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20 Truths ER Staff Need to Know About Patients Who Are Suicidal

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We’re taught to call 911 when we need help. We’re taught the emergency room is the place to go for medical emergencies. So when someone is suicidal — and has either attempted or is really struggling with suicidal thoughts — the ER is often the quickest way for that person to get help.

But the stigma we see in society sometimes seeps into the emergency room, and people who work there aren’t adequately trained to talk to or treat someone who’s going through a suicidal crisis. This isn’t true for everyone or every place — but enough negative experiences have emerged that we wanted to open the question to our community: If you’ve been to the ER for suicidal thoughts or after a suicide attempt, what’s one thing you wish the staff and doctors there understood?

Here’s what they had to say:

1. “I obviously need help. Despite the fact I’m cooperative, despite the fact that I have my master’s degree, I can’t control my suicidal thoughts. No, I don’t want to be here; yes, I’d much rather be at home and in my own bed. Clearly I can’t be safe at home. I’m too impulsive. I understand I’m not fun to deal with. I don’t like it either. But please, please, please, be kind because I don’t believe I deserve the help, and you brushing me off just reinforces the thoughts that brought me here.”

2. “Stop being condescending… I’m irrational, not unintelligent. Stop being rude and assuming I’m on drugs because even if I was, I would still need help. I’m just as worthy of your time and patience as someone with a physical ailment. Just because it’s in my brain doesn’t mean I’m not suffering immensely.”

3. “It’s not a cry for attention. Honestly this applies to everyone. Having suicidal thoughts is not fun, it’s not to ‘get your attention.’ Think more about the person who is so clearly hurting. Don’t call them selfish.”

4. “Please look at me as a person, not just another number on a statistic. Please don’t label me as the ‘suicidal one’ because those words hurt. I’m only human, my brain is sick — but I’ll be OK will your help.”

5. “I needed help just as much as the person experiencing a medical crisis. My mental illness might not show up on an x-ray or a blood test, but that doesn’t make it any less real. I came to the ER because I was having a crisis, and I deserve the same compassion and care as any other patient in the ER.”

6. “Just because I drove there doesn’t mean I am fine. Telling me things like ‘you are young and pretty and educated and too smart to be behaving this way’ won’t help. Oh… And things like ‘if you really wanted to kill yourself you could go down the hall to the bathroom and hang yourself with a towel’ are not helpful. At all. Let’s just say I had an epically bad ER visit.”

7. “I can hear you. When you’re standing in the corner or outside the door talking about how selfish you think I am or how crazy, please remember I’m human. I’m already in so much pain, and those words hurt worse now more than ever. Support me, don’t judge me.”

8. “I wish the ER would understand that I’m already internally beating myself up over attempting. A listening ear or an encouraging word can go much further while I am in need of support.”

9. “I’d like them to understand I am ill. I may not have physical symptoms, but I am ill. When you leave me on a bed in the hallway all night, you are confirming to me that I’m not worth anyone’s time.”

10. “Before my dad took his own life he went to the ER. Told them his anxiety was making him feel suicidal. The doctor looked at him like he was ‘crazy’ and said, ‘I don’t understand how anxiety would make you feel suicidal.’ I believe this MD should have been way more compassionate and never challenge someone when they say they are feeling that way. It’s hard enough for someone to admit they are experiencing those thoughts to begin with.”

11. “I deserve just as much of your time, compassion, patience and empathy that is given to a patient who’s come in with a physical injury. The brain is an organ, too.”

12. “I wish they didn’t see or treat me as an inconvenience or a burden. I already felt like that to my family and friends, it shouldn’t be that way with people who can potentially be there to help you. I wish they treated me like they would treat someone who came in with a broken bone, cut, chest pain, head wound, etc.”

13. “Empathy. Empathy is defined as the capacity to place oneself in another’s position… Take the time to sit and listen with an empathetic ear to a person who’s suicidal. Maybe they want to be heard and listened to and talked to. Maybe they are seeking some sort of answers to make the pain and the wild emotions like a tornado wind, calm within their minds. Maybe there is a reason behind the depression that needs to be addressed and dealt with.”

14. “I’m not a bad person. You treated me like I was a criminal, not to be trusted. You were extremely condescending and rough. You acted like I was some silly kid who was just trying to get attention and costing my parents a lot of money in the process. I had just been through one of the most traumatic experiences of my life and you spared no empathy for me. They need to realize how their actions affect those who are already scared and hurting. Mental pain is no less real or serious than physical pain.”

15. “I wish the ER staff knew I genuinely don’t have the ability to articulate my reasons for my actions. Sometimes I don’t know what or why I did it except that I hurt so bad and I think the world would be better off without me. Asking me why I did it is not the right question.”

