At my hospital at least, they invite you to come to the ER with any suicidal ideation. You get in pretty quick, and they'll call in a psych to evaluate you/talk with you. I've been there 4 times for suicidal ideation alone, and have never been involuntarily hospitalized. The only reasons they would hospitalize you would be:
1. You've made an attempt
2. You've engaged in self-harming behavior that day (which I think is idiotic)
3. You don't have support (no family/friends to watch for you)
4. You can not control your emotions (crying heavily, anger the next second)
5. You say you will kill yourself (not just having thoughts)
6. You are not willing to co-operate with any procedures while at the hospital (EX blood tests)
7. You have a very detailed plan(s), the means and the date/time (I've admitted to 2 of the 3 and was fine)
8. If they find anything on you like razors,pills,etc. (you're obviously determined enough to bring things to the ER when you're apparently searching for help)
9. If you are psychotic,hallucinating,etc
10. If the psych feels that, for whatever reason, you should be hospitalized until the feelings have passed (if you have past attempts, this would be reccomended)
11. If you have a outside doc/psych/therapist/etc who recommends hospitalization after they have been informed of your condition.
12. If you are a minor (18 and under) and your parents/guardians request that you be hospitalized.
11 and 12 really suck, because basically whatever they say you've got to do. Even if you are legal age, in the case of 11, your doc can say you're a danger to yourself and will have you hospitalized.
Basically, one you admit you are suicidal, you pretty much lose control on any say you have until the psych has cleared you.
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