[Humpty Dumpty]

So often it seems like the doctors think they know what's best and not even listen to what I have to say. I have SEVERE trust issues and because of that I am also paranoid (not delusional just paranoid). Because of these issues I have had a hard time finding a therapist to talk with that I can trust.

Today I went to a private facility that did an intensive outpatient program (IOP). Even though I told them they were my last hope and I didn't know where else to go to get help they still rejected me for 2 reasons.

Reason #1) I would not give them my wife's info as an emergency contact. They said they would only call her if I was going to kill myself. That's a big reason I don't want them having that info. I don't want her to know and worry.

Reason #2) They wanted me to sign a contract saying I would tell them if I was suicidal & if I were that I would goto an ER. I refuse to go to an ER because all they will do is have me committed to a mental hospital. I have not had good experiences with those so I refuse to ever go back to one again.

Those are fair terms. You will be hard pressed to find someone who will not require that information and promise. Can you put someone else as your next of kin rather than your wife? They do need that information. And a safety contract is completely run of the mill. They are not going to change the system for you.

[Humpty Dumpty]

Originally Posted by Supanova

Those are fair terms. You will be hard pressed to find someone who will not require that information and promise. Can you put someone else as your next of kin rather than your wife? They do need that information. And a safety contract is completely run of the mill. They are not going to change the system for you.

My only other options are my parents (bad idea) or my brother who would probably call my wife.
I have no intention of upholding a safety contract so why bother? Last time I seriously thought about killing myself I was on the phone with a support person while I was making my plan. So "calling" someone won't make a difference.
But from what I am understanding from you is either given in and accept their "terms and conditions" or don't get help. If that's the case then the cure is worse than the disease. I'm not willing to make that sacrifice.

[Gavinandnikki]

If you want help, sign the damn thing and then do what you want.

I think you are digging your heels in because of your "trust issues".

The cure is not worse than the disease unless you spin it that way.

Hope you change your mind and good luck.

But you didn't go through with it so how do you know calling someone didn't stop you?

If you are not going try and guarantee your safety than no pdoc will touch you. They have a duty of care - if you were to tell them what you just wrote you would be locked up. But if you said "I will do my best to stay safe" it is more likely they will take you on.

In my experience I have found most pdocs to be open to negotiation on the wording of te safety contract. Would that put your mind at ease? One of my previous contracts had it written in that I was to present to the ER but did not need to be admitted, rather stay there until they got in contact with my pdoc or stay until I could once again be safe. The er accepted these terms and the one time I went in I was not admitted and didn't need to stay long at all (I got the stitches and left out the front door no problem). Would something like that help? I don't know how rigid your particular clinic is

[Humpty Dumpty]

Originally Posted by Supanova

But you didn't go through with it so how do you know calling someone didn't stop you?

If you are not going try and guarantee your safety than no pdoc will touch you. They have a duty of care - if you were to tell them what you just wrote you would be locked up. But if you said "I will do my best to stay safe" it is more likely they will take you on.

To answer your first question I didn't have enough to do it. If I had just a few more I would have OD'd.

As for the 2nd part that's why I can't trust them. If they lock me up for being honest about how I feel then why be honest? If I can't be honest then is it not safe to assume that the therapy won't do any good? That is my main "sticking" point now. I've decided if I have to give them an emergency contact then I can give them a fake number. Come to think about it I should probably give them a fake address as well. I don't want any police showing up at my house.
But back to the contract. Say I do sign it. That also means I have to watch what I say and I can't be completely open about how I feel. Let's say I am having a very bad time and I just really want to die and the thought of suicide seems like the best way to go. If I say that they will lock me up. That is the last thing I want. So what am I supposed to do?

I am trying not to be a complete *** in this thread although I'm sure it's coming off that way. I'm just confused and depressed and don't know what to do.

You seem very paranoid. You want help but you dont want to get help in the way that is offered to you?

