I'm sorry that so many are in this situation. My suicidal ideation is part of the ptsd and chronic pain that I have... my T always wants me to call him when I am feeling so desperate...we decide together whether I can continue with his support only and be safe, or if I need more.

I don't know if it comes down to a liability/lawsuit issue with the Ts you are referring to, or not. And I don't know if my own T has some patients that (through agreement?) call / go to the ER first, but I would venture a guess and say yes.

If the T doesn't understand fully how you are feeling and why, that could be one reason...and it could also be that the T DOES understand fully and wants the ER to handle it. IDK..but I'm sure it's feeling lonely if your own T won't address it with you.