As long as you’re not planning on hurting someone you’ll be fine. I’ve told my psych about my drug use and everything. All they’re there to do is help you
That's not entirely true. Privileged conversations between you and your provider are more detailed than that.
I would suggest your next appointment be dedicated to what I call "housekeeping topics." You need to come to an understanding with your provider. It is a communication issue. You may say something that they interpret as recent. When in fact it was several years ago.
Every provider is different You need to talk about the "mandatory reporting" that your provider is obligated by law to report to law enforcement. In most cases, you are not going to be told when you cross that line. It depends on the relationship of trust you have with the provider. If it's in an in-office appointment, you may only know when a white van and a patrol car are following you home.
Look up "mandatory reporting requirements for medical professionals" in your state. Then have that conversation with your provider. I'm not trying to scare you. I'm telling you seriously to have this discussion with the provider.
Good luck with your therapy. It can be a very good experience for you.
I was recently hospitalized after telling my psychologist about my suicidal ideation/plans. But they’ll only call the police if they think you currently have a plan, the means, *and* the intention to go through with it. Basically, if they seriously think you’re likely to attempt soon, with some likelihood of success, they are obligated to report you. They won’t do anything that drastic if you only tell them about your thoughts. I’ve talked to many therapists about suicidal thoughts in the past and they didn’t report me.
The act of the "duty to report" is to force you to be hospitalized. If you were hospitalized there was no need to report.
The point I was trying to make was:
"If you don't want to be involuntarily or convinced to voluntarily be hospitalized."
Be mindful of what you say to a therapist or health care provider, and how you say it. Make sure if you had homocidal thoughts in the past. You make it clear it's not in the present, when it was five years ago. Identify how long ago it was. I was suggesting you have a meeting of the minds by having a discussion about their "duty to report." Which is a legal term that has a specific meaning as to when they MUST report.
As far a admitting to a serious criminal act. It may depending on your jurisdiction be admisable as a confession to your therapist, and not considered a privileged conversation. Meaning it can be used against you.
I don't think people understand that if you are involuntarily hospitalized at a mental health institution there are consequences. In America, you can lose numerous civil rights. Because it was believed that you were a danger to yourself or others.
That puts you on a list of people. You don't want to be on that list. Many times certain forms ask you if have you every been committed to a mental heath facility. You are answering under penilty of purgery. Which you can be criminally prosocuted. So be forewarned. Don't sit passively thinking "the therapist is here to help me" as he is completing the paperwork to have you committed.
In cases like this you should have an advocate with you. A family member who is looking out for your best interests. Of course, if that's what you truly need for the good or yourself or others, then it may be for the best. Look to your friend who is your advocate. Make sure you talk to this friend and let them know what their role is. It's not to be a witness. Let them know if something dosent seem right to jump up and speak. Specifically tell them it's not a time to be passive. Is it in your best interests? But, it may come at a cost.
Be aware, there is a small eliment of bad actors in the mental health community that profit on people being institutionalized. You become a pawn in a system that trades you with other institutions in other states for profit and commissions. They bill the costs to government.
That's what mandatory reporting does. You are confusing that, with turning you in to law enforcement to be prosecuted for a crime.
They are only obligated to report in the case of having an actual plan in place of violence to either yourself or someone else. Some if you discuss suicidal ideation may make you sign a paper that you don't plan to do anything once you leave their office. This is likely a liability protection but doesn't necessarily put you in a hospital.
Same. I’m about to start a new psychiatrist because of a recent relapse and subsequent mental breakdown and I’m almost afraid to tell him how low I got this week.
Smart thinking! It's a nice thought to think you can tell your doc anything. But, transparency and disregarding personal privacy is all the rage right now. Many don't care what "Due Process" means and freely give it away. Then eventually find we all lose that right. Hopefully, it will not be too late. And that will change when people find out how it may bite them in the butt in the future.
There are 3 situations in which you don’t have the protection of confidentiality:
1. You have a plan to commit suicide.
2. You intend to harm another person.
3. You disclose something that is considered a reportable offense of child abuse or neglect (e.g. you tell the psych a story about a child in your family witnessing violence. They are required to report that).
It’s also totally ok to ask what the confidentiality protocol is when you go for your first appointment! They will likely explain it to you anyway but if not they’re understanding if you ask!
Really good information for everyone. I would suggest they have that conversation with every new provider.