This thread may give you some insight into how you are feeling now. Read over what you have written. Why do you think you are coming across as an ***? Maybe cos you are being unreasonable and you know that.

Perhaps you could also write down some of these fears you have and see how likely they are to occur.

[Humpty Dumpty]

Well I have good reason to be paranoid. I have had someone contact my wife in the past and give her information that neither of us wanted her to know. I have also been locked up in a mental hospital against my will because I was too honest when talking about how I felt.
So I would say it is very likely that my fears will occur.

Originally Posted by Humpty Dumpty

To answer your first question I didn't have enough pills. If I had just a few more mg I would have OD'd.

As for the 2nd part that's why I can't trust them. If they lock me up for being honest about how I feel then why be honest? If I can't be honest then is it not safe to assume that the therapy won't do any good? That is my main "sticking" point now. I've decided if I have to give them an emergency contact then I can give them a fake number. Come to think about it I should probably give them a fake address as well. I don't want any police showing up at my house.
But back to the contract. Say I do sign it. That also means I have to watch what I say and I can't be completely open about how I feel. Let's say I am having a very bad time and I just really want to die and the thought of suicide seems like the best way to go. If I say that they will lock me up. That is the last thing I want. So what am I supposed to do?

I am trying not to be a complete *** in this thread although I'm sure it's coming off that way. I'm just confused and depressed and don't know what to do.

You are stating that you are unsafe, they are keeping you safe. If you are not unsafe then do not tell them you are. Simple. They need to take threats seriously.

Originally Posted by Humpty Dumpty

Well I have good reason to be paranoid. I have had someone contact my wife in the past and give her information that neither of us wanted her to know. I have also been locked up in a mental hospital against my will because I was too honest when talking about how I felt.
So I would say it is very likely that my fears will occur.

That happens to many mentally ill people, were you a danger to yourself or others when you were locked up? Were you there to stay safe? Did it save your life? They have a duty of care.

Emergency contact is harder if you have absolutely no one you can trust, usually most people will have someone. They would only call it in an emergency.

What other avenues have you tried? Perhaps you can work on your paranoia to the point where you can accept this type of treatment.

[Humpty Dumpty]

Originally Posted by Supanova

What other avenues have you tried?

I'm not sure what you mean?

Perhaps you can work on your paranoia to the point where you can accept this type of treatment.

I plan on trying to contact a different therapist today that does alternative treatment. After them I don't know where to turn if it doesn't work.
Maybe I can work on my paranoia. I have a hard time trusting, always have & I don't see how that can change. Which fuels my paranoia even more which in turn fuels my distrust.

[Humpty Dumpty]

The first time I was locked was of my own free will and yes I was in danger of killing myself. When they called my wife however I was not. I had been released from the inpatient facility and was attending their partial hospitalization program.
The 2nd time I was locked no I was not in danger of killing myself. I had simply gone up there to try and attend their partial hospitalization program. I told them that I had seriously considered suicide in the past and when they asked I told them I did have a plan. That's when they locked me up even though I told them it would do more harm than good.

[Nammu]

Hospitals are sucky places and they do treat people like kids but they do keep you safe from yourself. There is a difference between thinking about Sui and planing Sui. If all it takes is an impulse to carry out then yeah they will keep you safe. But it sounds more like you want compleat control to do what you want even if you are unsafe. It sounds manipulative on your part, and unreasonable. It doesn't work that way there has to be some give and take, if you really want help then you need to be willing to give up some control. I'm not sure you really want help at this time, not sure what it will take but I hope you decide your life is worth more than getting your way. I completely understand not trusting docs, I've walked out of more than a few places becouse I thought they were poisoning me.

Can you give them your brothers number?
As for agreeing to be honest about Sui thoughts that is reasonable request on their part, they can't help you if you refuse to be honest. You can explain your fear of being honest and why you did like hospitals so much and I'll bet they will work with you to keep you safe and not in the hospital, if you are willing to work with them.

