Should I Talk to My Therapist About Suicidal Thoughts?
Will my therapist be required to report this or make me go to the hospital?
In therapy, it’s important for you to feel like you have a safe space where you can be open and vulnerable about everything. However, if you are experiencing suicidal ideation, you might be reluctant to talk to your therapist about your thoughts. You worry that they will automatically hospitalize you or report what you have disclosed to someone else.
However, not every conversation about suicide results in hospitalization. That is because not all people with suicidal thoughts do not necessarily plan to act on them. Some people experience these thoughts chronically.
If you have suicidal thoughts or are engaging in self-harming behaviors, it’s important to talk to your therapist about it. Here’s why.
Learn more about bipolar hospitalization.
How Common Are Suicidal Thoughts in Bipolar Disorder?
Suicidal thoughts are very common in bipolar disorder, especially in bipolar II depression. Almost 80 percent of people with bipolar diosrder experience suicidal ideation during the depressive phase of the disorder. About 50 percent of people with bipolar disorder attempt suicide at least once.
Suicide death rates in people with bipolar disorder are 10-30 times higher than the general population. Talking to your therapist about these thoughts could literally save your life.
What Happens if I Talk to My Therapist About Suicidal Thoughts?
If you disclose suicidal ideation (thoughts) to your therapist, they will do a screening and risk assessment to determine if you are at an imminent risk of harming yourself or others. For instance, if you have the thought “I don’t know how much longer I can keep going,” your therapist will ask some questions to assess your level of risk. This assessment will determine if you are actively planning suicide and have the means to harm yourself. Your therapist might also inquire about your history of suicide attempts, current stressors, and other factors.
If your therapist determines that you are not in immediate danger, they might help you develop a safety plan, or they may recommend more frequent therapy. In some cases, they might refer you to a psychiatrist for mood stabilizers for bipolar disorder.
So, what happens if your therapist determines that you are a risk to yourself?
Learn about bipolar disorder medication.
Therapists Are Mandated Reporters
Therapists have an ethical and legal obligation to break confidentiality to keep their clients and others safe. Therapists are mandated reporters. Mandatory reporting laws vary depending on the state. However, in all 50 US states, therapists are required to report it to authorities (police) if they believe that their client is a danger to self or others. So, if your therapist feels that you are a danger to yourself based on a risk assessment, they may contact the police or another agency to ensure that you receive urgent treatment.
Keep in mind: Most therapists take your confidentiality very seriously. They will only break confidentiality if they believe that you are at an immediate risk of harming yourself or others.
Can I Tell My Therapist About Self-Harm?
Yes, you can and should talk to your therapist about any self-harming behaviors that you have, even if you do this regularly and don’t injure yourself seriously. People who chronically self-harm may do it for a number of reasons: to relieve strong feelings or to gain a sense of control over their lives. A therapist can help you identify the specific reasons why you self-harm and help you stop this behavior.
If you have engaged in life-threatening self-harm, your therapist will have to break confidentiality and report this to authorities to get you help.
Help Is Available
Crisis Text Line: Offers free, confidential support. Simply text HOME to 741741 to be connected to a trained crisis counselor.
988 Lifeline: Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Counselors are available 24/7 to listen and provide confidential, free support.
The Trevor Project: This is a crisis line for young adults and teenagers who identify as LGBTQIA+. To get help, text “START” to 678678.
Call 911 (in the US) or go to your nearest emergency room.
