After you have been treated for a suicide attempt in the emergency room and the doctors believe you are medically stabilized, you will either be discharged or hospitalized. If you are discharged after your suicide attempt, the staff in the emergency room should provide you with a plan for followup care.
The exact steps for followup care will vary with each person, but your plan should include:
- A scheduled appointment in the near future with a mental health provider (such as a psychiatrist and/or licensed therapist). Make sure that the name and contact information for the provider is given to you before you leave the hospital and that your appointment is scheduled as soon as possilbe.
- Information on any treatments that you received in the emergency room, such as medications, and what, if anything, you will need to do about those treatments after you leave.
- Referrals to local and national resources and crisis hotlines for information and support.
If the emergency room staff feel that you need more immediate care or longer-term care than the emergency room can provide, you will be referred to inpatient hospitalization. If hospitalization is necessary, you and your family can begin to work with the hospital to develop a plan for the next steps of your care. Hospital staff (usually a social worker) should help you with this process.
People generally have the right to consent to or refuse treatment. However, if the emergency physician believes you are still a danger to yourself or someone else, he or she must consider having you hospitalized involuntarily for a limited period of time (a 72 hour suicide watch is common). Laws about commitment vary by state. If you have questions about your rights as a patient, you should contact your local Protection and Advocacy organization. These are legal centers that are funded to protect the rights of persons with mental health needs. You can either go to their national website at www.ndrn.org or call the office at 202-408-9514 to inquire about the nearest center in your state.
Next Steps: Moving Ahead and Coping With Future Thoughts of Suicide
Recovery from the negative thoughts and feelings that made you want to end your life is possible. You may get to a place where you never have thoughts of suicide again and you can lead a happy, satisfying life. You also may learn to live with these thoughts in a way that keeps you safe.
After you leave the hospital there are several things you can do to help in your recovery. It may feel difficult and overwhelming right now, but over the next few days, following these tips can help turn things around.
- Create a safety plan. You and your doctor or therapist should work together to develop a safety plan to help reduce the risk of a future suicide attempt. When creating such a plan, be honest with yourself and your doctor to ensure that the plan meets your needs and that you feel comfortable with it. Although everyone's safety plan is different, some common things that may be included in yours are:signs that may indicate a return of suicidal thoughts and what to do about them; when to seek additional treatment; and contact information for your doctor, therapist, crisis hotline number, and a trusted friend or family member. Keep a written copy of your safety plan nearby so you can refer to it as needed.
- Build a support system. A support system is a key part of recovering from a suicide attempt and preventing future attempts. It is important that you have at least one person in your life who can be your "ally". This must be a person you trust and can be honest with-especially if you start to have thoughts of ending your life again. Family members or a close friend can serve this important purpose. A member of the clergy, mentor, or colleague also could be helpful to you at this time. Having more than one ally can be a tremendous asset. Even when you are feeling alone, always remember that there are people in your life who care about you a great deal and are willing to help.
- Learn to live again. When you are recovering, the world can look like a pretty bleak place. It may take a little while before your life starts to feel worthwhile again. One thing you can do to help is to get back into a routine. Eat three healthy meals a day, exercise 30 minutes a day, and go to bed and wake at the same times each day. Try to join in your usual activities a little at a time, and add in more when you feel comfortable.
- Listen closely and carefully consider the support and advice you receive from others. It is important to be honest with yourself, your doctor, and others about your feelings so that you receive the best possible care. Sometimes being under pressure and having thoughts of suicide can make it difficult for you to make the best decisions, and at those times, other people may have a more realistic view of your situation than you do. Your ally can help you work through these confusing and isolating thoughts and feelings and help keep you safe.
- Keep in mind that everyone's recovery is different. Some people have persistent thoughts of suicide. For others, such thoughts may accompany only certain moods and circumstances. Following the steps mentioned in this article can help you prevent negative and destructive thoughts taking control of you in the future.
- Remove the means for hurting yourself from your environment. Work with your ally to remove methods of self-harm. It is best not to have these items around while you are recovering. If you use medication, keep only a few days' supply on hand and ask someone else to hold onto the rest. For other means of self-harm, such as weapons, give them to someone else for safe-keeping until you are no longer a potential danger to yourself.
- Identify what triggers suicidal thoughts or behavior for you. It may be the anniversary of a painful event, or seeing a knife in the kitchen. Plan to minimize the effect of these triggers on your life. Sometimes you can avoid them or train yourself to respond differently, or you can involve your allies ahead of time to help you face a difficult situation. Remember that life events do not cause a suicide, but they can certainly increase the risk of an attempt.
- Learn all you can about mental illness. Whether you have been diagnosed with a mental disorder or not, it is quite common for suicidal tendencies to be linked to a chemical imbalance in the brain. Ask your doctor about screening you for illnesses such as bipolar disorder, schizophrenia, and major depression. The more you know the better you are at finding a successful treatment that is right for your particular needs.
- Keep a list of crisis hotlines in an easy to reach spot. Hotlines provide you with a trained person to talk to when you are having suicidal thoughts or other unbearable feelings. This person will listen to you and help you choose another path that does not involve harm to yourself or others. If you have a safety plan written out, make sure to have it on hand while you talk to the hotline worker, as he or she can help you through the actions you need to take to keep yourself safe. If you do not have a safety plan in place, the crisis staff will help you create one. This link will take you to a list of crisis hotline numbers that may be useful to you. The emergency room, your doctor or a mental health facility may have a list of local numbers to contact. Make sure to ask for a list of crisis hotline numbers, and keep them in an easily accessible place.
- Join a support group. There are many types of support groups, and you may wish to participate in one in your area. Learning from others and sharing your experience can make a big difference in the way you think about your life. It also may help save the life of someone else. Ask your doctor or therapist about what groups are available in your area. It may feel a little scary joining a group of people, but I personally have had great success in recovery thanks to group therapy (and I happen to be an extremely shy person). Sometimes stepping outside of your comfort zone can be a very rewarding experience, and you are bound to meet people and hear stories that will change your life-and perspective-for the better.
- Get involved in life. Finding a hobby or enjoying a favorite pastime-such as listening to music, watching your favorite movie, writing in a journal, or painting-is a great way to help you cope when life is overwhelming. Hobbies or activities that involve interacting with others are an especially good idea. Whatever your interests may be, make sure you have access to the things you enjoy. That way, if your negative thoughts come back, you can turn to something that brings you comfort and enjoyment.