First let me say that I'm really sorry you'd been mistreated and abused by the ppl who were supposed to take care of you.
I pay for my T, there's no way he has access to my medical papers, address... Come to think of it he doesn't even know whether or not I'd told him my real name (yeah I did).
So no, there's no way he can report me when I'm suicidal. He just had to deal with that- not anymore but there were times when he simply didn't know if I would come back for a next session. I really appreciate that and know that many T would not be able to do this for their clients (I wouldn't for sure). Yet I've needed that, I need to know that my body is under my sole control and that sharing my thoughts/feelings with someone else doesn't mean I'd have to share that control too.
I live in Germany but I think once you'll pay for your therapy there's no need for authorities/insurance/whatever to know about it.