“I’m scared to tell a therapist I’m suicidal.” I hear it all the time. That’s why I’ve designed this helpful guide that explains: who to talk to, what will happen, and how to have that tough conversation. Resources included.
If you’re experiencing a life-threatening emergency, call 911 immediately, or go to the nearest emergency room. If you’re having suicidal thoughts and need help now, please call the National Suicide Prevention Lifeline at 1-800-273-8255.
Lately, we’ve seen a surge of suicidality in the media, starting with the popular teen TV show “13 Reasons Why” and escalating with the very public deaths of American fashion designer Kate Spade and renown foodie Anthony Bourdain. Even now, suicide feels like this big, hairy monster that no one likes to address and nobody knows what to do with.
So what do we do?
Breaking the silence is a common call to action, heard among both mental health professionals and people struggling with suicide. But how? Well, I’ve noticed a gap in the conversation about suicide. There seems to be a good amount of information available about warning signs and resources; however, we’re still missing frank discussions about what it actually looks like to walk into a professional’s office and ask for help. To address this problem, I created a practical guide to having that tough conversation.
Here’s everything you need to know in order to safely tell a therapist you’re suicidal — and start healing.
How Do I Know If My Suicidal Thoughts Are Serious?
However, it helps to understand that suicide exists on a continuum of intent. On one side of the continuum is a person who’s entertaining vague ideas about suicidality. She might wonder what it would be like to not wake up the next day, or she may just feel like “disappearing” completely. On the other side is someone who has a detailed plan, a date and time, and the means to carry out his plan. He might be taking actionable steps, such as writing a note or preparing his things.
It’s important to understand this continuum because mental health professionals use it to determine the level of care you need. Once you understand this continuum, it’s time to consider who you can talk to with trust and safety.
What Should I Do If I’m Having Suicidal Thoughts?
First and foremost, the most important thing is that you talk to someone if you’re experiencing suicidal thoughts. Many people wait months or even years to reach out for help, even when they’re struggling. I’m here to tell you there’s no reason to suffer that long — especially not for fear of treatment.
However, it’s also important to choose this person wisely — whether it be a trusted friend, family member, mentor or mental health professional. So how do you find the right person?
For some people, a friend or mentor can be less intimidating than a parent or mental health professional. Most people have an intuitive fear of extreme reactions or forced treatment. You might be afraid, for example, that a parent or doctor will force you to take medication — or even hospitalize you. While there’s no reason to be ashamed of any treatment options, I realize these outcomes can be frightening enough to stop you from reaching out. (More information about this common fear is included below.)
If this is you, tell someone. And if you reach out to someone and don’t receive the help you need, then try talking to someone else. Try again and again and again, until you find a treatment plan that works. Please don’t stop reaching out until you’re on the road to healing.
Why Should I Tell A Therapist I’m Suicidal?
While it’s imperative that you talk to someone about suicide, there are reasons to choose your confidant with care. The average person, for example, doesn’t have the training and experience necessary to perform an assessment or guide you toward the best treatment options. Nonprofessionals also have much less experience determining where you fall on the continuum of intent. It’s possible they could project fears and risk escalating the problem, or they could miss a call for help.
And it’s true: Anyone can.
That’s why it’s so important to have another advocate in your corner, one who understands what you’re going through and how to treat it. Besides, if you’re more comfortable telling a friend, you can ask them to help you find a professional.
How Do I Tell A Therapist I’m Suicidal?
Assuming you found a safe therapist you trust, just be frank. It may sound simple, but thoughts of suicide feel anything but simple. It’s a complex experience that can come with shame, fear and guilt. That’s why it helps to just be straightforward and stick to the facts.
If you want to tell a therapist you’re suicidal, start by sharing:
- Whether or not you’re experiencing suicidal thoughts in the present moment
- The last time you experienced suicidal thoughts
- How often you’ve experienced suicidal thoughts
- What thoughts run through your mind
- How you’re feeling about it
- Anything else you want to unload or share
What Happens When I Tell A Therapist I’m Suicidal?