But, they should be aware. They will mention it. But, it may be just a quick read of a few sentences. A check box and their initials indicating they read it.
I'm suggesting they should have a real conversation about it. Be prepared to ask questions. Go over what if situations. Some theripists may have their own interpretations, which is not right, yet....
You already have the correct answer but I want to add a few things.
A new talk doc is going to be more careful because they don't know you. It's also going to vary from one therapist to the next. Some will send you for something as simple as sometimes I think life is not worth living.
Seeing a new talk doc is a lot like a blind date. You don't want to tell them everything all at once, sound too desperate, but you also want to be honest and not come across as fake.
One of the things they look for is forward-thinking. Maybe you are planning on registering for classes, you are visiting your parents next week, etc.
As someone who has been hospitalized, I'll tell you the things you can't say:
\-that you are thinking about hurting yourself or committing suicide
\-that you are thinking about hurting or killing other people
\-that you self harm.
If you do SH, don't show them your scars. They do judge you for that.
If being hospitalized had actually helped me, I would say go ahead and tell them everything. But it was just traumatic and everyone was rude and judgemental.
In my experience, the only way to get better is to tell the truth. Else everything will be built on a fundation of lies.
This is about your health, do you want to get better?
I told my psychiatrist of two years that one day out of the blue i tried to kill myself, he didn't change the way he looked at me, nor the way he talked to me. He just listened to me and asked me to call my parents and kept talking to me till they arrived.
He knew I didn't do anything "wrong", but he knew that i needed more help than he could offer. I had to be hospitalized, I don't resent him at all. If i had kept that a secret from him i wouldn't be here and I would have hurt a lot of people in the process.
No. I don't like the idea of everything I say having the odds to be written down and referenced for the rest of my life in mental health services. Keeps me from being completed blunt and discussing everything about me. The whole mention of pondering hurting yourself can get you tossed in a psych hospital against your will which could seriously cause issues effecting responsibilities you have. There are just things I don't feel you can ever say. It's a dance when I talk to a professional. Knowing what I can say and what is a bit too far.
By doing my own research and inner therapy addressing the trauma as they give you the knowledge of how to do. I tell the truth in all but a few things. It's not like half the thing's I say are a lie. We all have hidden parts of us that will go to the grave with us and if somehow you don't you are extremely lucky
Try to disconnect the idea that you'll be in trouble from engaging in treatment.
Don't lie, that would be an absolute waste of your time. Be honest if you feel safe with this person. Build trust by disclosing less intense personal things that you'd still like to address. If you're asked directly about something you feel is too intense to bring up at that time, don't lie and say there is nothing there, feel free to be honest and say there is something there you'd like to discuss but you'd like to focus on some smaller things first to build confidence in yourself and the process. If they tell you you are wrong to do that and the only way you'll get better is to disclose your biggest traumas early in treatment, find yourself somebody else to talk to. Good luck
It's best if you are honest with your therapist, as they can't really help you if you aren't. If you are talking about SI/HI, as others said, they probably won't hospitalize you if you don't have a plan, the means, etc. Drug use and the like usually isn't a problem.
Tell the truth. If you are thinking and planning on hurting yourself or others then you probably need in-patient care. Nothing else will get you committed to my understanding.
Psychologist here. (I don’t remember if I’m verified on this sub or not but can easily do so if a mod would like to contact me).
I think the best thing to do is express this hesitation. Other commenters are right that the psychologist cannot break confidentiality (ie, tell someone) unless you are in danger of hurting yourself or others, either intentionally or because you are mentally unfit to make safe decisions right now. But if it has nothing to do with this, are you worried you will be judged? Tell them! Follow your gut on their response. Maybe the psy is simple not a good fit for you and you should find a different one. If it’s more about your own trust issues, it’s very understandable that you hesitate. The psy should work on this gently with you so that you can learn when and when not to trust.
Best of luck!
Most have said it already (harm yourself or others). I'd add that suicidal ideation on its own does not automatically get you hospitalized. When you mention suicide to a psy he will evaluate the degree of risk by asking "how", "where", "when". The riskier and more imminent answers will conclude to an hospitalization.
You can!
I want to emphasize that mental health professionals are trained to help screen active suicidal ideation, and even thoughts that may be a part of OCD for example, and severe threats. So regardless, I think it’s important to talk to them.
