I have been having thoughts of suicide lately. I know that I would never kill myself and I do not want to kill myself but I have been having many thoughts. I have made an appointment at the counseling center and plan to attend, however I am scared to tell them that I have been having these thoughts. I want it to stay confidential and I know that is the one thing they do not have to keep confidential. What will they do/say if I tell them about these thoughts at my appointment? Thanks.
Dear Anonymous, Charlie hears you. You say that you have been having thoughts about suicide, but know that you “would never kill myself.” You have an appointment with the Counseling Center, but are worried how the counselor might react to hearing about the suicidal thoughts, and you wonder if they will continue to keep what you say confidential. First of all, Charlie is glad to hear that you have already made an appointment with my friends at the Counseling Center. Confidentiality is something that is important to the counseling process, and my friends at the Counseling Center take it seriously. Confidentiality essentially means that you can tell your counselor anything, without worrying who they might share that information with, because they will keep it to themselves. You are correct that there are certain limits to confidentiality. If someone is a danger to themselves, or to someone else, a counselor has an ethical obligation to prevent harm from happening. However, there are many individuals in counseling who experience suicidal thoughts, share them with their counselors, and these remain confidential. How can this be? It is because the counselor has been able to determine that the individual is not an immediate danger to themselves. Many times having the thought of suicide is not the same thing as intending to, or taking steps to end your life. When you come to your appointment at the Counseling Center, Charlie encourages you to share with your counselor that you have been having thoughts of suicide. Your counselor will ask you some questions to further assess these thoughts with you. They will want to know things such as how often you think about suicide, how strongly you feel you want to die, how strongly you feel you want to live, and if you have made plans to end your life. In many cases, it is clear that the person’s thoughts of suicide have not reached the point of taking action, or intending to end their lives, and there is no need to break confidentiality in order to keep them safe. In other cases, it is clear that the individual clearly intends to end their life, and through the process of discussing it with a counselor, they voluntarily decide to go to the hospital in order to keep themselves safe. Counselors understand that each person’s case is different, and this is why they will want to know more about your situation specifically, in order to get you the appropriate level of help you need. If you are not a danger to yourself, or to others, there would be no need to break your confidentiality in order to keep you safe. Your counselor will also want to develop a Safety Plan with you, which is an individualized plan of action you can take whenever you begin to experience thoughts of suicide. Even if your thoughts of suicide are not very strong, it is a good idea to develop this Safety Plan in order to begin learning how to cope with the thoughts, and where and when to reach out for help. Charlie is glad that you have taken the first step to getting help by making an appointment for yourself. If you begin to experience thoughts of suicide before your appointment, Charlie encourages you to call the Counseling Center (285-1736), or the National Suicide Prevention Hotline 1-800-273-8255. To feeling better soon, Charlie
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