Mental health professionals are legally and ethically mandated to report to authorities when a person is an imminent threat to him- or herself or others. That doesn’t mean, however, you need to worry about saying the wrong thing and — poof — you’ll be automatically taken away. In fact, not every person who experiences suicidal thoughts should go to the hospital or even take medication.
Each individual case is handled differently.
So what does happen when you tell a therapist you’re suicidal? The therapist or mental health professional will likely follow a process that begins by assessing where you fall on the continuum and ends by recommending the most appropriate treatment for you. For example, I would walk you through the following process.
I ask you a series of questions to determine:
- Are you currently having suicidal thoughts?
- If not, then how recently and often have you had them?
- Do you have a plan?
- Do you have the means to carry out your plan?
- Is your plan viable?
Recommend A Treatment Plan
Treatment options I might recommend include:
- Check-in calls between sessions
- Self-care plan
- “No Suicide” contract
- Involvement of your support system
- Increased frequency of sessions with me or another professional
- Referrals to health professionals, including a mental health specialist, psychiatrist or doctor
- Medication management
- Hospitalization, in the event of imminent threat or danger
Increase Level of Care
With the treatment plan as our guide, I will adjust your level of care as needed until suicidal thoughts, and other possible symptoms, are eliminated. If we hit a roadblock, then I can recommend services to use in tandem with psychotherapy, until we figure out the right plan for you. It’s as simple as that.
How Do I Get Help?
I know it’s really scary to talk to a therapist about suicide, but it’s much more common than you think. More importantly, it’s very treatable, and at the end of the day, I don’t want anyone to suffer longer than they would have to otherwise. So — please — if you want to tell a therapist you’re suicidal, make a plan to get help, and reach out to someone you trust.
It can get better.
In fact, if you want to talk to a professional, here are 3 steps to finding a therapist in Santa Clarita:
- Some therapists accept insurance and some do not. To use your insurance, it’s best to call your insurance or make an account online, and search for in-network providers.
- If you have the flexibility to pay cash, you can search online directories and listings, such as Psychology Today, and click on “Find a Therapist.” You can also search the EMDRIA Directory, which has only EMDR therapists.
- If you’re age 25 or younger and have MediCal, our local resource is Child and Family Center.
- College of the Canyons Student Health & Wellness Resource Website (661-362-3259)
- Child & Family Center, Santa Clarita (661-259-9439)
- SCV Youth Project (661-257-9688)
- SRD~Straightening Reins Equine Therapy (661-803-1641)
- Los Angeles County Department of Mental Health (800-854-7771)
- Child and Family Guidance Center – Northridge (818-993-9311)
- Henry Mayo Newhall Hospital Behavioral Health Free and Confidential MH Screening Website
- Santa Clarita City Mental Health Resource Page
Regional and National Resources
- Pepperdine Encino Community Counseling Center (818-501-1678)
- National Suicide Prevention Lifeline (1-800- 273-TALK)
- Mental Health America
- Mental Health: It’s Part of All Our Lives (1-800- 789-2647)
- National Child Traumatic Stress Network
- National Council for Community Behavioral Healthcare
- National Institute for Mental Health
- SAMHSA Site for Coping with Disaster and Traumatic Events
- Stop Bullying
About Your Santa Clarita Therapist
Kristina de Bree is a Licensed Marriage and Family Therapist (LMFT) in the state of California and an EMDRIA certified Eye Movement Desensitization and Reprocessing (EMDR) therapist with a private practice in Valencia. She focuses on helping individuals build, mend and develop healthy relationships and authentic connections with others and with themselves, and as a Valencia EMDR therapist, she is specially qualified to treat trauma, kids and teens, performance enhancement and medical illness, right here in Santa Clarita. Kristina believes that the core of every working relationship should be built on trust, authenticity and quality. She brings a deep value and care for the patient experience, believing that change is made through relationships that are trusting, caring and safe.