I am completing a typical psychiatrist intake questionnaire that asks about mental health symptoms over the last two weeks. One of the questions asks how often I think about hurting myself. The true answer to this is the maximum the scale allows, but I am not sure if I should tell the truth. I would describe myself as semi-actively suicidal. I recently purchased a suicide method and think often about using it, but I haven't yet made an attempt.
I think the reasons to tell the truth are pretty obvious - receive best possible care with psychiatrist fully understanding my symptoms and so forth; maximize chances of personal survival. Also, it's possible that an accurate answer to this question could change treatment strategies if e.g. a medication is much higher risk.
However, I am also wary of offering a legitimate answer for the following reasons:
- I want to avoid hospitalization at all costs. If I answered "nearly every day," I would subsequently have to lie about it being passive thoughts anyway in order to avoid hospitalization. I'm not sure how useful it would be to provide a truthful answer to this specific question about suicidality since I can't be fully truthful regardless.
- Lying to providers causes me a lot of stress. The extended lying necessary to tell a half-truth (I do have access to lethal methods, I do think about it a lot, I do have a step-by-step plan, etc.) would probably not be great.
- Previous encounters with therapists/psychiatrists around this question have always resulted in the creation of a safety plan and pretty much nothing else. I find safety plans pretty unhelpful, as when I'm not feeling suicidal I don't need it, and when I am feeling suicidal, I generally have no desire to talk myself out of it and thus don't utilize my safety plan. Making a safety plan typically creates additional stress for me.
- Meetings with psychiatrists and therapists in general tank my mood for the rest of the day/next day because talking about my mental health problems causes me a lot of distress. Talking a lot about my suicidal feelings has a decent chance of just making them worse. I also don't want to end up having more frequent meetings with the psychiatrist because of my answer to this question.
Thoughts? Advice?
I think the reasons to tell the truth are pretty obvious - receive best possible care with psychiatrist fully understanding my symptoms and so forth; maximize chances of personal survival. Also, it's possible that an accurate answer to this question could change treatment strategies if e.g. a medication is much higher risk.
However, I am also wary of offering a legitimate answer for the following reasons:
- I want to avoid hospitalization at all costs. If I answered "nearly every day," I would subsequently have to lie about it being passive thoughts anyway in order to avoid hospitalization. I'm not sure how useful it would be to provide a truthful answer to this specific question about suicidality since I can't be fully truthful regardless.
- Lying to providers causes me a lot of stress. The extended lying necessary to tell a half-truth (I do have access to lethal methods, I do think about it a lot, I do have a step-by-step plan, etc.) would probably not be great.
- Previous encounters with therapists/psychiatrists around this question have always resulted in the creation of a safety plan and pretty much nothing else. I find safety plans pretty unhelpful, as when I'm not feeling suicidal I don't need it, and when I am feeling suicidal, I generally have no desire to talk myself out of it and thus don't utilize my safety plan. Making a safety plan typically creates additional stress for me.
- Meetings with psychiatrists and therapists in general tank my mood for the rest of the day/next day because talking about my mental health problems causes me a lot of distress. Talking a lot about my suicidal feelings has a decent chance of just making them worse. I also don't want to end up having more frequent meetings with the psychiatrist because of my answer to this question.
Thoughts? Advice?
