suicide prevention, basic first aid

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clinicians distinguish between suicidal thoughts and urges and impulses and imminent danger of acting on those thoughts, urges, or impulses.

there are a whole range of indicators that are predictive on whether someone is likely to act on their thoughts, and there have to be some major red flags present, aside from thoughts, before anyone would be sectioned against their will.

as a crisis counselor part of my job was to advocate FOR the patient's rights in this matter. we did not section people lightly, nor is it easy to do (at least in massachusetts). you might be surprised what you canNOT get sectioned for (active psychosis, for instance).

having hospitalized myself for suicidality, and had a really awful experience at the hands of unskilled and insensitive staff, as well as having worked a number of psych hospital inpatient units, i really think it's a last resort. essentially in the US what most offer is simple containment and monitoring until you are assessed to be stable enough to leave without harming yourself or anyone else. i wouldn't call many of them actually therapeutic. it's more like emergency triage. which, like any triage, does have it's place in treatment, but it's only a first step.

in fact, many of these units if not all) will take you OFF any meds you are on so they can observe a "baseline" which has *some* good reasoning behind it, but fundamentally i've seen it be incredibly DEstabilizing to people already in immense emotional crisis.

FORTUNATELY there are a lot of levels of care between hospitalization and, say, dropping in to see your therapist once a month, and a good clinician will help you find the level of care you both want and need.

as has been observed early in the thread, being willing to talk about thoughts and desires is considered a *good* sign. no decent clinician should be jumping off the back of the bus waving their arms and screaming frantically if you report having some thoughts or urges to self-harm. there's a lot more to suicide assessment than that. it's OKAY to tell someone.

once my thinking dips down into suicidal "ideation" (thoughts), i know it's a short road to a depth of depression i can't work my way out of (many levels of depression i can).

so personally i'd rather go to a partial or intensive outpatient program for a few days or weeks, for instance, than end up behind a locked door again, even if it's my own choice (again). or ramp up my treatment/support in some other way.

retep, I am glad you are still with us. And I mean with us as both a person on the Spectrum and just as a human being on this planet.

The way they treated you on the job, and this does resonate with me although I may not have experienced as bad, I think their actions constitute a cheat, a pounce, an ambush. They can't coach and work with a willing worker ? ? If so, they're not very good managers. I've also had jobs that say, ask questions. But when it comes down to it, they don't really mean it.

And it sounds like your psychiatrist was generally helpful. That's a good thing, and more power to you. But . . . that has not been my experience. I've been pretty disappointed with so-called mental health professionals.

So, one thing and I hope you're join with me, I want people to realize they have a choice. A person can see a psychiatrist, or an internist who can just as well prescribe an antidepressant, which are trial and error in a respectful sense anyway. I have not yet tried antidepressants, but they are kind of my ace in the hole. Can also be important to phase down in steps, even if the medication do not seem to be working.

And one of the better counselors I saw was actually not a counselor at all, but a speech therapist. She would also talk with me and give some advice. But her ego wasn't all wrapped up in her being "right," so the whole dynamic worked much better.

Opi, I am glad you were in there advocating for patients. And I'm glad in theory that it's hard to commit someone. In practice, although I don't know this, I suspect some practitioners decide a person should be committted, and then, yes, yes, yes, they just check it off, 'a danger to self or others,' whatever the paperwork asks for. Not that they're consciously lying, but some people just have a looser view toward paperwork.

If a person is in the hospital for any reason, appendicitis, cardio monitoring, it helps to have friends and family present to advocate for you if need be. But times I've been really down, I haven't had any friends. And family members, have been a little sketchy, let's just say that. I think if I ever was in a psych ward, I would write things down, for that's often how I understand things, and I would plan for and be diplomatic that what I write might well be discovered and read.

On the other thread, I think that someone wrote that if you voluntarily check yourself in, you can also check yourself out, something like 72 hours, something like that. If Opi or anyone else knows about this, please share with us if you have the time.

And yes, I'm glad clinicians distinguish between suicidal thoughts and urges and impulses on the one hand, and imminent danger on the other hand. And what we're doing here is talking about emergency first aid, as a back up, in case things get really bad. And we might also talk about general depression, and that would be fine, too.

you mean that one guy was lying about his son commiting suicide? He was just a troll

If I respond from my heart, I will get yelled at by a bunch of people and they will say you're just an 18 year old kid what do you know?

And please remember, the person made largely the same post on another website:

http://www.city-data.com/forum/mental-h ... cause.html

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And regarding this particular thread, I think this other forum may have handled it better than we did. One person said they thought it was a troll. Another person said, yeah, that's kind of what I was thinking, while does the dad keep talking on the Internet instead of getting help for his son?

And then a moderator said:
"There are plenty of excellent suggestions. Thread closed."

That is, action based on incomplete information, but being decent about it and that's perhaps the key. And it was three pages of back and forth with a lot of excelllent suggestions. And if we're mistaken, the door is still open for the person to come back and begin another thread as needed.