I have sought help before. A few times in fact but it never ended well. This IOP was a last ditch effort. (Quick side note I am a citizen) There is no help to be had for me. Everytime I try and seek help no one understands that I've been dealing with this crap for the better part of 30 years. So when I say I'm feeling suicidal well "what's new?" But rather than looking at the picture as a whole they want to focus on the very small and narrow window of the immediate. Never hearing "Yes i was feeling suicidal yesterday, but it has past today."
My family is trying to be supportive but they don't understand. My wife is pushing for inpatient because that's what everyone else is saying. I finally ended up having to tell her "What you are saying to me is the equivalent of telling a rape victim they have no choice but to live with their rapist. I can not put into words how traumatic inpatient is for me." Finally she agreed not to bring it up anymore. Although she doesn't understand why.

I've made it this far on my own. It looks like I am the only one I can rely on.

Earlier you said I sounded really messed up. Well not those exact words but basically that was the jest. And yes I am REALLY F'd up. This IOP did help to shine a light on more ways I thought were normal but aren't.