16. “I wish the ER staff didn’t scold me for ‘doing the same thing again’ after they saved my life last time. Comments like that only increase my feelings of self-loathing, hopelessness and helplessness.”

17. “Just because I ‘did this to myself’ does not mean you can treat me differently than those there who have unintentionally injured or hurt themselves. I was treated terribly and made to feel small and embarrassed because I was clearly wasting their time because I was doing this to myself.”

18. “Anyone who walks through the doors of an ED/ER related to a psychological issue is there because they’re in legitimate crisis. People with a mental illness are human –not weak, ignorant or unable to understand what you’re saying… Don’t speak in a condescending way. We aren’t in a rational state of mind, but that doesn’t mean we don’t hear you. We come to you for help, because we are afraid and we are struggling. The courage it takes to seek out help during a crisis or after an attempt is unimaginable until you’ve been there yourself… it’s not that we want everyone’s validation or attention, or even sympathy; just a non-judgmental environment and medical treatment/admission to the hospital if needed. You may not completely understand what we are feeling or what made us attempt suicide, and that’s OK; just don’t degrade us or make the guilt worse.”

19. “I wish they understood just how hard it was for me to be there. I constantly felt like I was wasting their time, and felt like they could have been treating patients with ‘real’ problems. Little did I know that that was the stigma talking. I want them to know I need to feel validated and like I had as many right to be there as other patients.

20. “Please know this was my last resort. Despite my life looking good from the outside circumstance wise, my mind is a war zone. Please don’t see me as an inconvenience because I did this to myself, and as much as I didn’t want your help so I wasn’t cooperative at first, the way you dealt with me at that time could make or break me. Give me hope or make me continue on the road of giving up.”

When we asked this question to our community, we were offered some other perspectives we wanted to share: 

From a paramedic:

“Let me speak from the figurative other side of the curtain, as a paramedic. Yes, we care about you. We know you are human. I went into this career to help. If you talk, I’ll listen, no matter the story or tears. Just talk.

Sometimes, I do not know what to ask or how to talk to you. I smile and try to make the ride comfortable either from your home to the ER or the long ride from a hospital to a psych facility. Give you what food or drinks I can find… The ER cannot handle low to mid-tier psychiatric emergencies well. It was never meant to. After a crisis evaluation, the crisis worker calls as many psych facilities as they can to find an open bed. This may take six hours to two days. The scrubs you might have to wear are meant to protect you and staff. People hide medication and weapons… it has happened. We keep you in the hallway or in a room with a curtain open to make sure you don’t hurt yourself.

As a healthcare provider we see so much, I have to go home knowing the tragedies of others. I can’t internalize it. There are high suicide rates for people who work in Emergency Medical Services. So if we come off cold, we may also have been affected by mental illness. We may have anxiety, depression, and suicidal thoughts, too. We may just swallow it down and keep going to help people the best we can. The ER psych treatment system is broken. We all know it and wish there was a better solution.”

From a mom who lost her daughter to suicide:

“I had four ER experiences with my daughter after her attempts before she [died by] suicide. Each time was different. Mostly, everyone was just concerned and wonderful but ultimately unsuccessful. I wish just one of them told us there was hope. That there was light somewhere beyond our darkness. I’m not sure anything said different would’ve changed anything though in our story. I just don’t know. As a mother who lost her sweet daughter who I loved with all my heart, to all of you who commented… I read and heard every single one of you. I’m going to say what I wish she would have heard…

You’re here for a reason. You’re worthy. You’re fighters. You’re amazing and strong. Please keep fighting each day. You’re worth it and I’m sure someone in your life would be devastated without you here, even if you think they’re better off without you. They aren’t. You complete somebody. Whoever that somebody is, look to them for that strength when you don’t have your own. I beg you. Keep going. Your story isn’t over yet.

Sending each of you my love and wishes of peace and strength for you when you need it most.”

From a nursing student:

“To anyone reading this, I’m praying first and foremost you know you matter. Your life has value and you are so worthy of happiness, even when the darkness tells you that you are not. You are so worthy of love and joy and the world would not be complete without you. Even if you don’t think so, there are people who need you and would be incomplete without you. And please know it will get better. I promise you that, just hold on and seek out people to help you and it will get better.

And secondly, as a nursing student please know that I hear your stories and I promise to do my very best to never let a patient get treated in a negative way like many of these stories again. I pledge to be an ally and stand with you in solidarity and do everything I can to help you overcome.”

*Some answers have been edited for length and clarity

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to 741-741.

20 Truths ER Staff Need to Know About Patients Who Are Suicidal

Originally published: December 15, 2016
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