Talking to your therapist about suicide: What to expect

Life can feel really heavy at times. Our minds and bodies work hard to keep us going through our days, but sometimes it can feel like too much. If you’ve ever had suicidal thoughts or even just thoughts like “what is the point of living?” and considered telling a therapist about these thoughts, you may have felt afraid of what would happen next.��

Worries can include:��

“Will the police come and take me to the hospital?”
“Will I be forced to drop out of school?”
“Will people think I’m crazy?”��

It’s totally understandable to have these fears—they’re actually very common. Because of them, lots of students keep their feelings to themselves and try to get through things alone. But hiding your pain can make you feel even more alone and scared. That’s why it’s so important to know what really happens if you open up about suicide or hopelessness in therapy. The truth is, being sent to the hospital is only considered as a last option. Therapists are there to listen with compassion and help you feel heard and supported. Being honest with them can be a huge relief and a big step toward feeling better.��

Here’s what you can expect if you talk to your therapist about feeling hopeless or having thoughts of suicide.��

Listening��

When your therapist learns that you have been experiencing suicidal ideation or hopelessness, their first priority is to listen. They’re there to acknowledge the pain you’ve been carrying and to let you know your feelings matter. Therapists often thank you for being honest about something so difficult, because they understand how much courage it takes to open up and trust someone with these vulnerable thoughts.��

Risk assessment��

Your therapist isn’t trying to “catch” you or get you in trouble. Their main goal is to truly understand what you’re experiencing so they can offer help in the safest and most supportive way possible. When they do a risk assessment, they focus on three important areas:��

The strength of your thoughts:
- They might ask questions like:
  - “How often do you think about this?”
  - “Are these just passing thoughts, or do they feel like strong urges?”
If you have a plan and means:
- They may ask:
  - “Have you thought about how you would act on these thoughts?”
  - “Do you have access to anything dangerous at home?”
  - “Have you thought about following through with a plan?”
Your reasons for staying safe:
- They’ll want to know:
  - “What’s stopping you from acting on these thoughts?”��

Remember, reaching out for help is a sign of strength, and support is available to guide you through tough times. ��

Safety planning��

Most of the time, sharing with your therapist that you’ve had thoughts of suicide doesn’t mean you’re in immediate danger. In these situations, your therapist won’t rush you into hospitalization. Instead, you’ll work together to find ways to keep you safe and make sure you have the support you need.��

This process is called “safety planning.” While each therapist may approach it a little differently, it often involves creating a written plan that includes warning signs to watch for, coping strategies you can use, people you trust to reach out to and helpful resources in your community. Your therapist’s goal is to help you feel supported and empowered during tough times.��

When hospitalization does become necessary��

The following criteria must be met for a therapist to initiate a hospitalization:��

You have a plan
You have the means to carry out this plan
You intend to act on it soon and are unable to agree to following your safety plan��

Even if these criteria are met, your therapist will still try to work with you to find a way to keep you safe without hospitalization. This might involve removing anything dangerous from your home, reaching out to a trusted friend or family member you can stay with, or creating a safety plan together that feels realistic and supportive for you.��

Common misconceptions��

Sometimes students worry that if they talk about suicidal thoughts with a therapist, they’ll be forced into a hospital. In reality, therapists are there to help you feel safe and supported. If you share that you're having these thoughts, they’ll ask some follow-up questions to understand what you're going through. Their goal is to work with you—not against you. Hospitalization is rarely the first step, and if it ever becomes part of the conversation, it’s usually something you decide together.��

Another concern students have is that going to the hospital means falling behind in classes or having to drop out. But your mental health matters, and ��Ҵ�ý�ƽ�� has systems in place to support you. Counseling & Psychiatric Services and Student Outreach, Advocacy & Support can help communicate with your professors, provide documentation and offer follow-up care after discharge. You won’t be left to figure it out alone—there are people here who want to help you stay on track.��

It’s also common to worry that talking about suicide will make a therapist think you’re “crazy” or beyond help. That’s not true. Therapists are trained to respond with compassion and respect. They understand how hard it can be to open up and appreciate the courage it takes to speak honestly. You’re not alone, and you’re not broken—help is available and you deserve it.��

Here’s the bottom line:��

Hospitalization is rare.
Most of the time you’ll create a safety plan and get more support, not less freedom.
Talking about suicide helps you feel less alone and more understood.��

If you’re struggling, please don’t wait. Reaching out is the first step toward feeling better.��

Resources��

Immediate emergency

If someone is in immediate danger or at risk of harming themselves right now—call 911.��

24/7 crisis lines (first step)��

Counseling & Psychiatric Services (CAPS): 24/7 phone support at 303-492-2277
: Call or Text 988 or live chat at . Available 24/7 for confidential crisis support.��

Local, in-person crisis care��

��24x7 walk-in urgent mental health and substance use crisis services��located��at��1107 W. Century Drive, Louisville, CO 80027.

Local phone numbers and hospital options��

(Foothills Hospital Emergency Department): for medical/psychiatric emergencies and emergency care. If someone needs immediate medical attention or emergency psychiatric evaluation, go to the nearest emergency department.��

Other helpful hotlines (special populations)��

(LGBTQ youth) for 24/7 chat and phone: 866-488-7386��

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