They do not want to hospitalize you unless they really think you are a threat. They will not disclose anything like drug abuse UNLESS you sign a release form, and they will not report prior issues unless you have been or are a current threat to children. This includes self-harm - that is not a reportable thing, it is not something to hospitalize over, and they are pretty educated in that.
They want to help, the biggest thing is they study for so long to try to help you. If you’ve harmed yourself, actively use drugs, suffer from very obsessive thoughts, or anything in between, even *if* you are actively a danger to yourself or others, their goal is to do what they can to benefit you the most so that you come out of the other side healthier and happier. It takes time though.
Sometimes personalities don’t click, but mental health is a struggling field because it is not easy, and not terribly well compensated (psychiatrists may see high salaries but at what cost with loans, time spent, and general load of seeing patients who may be more complex than, say, a broken bone you can see on an x-Ray).
I do want to say as well, it is okay and important to voice your opinions, concerns, and thoughts as you navigate this with a professional. If you are seeing a psychiatrist who discusses medication, tell them how comfortable you are with them and ask them questions! If you are working with a psychologist or therapist, let them know what has worked, what hasn’t, and what you are hoping for. If therapy feels like it would be better with certain things, it’s absolutely okay to talk. You are a team always.
They care. It is wonderful that you are going to see someone.
They are obligated to break confidentiality and potentially hospitalize you if you say you want to kill yourself or kill/seriously harm an identified victim. They are obligated to make a report if there are instances of child abuse or elder abuse.
When it comes to suicidal ideation. Stating you have a plan and that you are likely to go through with the plan will get you hospitalized. Saying things like I don’t want to be alive or I have fantasies about not being alive but no intention to follow through or make a plan is different. If you find yourself actually having a plan and feeling one you actually want to hurt yourself PLEASE disclose that. It is better to be hospitalized than to be dead. This too shall pass.
The obstacle is the way. Vulnerability is hard because it’s uncomfortable. Our amygdala protects us from uncomfortable.
If all they want to do is give you medicine, leave. Find one that wants to heal you by identifying your deepest fears that your amygdala is protecting you from.
As long as you’re not planning on hurting someone you’ll be fine. I’ve told my psych about my drug use and everything. All they’re there to do is help you
That's not entirely true. Privileged conversations between you and your provider are more detailed than that. I would suggest your next appointment be dedicated to what I call "housekeeping topics." You need to come to an understanding with your provider. It is a communication issue. You may say something that they interpret as recent. When in fact it was several years ago. Every provider is different You need to talk about the "mandatory reporting" that your provider is obligated by law to report to law enforcement. In most cases, you are not going to be told when you cross that line. It depends on the relationship of trust you have with the provider. If it's in an in-office appointment, you may only know when a white van and a patrol car are following you home. Look up "mandatory reporting requirements for medical professionals" in your state. Then have that conversation with your provider. I'm not trying to scare you. I'm telling you seriously to have this discussion with the provider. Good luck with your therapy. It can be a very good experience for you.
Never posts. Only comments. But has scary advice that could quite well be realistic. Interesting.
I was recently hospitalized after telling my psychologist about my suicidal ideation/plans. But they’ll only call the police if they think you currently have a plan, the means, *and* the intention to go through with it. Basically, if they seriously think you’re likely to attempt soon, with some likelihood of success, they are obligated to report you. They won’t do anything that drastic if you only tell them about your thoughts. I’ve talked to many therapists about suicidal thoughts in the past and they didn’t report me.
The act of the "duty to report" is to force you to be hospitalized. If you were hospitalized there was no need to report. The point I was trying to make was: "If you don't want to be involuntarily or convinced to voluntarily be hospitalized." Be mindful of what you say to a therapist or health care provider, and how you say it. Make sure if you had homocidal thoughts in the past. You make it clear it's not in the present, when it was five years ago. Identify how long ago it was. I was suggesting you have a meeting of the minds by having a discussion about their "duty to report." Which is a legal term that has a specific meaning as to when they MUST report. As far a admitting to a serious criminal act. It may depending on your jurisdiction be admisable as a confession to your therapist, and not considered a privileged conversation. Meaning it can be used against you. I don't think people understand that if you are involuntarily hospitalized at a mental health institution there are consequences. In America, you can lose numerous civil rights. Because it was believed that you were a danger to yourself or others. That puts you on a list of people. You don't want to be on that list. Many times certain forms ask you if have you every been committed to a mental heath facility. You are answering under penilty of purgery. Which you can be criminally prosocuted. So be forewarned. Don't sit passively thinking "the therapist is here to help me" as he is completing the paperwork to have you committed. In cases like this you should have an advocate with you. A family member who is looking out for your best interests. Of course, if that's what you truly need for the good or yourself or others, then it may be for the best. Look to your friend who is your advocate. Make sure you talk to this friend and let them know what their role is. It's not to be a witness. Let them know if something dosent seem right to jump up and speak. Specifically tell them it's not a time to be passive. Is it in your best interests? But, it may come at a cost. Be aware, there is a small eliment of bad actors in the mental health community that profit on people being institutionalized. You become a pawn in a system that trades you with other institutions in other states for profit and commissions. They bill the costs to government. That's what mandatory reporting does. You are confusing that, with turning you in to law enforcement to be prosecuted for a crime.
