.

Why would she not be allowed her phone? 🫤 She’s ill, she’s not in prison.

@aliasname that wouldn’t be reason to remove someone’s phone.

I wondered because sometimes she goes silent and I don't hear from her for a while

and also somebody upthread said they allow phones 'depending on individual risk'

I wondered because sometimes she goes silent and I don't hear from her for a while

and also somebody upthread said they allow phones 'depending on individual risk'

The poster said she had already told her psychiatrist so the ward would definitely be aware and ensuring she was safe, if there is ever any risk of suicide ideation patients are monitored closely and this is looked at twice daily in handover

Friend says she has been forced to have ECT which she doesn't want. Google tells me it is rarely carried out unless the patient lacks mental capacity & is severely depressed & other medication hasn't worked. She must be in a truly bad state.

Talking to me, she still has a bit of a sense of humour, but I can feel her anger at the situation.

I meant, it is rarely carried out against the patients wishes

@askgoogle if her friend is telling her the truth.
Risk (of any kind) is assessed more than just during handover.