While I do not have a solution, please be aware that in the US (and I’m guessing outside the US) those who are in mental crisis and are suffering from high suicidality are grossly under-served. As it is, most psychotherapists and psychiatrists (at least the over-a-dozen I’ve sought treatment from) only knew to handle danger-to-self situations by contacting the authorities and arranging for committal, voluntary or otherwise.

Those of us who don’t have rich relatives or truly amazing health insurance will end up in a public facility. (like a general hospital.) About a third (30% and change) of inpatients in public facilities experience abuse, sometimes violent or sexual abuse, from the staff of the facility. Nurses are especially fond of tranquilizing their charges so they aren’t too much trouble on their shift. This is routine. And it makes it easier for the orderlies to have their way.

Note this is a national statistic. You may want to check your own municipal region and where you’d be sent. Maybe the madhouse in your area is a shining example of how such a place should be run. This also is based on what is reported by patients who successfully got out of the facility. Those who were abused until they found a way to escape by suicide never get a chance to report, and much like US prisons, such incidents are commonly covered up.

To be fair, a lot of for-profit hospitals don’t necessarily have better statistics on the treatment of their patients. If your family wants to send you to a swanky place, and the first thing they want to do is confiscate your cell phone, then it’s time to check what overseeing parties are making sure you’re safe. Otherwise, you’re totally not.

In the meantime, before you turn someone who is suicidal away, before you send them to a list of hotlines and professionals, note that in the United States their normal, common recourse is to send our mental health crisis to a facility where they’ll have no communication outside, will be prescribed sedatives by the hospital psychiatrist so they aren’t too much trouble for the nurses, and become a plaything for the orderlies. This is what our public mental health institutions look like in the US in 2023. This is what we get for having underfunded mental health for over a century now.

Now I get that here, resources are limited. There are reasons to keep topics safe for everyone. And I do not have a good solution to this. It just means that when we can’t serve people in crisis, we have to accept the risk that we’re never going to see them again.

In the United States in 2021, there were 48,183 suicides with fatal outcomes, which has been rising since 2015. It’s estimated about three times this number do not succeed and end up in the ER or recovering.

So I, for one, as someone who deals with (a managed level of) suicidality on a daily basis, know that if ever I go critical I’m on my own.