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Psychologists and confidentiality (non detailed mention of suicidal thoughts)

Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
in Health & Wellbeing
Hi everyone! I hope you're all well!

I have been experiencing suicidal thoughts for a long time which with time have gotten stronger and have grown into detailed plans. I've decided I should tell my psychologist about this for the sake of my family as it's at the point where it's a choice between taking my own life or admitting it and getting the help I need and I'm choosing to get help. I was thinking of writing this down and giving it to him in our next sessions as I struggle to talk about it so thought writing it down may help.

I want to know exactly what will happen if I tell a psychologist in the UK that you are experiencing these kind of thoughts and ideas. Nothing that'll happen will stop me from telling them, I just like to be aware of every possible outcome in situations so I can prepare myself.

I know if a psychologist thinks a patient is at risk they have to break confidentiality but what even does breaking confidentiality involve? I'm over 18 so I'm assuming it won't involve telling my family but will they call my next of kin? Will they even do anything?

I guess my question here is; has anyone had experience expressing suicidal ideation to their psychologist and if so what happened after this? Also has anyone been in a situation where their psychologist had to break confidentiality and if so who do they talk too?

Thanks to all in advanced

nightowl :)

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    plugitinplugitin Posts: 2,197 Boards Champion
    Hey nightowl, welcome :)
    I'm sorry to hear you're feeling so bad; but it's good you're considering speaking to your psychologist.

    In my experience several things can happen. It depends on how much of a risk they think you are, but the main outcome will be closer monitoring.

    Sometimes professionals will not act on their client expressing suicidal ideation - ideation can play a big part of some conditions and some peoples' experiences with that and they don't see an issue with the ideation if there is no plan to back it up. Even if you are having suicidal ideation without intent it's good to speak to your psychologist about this so you can explore it but so they are aware of it in the future in case anything changes and you start making plans etc.

    Breaking confidentiality only happens when you are a risk to yourself or other people, but this means it is more likely they are to tell other professionals in your care than family etc unless your plans involve doing something to them. You can mention to your psychologist that you don't want your family getting involved (but depending on what happens they might find out anyway)

    I've experienced all of the following after telling someone about suicidal feelings:
    Closer monitoring and linking up with my GP to see them on a daily basis at worst for them to keep tabs on me and check that I'm still alive
    Referral to the Crisis Team
    Medication review with my Psychiatrist to see whether any meds need changing

    If your psychologist is concerned that you are definitely posing a risk to yourself, they could choose to get you assessed under the Mental Health Act which could potentially lead to sectioning. Thing to remember here is that it really, truly is a last resort because they don't want to send people to hospital needlessly and for you, it might not be the right place for you. That said, it really depends on the outcome of talking with your psychologist.

    When either of the psychologists I saw were concerned about me and my welfare, they explicitly asked my permission to tell whoever they needed to tell (and told me who they were going to tell).

    I hope letting you know about some of my experiences have helped, good luck with your psychologist.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Suicidal ideation after starting therapy is not uncommon, as therapy tends to stir a lot of things up. I don't think your psychologist will be surprised by it or frightened by it.

    What they will do will depend on what you tell them and in what form your suicidal ideation comes out. They'd generally discuss it with appropriate professionals involved in your care, e.g. getting your CPN to keep a closer eye on you between therapy sessions. They wouldn't normally disclose things to your family unless you wanted them to.

    If the suicidal ideation is severe and presents a huge risk then they may refer you to another service which can support you through crisis; psychological services are not normally appropriate for people in severe crisis. If you have children and your crisis means you're struggling to care for them then they may also make appropriate referrals to get you support there.

    T'missus is a clinical psych, I'll ask her if there's anything else she'd do.
  • Options
    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    plugitin wrote: »
    Hey nightowl, welcome :)
    I'm sorry to hear you're feeling so bad; but it's good you're considering speaking to your psychologist.

    In my experience several things can happen. It depends on how much of a risk they think you are, but the main outcome will be closer monitoring.

    Sometimes professionals will not act on their client expressing suicidal ideation - ideation can play a big part of some conditions and some peoples' experiences with that and they don't see an issue with the ideation if there is no plan to back it up. Even if you are having suicidal ideation without intent it's good to speak to your psychologist about this so you can explore it but so they are aware of it in the future in case anything changes and you start making plans etc.

    Breaking confidentiality only happens when you are a risk to yourself or other people, but this means it is more likely they are to tell other professionals in your care than family etc unless your plans involve doing something to them. You can mention to your psychologist that you don't want your family getting involved (but depending on what happens they might find out anyway)

    I've experienced all of the following after telling someone about suicidal feelings:
    Closer monitoring and linking up with my GP to see them on a daily basis at worst for them to keep tabs on me and check that I'm still alive
    Referral to the Crisis Team
    Medication review with my Psychiatrist to see whether any meds need changing

    If your psychologist is concerned that you are definitely posing a risk to yourself, they could choose to get you assessed under the Mental Health Act which could potentially lead to sectioning. Thing to remember here is that it really, truly is a last resort because they don't want to send people to hospital needlessly and for you, it might not be the right place for you. That said, it really depends on the outcome of talking with your psychologist.

    When either of the psychologists I saw were concerned about me and my welfare, they explicitly asked my permission to tell whoever they needed to tell (and told me who they were going to tell).

    I hope letting you know about some of my experiences have helped, good luck with your psychologist.

    Hi,

    Thanks for the response! It's good to know a bit about what I could expect when I tell them. Sharing your experiences has helped a lot. I get anxious going into situations that I am not prepared for your input has definitely helped ease some of that anxiety.

    Thanks :)
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Arctic Roll wrote: »
    Suicidal ideation after starting therapy is not uncommon, as therapy tends to stir a lot of things up. I don't think your psychologist will be surprised by it or frightened by it.

    What they will do will depend on what you tell them and in what form your suicidal ideation comes out. They'd generally discuss it with appropriate professionals involved in your care, e.g. getting your CPN to keep a closer eye on you between therapy sessions. They wouldn't normally disclose things to your family unless you wanted them to.

    If the suicidal ideation is severe and presents a huge risk then they may refer you to another service which can support you through crisis; psychological services are not normally appropriate for people in severe crisis. If you have children and your crisis means you're struggling to care for them then they may also make appropriate referrals to get you support there.

    T'missus is a clinical psych, I'll ask her if there's anything else she'd do.

    Thank you, this was very informative. I have not had any interaction with any other professional other than a psychologist such as a CPN or psychiatrist etc. so maybe to outcome will involve just getting a little more support. Thanks for the input, it's helped a lot :)
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