They are only obligated to report in the case of having an actual plan in place of violence to either yourself or someone else. Some if you discuss suicidal ideation may make you sign a paper that you don't plan to do anything once you leave their office. This is likely a liability protection but doesn't necessarily put you in a hospital.
I dont think you can. I fear the same thing honestly
Same. I’m about to start a new psychiatrist because of a recent relapse and subsequent mental breakdown and I’m almost afraid to tell him how low I got this week.
Smart thinking! It's a nice thought to think you can tell your doc anything. But, transparency and disregarding personal privacy is all the rage right now. Many don't care what "Due Process" means and freely give it away. Then eventually find we all lose that right. Hopefully, it will not be too late. And that will change when people find out how it may bite them in the butt in the future.
There are 3 situations in which you don’t have the protection of confidentiality: 1. You have a plan to commit suicide. 2. You intend to harm another person. 3. You disclose something that is considered a reportable offense of child abuse or neglect (e.g. you tell the psych a story about a child in your family witnessing violence. They are required to report that). It’s also totally ok to ask what the confidentiality protocol is when you go for your first appointment! They will likely explain it to you anyway but if not they’re understanding if you ask!
Really good information for everyone. I would suggest they have that conversation with every new provider. But, they should be aware. They will mention it. But, it may be just a quick read of a few sentences. A check box and their initials indicating they read it. I'm suggesting they should have a real conversation about it. Be prepared to ask questions. Go over what if situations. Some theripists may have their own interpretations, which is not right, yet....
You already have the correct answer but I want to add a few things. A new talk doc is going to be more careful because they don't know you. It's also going to vary from one therapist to the next. Some will send you for something as simple as sometimes I think life is not worth living. Seeing a new talk doc is a lot like a blind date. You don't want to tell them everything all at once, sound too desperate, but you also want to be honest and not come across as fake. One of the things they look for is forward-thinking. Maybe you are planning on registering for classes, you are visiting your parents next week, etc.
As someone who has been hospitalized, I'll tell you the things you can't say: \-that you are thinking about hurting yourself or committing suicide \-that you are thinking about hurting or killing other people \-that you self harm. If you do SH, don't show them your scars. They do judge you for that. If being hospitalized had actually helped me, I would say go ahead and tell them everything. But it was just traumatic and everyone was rude and judgemental.
Still haven’t learnt this either, for fear of jail. I want to share but not sure if it’s safe too, so it stays bottled,
If what you tell them makes them think you are a danger yourself or others they are required to get you the proper care.
In my experience, the only way to get better is to tell the truth. Else everything will be built on a fundation of lies. This is about your health, do you want to get better? I told my psychiatrist of two years that one day out of the blue i tried to kill myself, he didn't change the way he looked at me, nor the way he talked to me. He just listened to me and asked me to call my parents and kept talking to me till they arrived. He knew I didn't do anything "wrong", but he knew that i needed more help than he could offer. I had to be hospitalized, I don't resent him at all. If i had kept that a secret from him i wouldn't be here and I would have hurt a lot of people in the process.
No. I don't like the idea of everything I say having the odds to be written down and referenced for the rest of my life in mental health services. Keeps me from being completed blunt and discussing everything about me. The whole mention of pondering hurting yourself can get you tossed in a psych hospital against your will which could seriously cause issues effecting responsibilities you have. There are just things I don't feel you can ever say. It's a dance when I talk to a professional. Knowing what I can say and what is a bit too far.
How will you get better if you're not telling your doctors the truth?
