depends on where you are located. since 9/11 New York has enacted zero tolerance laws around the issues of suicide/self injury and harming others. treatment providers are now mandated to take action when they know of someone who may be a danger to their self or others. what that means per agency is that each mental health agency must have a system in place to assess the situation and take appropriate action.

with some agencies their agency rule is taking extra time with the suicidal or self injuring one to evaluate the seriousness of it, whether it meets the agency criteria for inpatient or outpatient services like hospitalization, notifying the police, contracts between the client and therapist, a change in medications....

the crisis center's rule where I work is if those manning the phones feel the person on the phone is a danger to their self and others we must contact the police to issue a well check..thats where the police go to the person that has called and do a face to face contact to decide whether that person is a danger to their self and others and needs to be either arrested or transported by ambulance to the hospital for further evaluation.

examples...

if a person calls us and says they...feel ....like doing something but they are not going to, they chose to call in instead. we stay on the line and help them get through the night so that they can contact their own treatment providers in the morning.

if a person calls and says they want to die, they are going to do this that or the other thing, we immediately notify the supervisor and the police while we keep the caller on the phone with various suggestions...Ok you want to do this, have you decided when, sounds like you thought of everything, let me ask you, is there anyone special you would like to be the one to find you when you are gone? do you have children if so are they home with you? I ask because if you do this tonight it may be your children that are the first to find you in the morning. would you rather someone else find you..... we keep the conversation going at all costs even if it means seeming like we are agreeing with the caller and making suggestions to how the caller can change their plans for the better, all the while wording the questions in ways that will illicit more information...while locating where they are and waiting for the police come on the line to let us know they are there.

if a caller says to us they have cut or other wise harmed their self with in the past 24 hours and are thinking about doing it again, we ask them questions to assess their plans, and mental state of mind. if we feel this person may be self injuring while on the phone with us we immediately contact the police for a well check.

if a caller is obviously agitated and there have been comments of suicide/self injury or harming others and suddenly hangs up, we have to notify the police for a well check.

if someone calls in and says they are going to harm someone else we notify the police...

during training we go through many many role playing emergency and non emergency events that we may have to deal with and how NY laws say we have to deal with them and how the crisis center rules say we have to deal with them.