How to differentiate between SH and an attempt?

If someone, for example, took a bunch of pills and ended up at the ER, how would the dr. be able to differentiate if the person was trying to commit suicide or were "simply" engaging in SH? Would they be treated differently?

I'm just thinking because if it was classified as a suicide attempt, the person would likely have to stay for 72 hours for observation (I realize this is different in different locations). BUT, if it was classified as SH, and they didn't have the direct intent to kill themselves, wouldn't they not have to stay for 72 hours because they weren't necessarily an immediate threat to themselves?

Maybe I'm way off, or maybe there is an easy answer... I was just curious

I've never been placed on a hold even after attempts so I might not have the answers you're looking for. It's kind of funny you should post this today as taking a bunch of pills for SH is exactly what I have done.

When I've OD'd in the past for attempts I have always been asked what the intent was. And I've always been honest with them. Once my medical treatment is completed I've always just been free to go after talking with the psych team.

Tbh I feel more at risk now after doing it for SH than I do after an attempt. Big attempts always seem to get it out of my system for a bit and things start to calm down again. SH is something I repeatedly do. Normally it is cutting though.

Hmm I'm not really sure what the answer is....

With my OD I was asked about my intent and was honest about it being an attempt. Like Secret I was free to go once I'd talked with the pdoc. Other SH episodes that landed me in the ER I didn't even get asked, once I'd been checked over I was free to go. It must have seemed odd that someone could fall from the same staircase by accident more than once, but no-one ever asked. Sometimes I think medical staff overlook what is staring them in the face and sometimes I've felt that they treated me with less respect because of my attempt. I've lived in the same (smallish) town for a long time, there's just one ER and my file is quite a big one, but it always falls open on the page where my attempt notes are.

I've overdosed a few times for SH rather than an attempt and ended up in the er. I've always been asked what my intent was and I was always honest saying I just wanted to hurt myself. After I was medically cleared I was always free to go. The only 2 times that my SH lead me to staying was when I stabbed myself and needed surgery and again when I re cut it.

My shrink and I had to go over this very thing recently.

She said when I overdosed last time that it was not an "attempt" because that was not my intent.

It is all about your INTENT at the time.

She said my intent was not to die, but to simply escape reality for awhile. Another form of self harm.



PS I was not totally honest on my answer about "intent". My sixth sense told me to tell them what they wanted to hear.

Thank you all so much for your thoughts. I'm so sorry to hear of the struggles that everyone has gone through

It all depends on where you live and what the professionals say around you. Not to mention if you are conscious and talking. This decision is not easy.

I struggled with SH for a while, but never attempted suicide. When I SHed it was to stop feeling so numb, and my purpose for doing so was not to kill myself. At the hospital, I told them (honestly) that I was not suicidal, but that I was harming myself. They kept me for a few hours under "watch" and then let me go home. If I was suicidal, they would have had me stay much longer.

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I have to agree with most everyone here. It's all about intent. And then of course, they would have to believe you when you said that you weren't trying to kill yourself.