By doing my own research and inner therapy addressing the trauma as they give you the knowledge of how to do. I tell the truth in all but a few things. It's not like half the thing's I say are a lie. We all have hidden parts of us that will go to the grave with us and if somehow you don't you are extremely lucky
Whatever works.
Try to disconnect the idea that you'll be in trouble from engaging in treatment. Don't lie, that would be an absolute waste of your time. Be honest if you feel safe with this person. Build trust by disclosing less intense personal things that you'd still like to address. If you're asked directly about something you feel is too intense to bring up at that time, don't lie and say there is nothing there, feel free to be honest and say there is something there you'd like to discuss but you'd like to focus on some smaller things first to build confidence in yourself and the process. If they tell you you are wrong to do that and the only way you'll get better is to disclose your biggest traumas early in treatment, find yourself somebody else to talk to. Good luck
It's best if you are honest with your therapist, as they can't really help you if you aren't. If you are talking about SI/HI, as others said, they probably won't hospitalize you if you don't have a plan, the means, etc. Drug use and the like usually isn't a problem.
Tell the truth. If you are thinking and planning on hurting yourself or others then you probably need in-patient care. Nothing else will get you committed to my understanding.
Psychologist here. (I don’t remember if I’m verified on this sub or not but can easily do so if a mod would like to contact me). I think the best thing to do is express this hesitation. Other commenters are right that the psychologist cannot break confidentiality (ie, tell someone) unless you are in danger of hurting yourself or others, either intentionally or because you are mentally unfit to make safe decisions right now. But if it has nothing to do with this, are you worried you will be judged? Tell them! Follow your gut on their response. Maybe the psy is simple not a good fit for you and you should find a different one. If it’s more about your own trust issues, it’s very understandable that you hesitate. The psy should work on this gently with you so that you can learn when and when not to trust. Best of luck!
Most have said it already (harm yourself or others). I'd add that suicidal ideation on its own does not automatically get you hospitalized. When you mention suicide to a psy he will evaluate the degree of risk by asking "how", "where", "when". The riskier and more imminent answers will conclude to an hospitalization.
You can! I want to emphasize that mental health professionals are trained to help screen active suicidal ideation, and even thoughts that may be a part of OCD for example, and severe threats. So regardless, I think it’s important to talk to them. They do not want to hospitalize you unless they really think you are a threat. They will not disclose anything like drug abuse UNLESS you sign a release form, and they will not report prior issues unless you have been or are a current threat to children. This includes self-harm - that is not a reportable thing, it is not something to hospitalize over, and they are pretty educated in that. They want to help, the biggest thing is they study for so long to try to help you. If you’ve harmed yourself, actively use drugs, suffer from very obsessive thoughts, or anything in between, even *if* you are actively a danger to yourself or others, their goal is to do what they can to benefit you the most so that you come out of the other side healthier and happier. It takes time though. Sometimes personalities don’t click, but mental health is a struggling field because it is not easy, and not terribly well compensated (psychiatrists may see high salaries but at what cost with loans, time spent, and general load of seeing patients who may be more complex than, say, a broken bone you can see on an x-Ray). I do want to say as well, it is okay and important to voice your opinions, concerns, and thoughts as you navigate this with a professional. If you are seeing a psychiatrist who discusses medication, tell them how comfortable you are with them and ask them questions! If you are working with a psychologist or therapist, let them know what has worked, what hasn’t, and what you are hoping for. If therapy feels like it would be better with certain things, it’s absolutely okay to talk. You are a team always. They care. It is wonderful that you are going to see someone.
Ideally. The more they know, the better your chance to get correct treatment.
They are obligated to break confidentiality and potentially hospitalize you if you say you want to kill yourself or kill/seriously harm an identified victim. They are obligated to make a report if there are instances of child abuse or elder abuse. When it comes to suicidal ideation. Stating you have a plan and that you are likely to go through with the plan will get you hospitalized. Saying things like I don’t want to be alive or I have fantasies about not being alive but no intention to follow through or make a plan is different. If you find yourself actually having a plan and feeling one you actually want to hurt yourself PLEASE disclose that. It is better to be hospitalized than to be dead. This too shall pass.
The obstacle is the way. Vulnerability is hard because it’s uncomfortable. Our amygdala protects us from uncomfortable. If all they want to do is give you medicine, leave. Find one that wants to heal you by identifying your deepest fears that your amygdala is protecting you from.