[LittleEarthquakes]

What else can they do other than put you in a hospital if you're at risk of killing yourself?

[Humpty Dumpty]

If I'm going to kill myself then I am going to kill myself. I have figured out a way to even do it in a hospital. Once your have a plan you can never unhave a plan. Much like buildings have emergency evacuation plans. If you learn the best way to get out of a building on fire does not mean you plan to set fire to it. So putting me in a hospital "to keep me safe" won't work.
Yes I do want help but I am not willing to give up my freedom.

[pinkbutterfly]

Originally Posted by Humpty Dumpty

If I'm going to kill myself then I am going to kill myself. I have figured out a way to even do it in a hospital. Once your have a plan you can never unhave a plan. Much like buildings have emergency evacuation plans. If you learn the best way to get out of a building on fire does not mean you plan to set fire to it. So putting me in a hospital "to keep me safe" won't work.
Yes I do want help but I am not willing to give up my freedom.

So what I hear you saying that you do have a plan. But at this point you have no intention of carrying out that plan. Is that correct? I mean, sure, I know how I would kill myself if I chose to do it...but that does not mean I am actively suicidal. There is a difference. It sounds like they took the idea that you had a plan as intent. Plan and intent are not the same. However, they do look at it kind of like a continuum - with no suicidal thoughts on one end to completing a suicide on the other...in between I would say goes like this...

*No suicidal thoughts
*Thoughts about wanting to no longer live/feel pain
*Wishing/praying to die in a general sense
*Hoping something will happen to cause death - like a plane crash or freak accident type of thing. (I refer to this as passive suicidal thoughts)
*Thoughts of killing oneself
*Thoughts of how to kill oneself (planning)
*Desire to carry out the plan
*Acquiring the means to carry out the plan
*Attempting suicide
*Completing suicide

The closer you get to the last two...the harder time you will have convincing them you will stay safe. If you have past suicide attempts, they will take the planning much more seriously. Obviously you have not reached that last level, but it sounds like you have attempted before. Every professional you work with will take that very seriously. They say that a person who has a previous attempt is something like 40x more likely to attempt again.

I've struggled with this continuum a lot in my life. I've been hospitalized 8 times in a three year period. Several attempts. Now my struggles are more in the passive suicidal area...but at this point my therapist knows me well enough to know that I am where I say I am. She trusts me to be honest. And I trust her not to jump when I say I've been feeling suicidal. We talk through it. She works to understand where I am at -- and we discuss things I can do to stay safe. We come up with a plan. Together.

I also work in the mental health field (ironically). And when I have someone tell me they are having thoughts of killing themselves - I know a knee jerk reaction is never helpful -- but sometimes the hospital is necessary. Even when they don't think so.

Trust is hard. So very hard. Especially when people have proven to be untrustworthy time and time and time again. And guess what? They will ALWAYS let us down. ALWAYS. There is NO ONE on earth that can never break your trust or let you down. It's part of life. Unfortunately. It's scary and it hurts. But when we do finally allow ourselves to be vulnerable and risk trusting someone...only then can we find someone who is trustworthy.

I challenge you to look at your expectations of what someone has to do or be like in order to be worthy of you trusting and being open and honest with. What makes someone trustworthy? Sometimes our expectations get in the way of reality...and when our expectations aren't realistic, we will always be devastated when they aren't met.

Sorry this was long...I hope some of this helps a little.

[Humpty Dumpty]

Pink - I have not tried to kill myself. I can't really say why. I have really wanted to twice. If I attempted I would have succeeded, which is part of the reason I didn't attempt the 2nd time because I wasn't 100% sure it would work.
As far as the stages go Planning and Acquiring go hand and hand. My plans have always involved the means that I have at my disposal.
At this point I don't want to kill myself. I do wish I could die, but I don't want to kill myself. I am often envious when I hear about others that die. For example the shooting in TN I wonder why do they get to be the lucky ones?

