Suicide / Question
Published: April 28, 2008
Dear TeenHealthFX,
I need serious help. I am actively suicidal, but I am afraid to tell my counselor. I know that he is legally mandated to report any suicide threats, and if I tell him how I am feeling, he will send me to the hospital. I know that it is not a bad thing to be hospitalized, as they are only trying to help with crisis stabilization, but I am still scared. I have heard about people being ignored in psychiatric wards, and the staff mistreating them. I also have heard about people being raped or abused by other patients (and sometimes the staff). On top of all of this, I am 18, so I would be in an adult inpatient section, as opposed to a pediatric or adolescent one. I heard that the adults get treated worse. I know what the doctors think - they think that people like me are crazy (my dad works in a local ER and he talks about the "crazy psych patients" all of the time). I don't want to go...but I really want to tell my counselor what is going on. I have an appointment in a few days to see him, but I will not tell him the truth unless I know that everything will be okay. Please let me know exactly what happens in psych wards as soon as possible...I know that you can only answer a few questions, but I really need some help - I am so scared!
Signed: Suicidal, But Afraid To Tell My Counselor And Be Hospitalized
Dear Suicidal, But Afraid To Tell My Counselor And Be Hospitalized,
TeenHealthFX understands what a scary position you are in right now – to be feeling suicidal and to have the possibility of being admitted to an inpatient psychiatric setting, a completely new and unknown experience for you. While you mentioned that you did not want to tell your counselor about your suicidal thoughts and impulses unless you know everything will be okay, FX sees it somewhat differently. We think that you need to tell him right away to ensure that everything will be okay for you.
FX thinks that it is very important to discuss this with your counselor for the following reasons: Once told about your suicidal thoughts/impulses, your counselor can take whatever action to help ensure that you do not harm yourself. You can also discuss with your counselor your concerns about what may happen to you on an inpatient ward, if that becomes a necessary step for you. Since you mention that you’ve “heard” about people being ignored, abused, or harmed in various ways on inpatient units, you could also clarify to him where you have heard this and give him the opportunity to correct any misinformation you may have about the hospitals near you. If you trust your counselor, you could also use him to help you through this process – if hospitalization is necessary, he could help with the admission process, and he might be able to visit you while you in the hospital. If you had any concerns while you were there, you could always inform him and he could advocate for your needs.
FX also thinks that it might be helpful for you to talk to your counselor and your father about any worries you may have about how your father might view you in light of what you are going through right now. Since he works in the ER and has talked about the “crazy psych patients,” FX wonders if you feeling anxious that he would view you in a negative way if you did require hospitalization? If you are worried that your father would react negatively to how you are feeling and the interventions that might be needed at this point, this might also be another factor getting in the way of your reaching out for the help that you need. And if this is a concern of yours, FX wants to stress that having to be admitted to a psychiatric unit does not mean a person is bad or unworthy in any way – it simply means that a certain level of treatment is required to be helpful at a particular point in time.
As for inpatient psychiatric units, the main purpose of these facilities is to stabilize people who are at risk for harming themselves or others, or who are dealing with mental illnesses that have not properly been treated and that are significantly interfering with that person’s level of functioning. Generally, the goal is to get the patient stabilized so that he/she can be moved to a less intensive level of treatment as soon as possible – whether it is a day treatment program or weekly outpatient therapy. During an inpatient stay, patients generally participate in group therapy, and may participate in individual and family sessions as well. Patients will usually meet with a psychiatrist towards the beginning of the stay, and psychotropic medications will often be introduced or altered to help address the symptoms that first lead to the hospitalization. Patients generally eat their meals on the inpatient unit, students in grade school or high school are sometimes permitted time to work on school work (depending on the unit and the patient’s needs at that time), there are scheduled visitation hours so that your family or counselor could come to see you, and some units will give the opportunity to earn different status levels on the unit that will allow you to leave the unit and go to other areas of the hospital grounds when accompanied by a staff member. Patients are usually hospitalized on an inpatient unit anywhere from 2 days to 2 weeks depending on that patient and his/her needs. Your counselor would probably be able to give you a better idea of how the units near you tend to operate and what you shoud expect.
As for concerns about your safety on an inpatient unit, it is obviously illegal for any staff members of a hospital to be abusing or harming the patients in any way, and hospitals today tend to make patient safety a significant priority. In addition, there are many different staff members present on the unit – mental health workers, nurses, psychiatrists, social workers, psychologists, and the unit director – so there will always be someone to go to in the event that you do have any concerns. And day and night there is almost always more than 1 staff member present on the unit, in addition to all the other patients there, so you will not be isolated and alone. Again, FX thinks these concerns should be discussed with your counselor so you can get more accurate information about the inpatients units near you and so that you can calm your fears about this.
If you get to the point that you are seriously considering suicide or are afraid of your impulses then you need to seek help immediately. You can call 911 or go to your nearest hospital emergency room. In northern
Signed: TeenHealthFX
In the 
