How can I talk about my suicidal impulses without being locked up?

Anyone? Im kind of desperate….

Jim
I understand you talk about suicide impulses and then “get locked up.” Unfortunately suicide impulses, urges and thoughts are part of a risk assessment for possible suicidal acts. Your comments also indicate a history of self harm by taking pills, which is a significant risk for completed suicide. If your risk of self harm is high and you do not have other coping skills than self harm acts, there is really not much choice ethically for health care professionals or police but to place you in a secure environment until those impulses can be managed often with medication, but hopefully with compassion, and skill development. This may even occur even if you do not want this. I agree secure psychiatric environments are challenging. You have not disclosed the nature of the “abuse.” One way to address this is to ask your psychiatrist for nursing observations on a regular basis to minimize harm. Often people with repeated self harm attempts have a history of abuse/ trauma, and lack self care skills. This can result in a diagnosis of borderline personality disorder.One way to address this is to ask for help from the treating team ( Clinical Psychologist etc) to develop skills to take care of yourself in hospital. The goal hopefully would be to gain an understanding of the inner triggers for your distress leading to self harm and learn other coping strategies with appropriate support. There are treatment programs which can address long term abuse such as Schema Therapy, Dialetical Behaviour therapy. However you need to be stable enough to engage with this longer term therapy.
If you are mistreated in hospital you can complain to the council of official visitors and your state mental health board to address your concerns. Most hospital have information about how to contact these representative in the wards. Please ask to speak to a peer support work or a council or official visitors. You do not have to say why you want to talk to those people.
While it is often hard to trust others after abuse it is important to find a support few people who can support you when you are distressed so that you do not see the only way forward in life as harming yourself.

Dear Jim
I hear your frustration around the mental health system and have empathy for your experience in it.
As explained, duty of care is a way we as clinicians assist our clients to stay safe, saying this the system can fail us.
I would suggest you get involved with a Dialectic Behavior Therapy group and therapist.
DBT works specifically in building skills around managing suicidal ideation, through emotional regulation and distress tolerance techniques within the confines of a supportive group and clinicians.
The PA Hospital in Brisbane run a group and in the Hunter Valley NSW health manage a DBT program, form which you could get referrals.
Hope this is helpful.

This is an excellent question.  Thank you for your courage to ask it.  My answer is relevant to Australia – please make sure same happens in the area you live. 
 
I am sorry to hear about your experience in the hospital and suggest that you use the feedback procedure to report what you experienced, so that improvements can be made.
 
Yes, you are able to seek help for suicidal thoughts without being locked up.  I work within suicide prevention framework and as a result find myself in a very humbling position assisting Clients in some of their lives’ deepest, darkest moments – and seeing some amazing things they are able to do to bring their lives around and regain a sense of meaning in their journey on this planet.  And as a therapist, I can help in many ways, including by bringing along a professional tool box. 
 
Yet, nothing can be done if you are already dead. 
 
When we experience pain, our minds can make it feel quite permanent.  In our moments of reasoning and clarity we understand that lives go up and down and that things can change.  In our emotional moments however, things may seem more ever-lasting and unbearable.  As a result, we may act to end the pain permanently by ending our life.  Safety during that time becomes important and psychiatric emergency will act on that – safety.  You may have better experience with some practitioners or in some hospitals compared to others.  It is important that when you are safe, you also seek sustainable long-term growth, and the hospital is likely to link you with a therapist prior to discharge. 
 
Through therapy, being able to look past the perception of permanence, to dive under the waves of pain in to the stillness, and have a chance to regain perspective can be very helpful.  In seeking this support, Clients may feel threatened by the possibility of being locked up.  Psychologists are trained to check a number of factors that may indicate whether or not there is an immediate danger to yourself and others (emergency).  If this is not the case, the therapist is likely empower you take charge of your own destiny and put your own strategies in place that will help you be effective during times things are most difficult.  The focus here is likely to be more on long-term sustainable change, rather than safety alone.
 
I hope this helps!
 
Kind regards,
 
Nik
 
Nikita (Nik) Kotlarov
Psychologist | Mind Zone Psychology (ME)
Mobile: 0450 MY MIND (0450 696 463)
Website: www.mindzone.com.au
Enoggera, Brisbane, QLD