[pinkbutterfly]

Originally Posted by Humpty Dumpty

Pink - I have not tried to kill myself. I can't really say why. I have really wanted to twice. If I attempted I would have succeeded, which is part of the reason I didn't attempt the 2nd time because I wasn't 100% sure it would work.
As far as the stages go Planning and Acquiring go hand and hand. My plans have always involved the means that I have at my disposal.
At this point I don't want to kill myself. I do wish I could die, but I don't want to kill myself. I am often envious when I hear about others that die. For example the shooting in TN I wonder why do they get to be the lucky ones?

I can definitely relate to those feelings. I think it's an important thing to note that while you may want to die, you do not want to kill yourself. That's a significant difference. And if your mental health providers aren't listening and understanding, I can see how they would react. So part of that may take a little bit of patience on your end (unfortunately) to be able to articulate that so they understand. Sometimes that takes having already built some trust/rapport with the therapist.

Don't agree to staying safe longer than you really feel like you can. Sometimes it may be a day -- sometimes more. Sometimes less. And then the plan becomes - ok, you agree to stay safe until you return here in the morning. We can think about after that tomorrow...but until then, what can you do to stay safe? And if you really begin to feel that you can't stay safe - what are you willing to do?

Hope that makes sense.

[Clara22]

Hi,
I think this is an issue of rights . I think you have the right to refuse any treatment ( for example involuntary hospitalization ) and the right to privacy (not sharing your mental health information with anybody but your health providers). However, I am not sure about if your country and state recognize those rights. If I could give you a piece of advice: please don't mention your paranoia when discussing these issues with your mental health providers. These are patient's Rights matters that should apply equally to everyone regardless status or symptoms. Paranoia is irrelevant here (I mean, in the framework of a discussion about patients' rights)
Particularly, I remember my experience as a health insurance user in the U.S. : I was living alone there, all my family and closest friends were overseas . Each time I had to be hospitalized I had problems because I did not have anybody to sign off as my contact person. I fought too hard but finally the hospital accepted not to have anybody . I do not know if they broke a rule but I told them I did not have anybody to put as my contact and that that was all
And they accepted that at the end.
I am not sure if the Independent Living Center of your region knows about your rights as a user of mental health services but they may know where you can get advice
Resources
Good luck with everything

[Clara22]

Hi,
It's me again. I remembered these guys, they may be of help ADAPT: Tennessee

[robcalher]

Ok so I have not read all the responses to your posts but I understand where your coming from. I too have trust issues, same with bad experiences asking "the system" for help, and also do not want to tell loved ones about the s******l thoughts that I have for fear of them worrying. I called a suicide hotline once only for them to call the cops on me and have about 15 police hold me up and handcuff me in front of the the whole town, literally. Then lock me up in a small mental place for a few weeks. Twice. Also the last time I went to a hospital, then respite for a s*****e attempt. I left there early giving up my legal rights. In other words, I too would get locked up in a mental hospital or whatever the laws see fit if I made another attempt in the near future. So I hear you. On the other hand, I would love to be in an IOP if I had the chance as I feel that is what I need right now. It seems logical for them to want you to sign the contracts, even though I too would be hesitant, but I would do it anyways if I were you.

[robcalher]

Ok so I have not read all the responses to your posts but I understand where your coming from. I too have trust issues, same with bad experiences asking "the system" for help, and also do not want to tell loved ones about the s******l thoughts that I have for fear of them worrying. I called a s*****e hotline once only for them to call the cops on me and have about 15 police hold me up and handcuff me in front of the the whole town, literally. Also the last time I went to a hospital, then respite for a s*****e attempt. I left there early, against their advice, giving up my legal rights. In other words, I too would get locked up in a mental hospital or whatever if the laws see fit if I made another attempt in the near future. So I hear you. On the other hand, I would love to be in an IOP if I had the chance as I feel that is what I need right now. It seems logical for them to want you to sign the contracts, even though I too would be hesitant, but I would do it anyways.