How clinicians view suicidal ideation

[seekingERPnorthwest]

When I had a mental health assessment last year, when I answered "yes" to the suicidal ideation question, the assessor said "yeah, but you've had that all your life, right?".  I saw another professional this week and she said "You don't have any suicidal thoughts, do you?", and was about to tick it off and move on to the next question.  I hesitated, wondering whether or not it was easiest just to go along with what she'd said, but I decided not to, saying: "actually, yes I do".  What do you think about these two experiences? 

I don't understand why some clinicians are dismissive of suicidal ideation disclosure, and why people with suicidal ideation can't get more urgent help.  Unless you have a history, you're "low risk".  What if your one attempt is successful - then you go from being low risk to being dead.  Why can't they figure that out?

Edited January 29, 2018 by seekingERPnorthwest
typo

[Headwreck]

I relate to this completely. I went to my GP a year or so ago and told them that I was contemplating it heavily. It was shrugged off, I was given tablets and sent home on my own. Part of me wonders if there are so many people saying that they feel that way, clinicians have become desensitised to it. 

[Wonderer]

Hey, I think there’s a bit more criteria for being suicidal and having suicidal thoughts, for example they should be asking questions about intent etc. I know when my son was having such thoughts the therapists figured out it was desperation talking rather than him intending to end his life, but they didn’t just dismiss him, they worked with him to figure it out. Then when he had such thoughts as a reaction to sertraline they took it seriously as it is known that the med can do this to people and he would be in a very different mindset than he normally was. When I had those thoughts it was scary but I knew I wouldn’t do anything because I just wanted to get better, but I did worry that I was so unwell I might harm myself, my therapist then kept an eye on that for a month or so until I settled a bit.xx

[snowbear]

The topic of suicide comes up again and again on the forum so it's worth a moment of discussion.

Any health professional who dismisses suicidal ideation without asking further questions or having made a fuller assessment is indeed a disgrace. 

HOWEVER, there is a world of difference between suicidal thoughts and suicidal intent and one does not routinely (or even often) lead to the other. 

A health professional's job is to identify those with suicidal intent, particularly those whose intentions have progressed to the initial planning stage or beyond. When you've spoken to a lot of people who have suicidal ideation, you get a bit of a gut feeling for when you need to dig deeper, when there's a genuine risk of action and when someone is just 'wishing'. Fears of taking your own life are extremely common, (not just in OCD either) and wishing for/thinking about death as a 'solution' to one's emotional pain is common as mud. 

Where there is a perceived genuine risk most health professionals will take it very seriously indeed and will intervene as their powers allow or at the very least keep a close eye on the situation.

If anyone feels they are genuinely at risk of taking their own life in the immediate future, disclosure is vital. Fear of suicide intent being dismissed, belittled or ignored is unwarranted. Admittedly, suicidal thoughts are sometimes taken 'lightly' by health professionals, but this is a reflection of their commonality and non-progression to action in the vast majority of cases rather than not caring. 

If anyone feels they have genuine suicidal intent and are not being taken seriously or that there has been a misunderstanding, difficult as it is to go through the process a second time they need to speak to someone else asap. Chances are exceptionally good they will be taken seriously and will receive the help and support they need. No health professionals wants someone to kill themselves, or to miss the warning signs in someone genuinely at risk of acting on their suicidal thoughts.