At what point is a counselor required to involuntarily commit someone to a hospital for self-harm? For example, can you tell them that you have self-harmed or that you have urges to self-harm, without the risk of being committed?
Last Updated: 04/17/2018 at 6:30pm
Lara Gregorio, LCSW
I believe that depression can feel all-consuming. I have a real passion for helping my clients to reclaim their voices and lives from depressive thoughts.
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For a counselor to have someone involuntarily committed, the procedure varies from state to state, but the policies are generally the same. A counselor will generally encourage you to seek commitment on your own, but if they believe you won't follow through, they can call the police, because in the states I've lived in, only police officers can involuntarily commit someone. They are then on a 72 hour hold, and the case must be brought before a judge. Counselors will generally ask you to have yourself committed if they feel that within a short period of time, like 24 hours, you have a strong desire to harm yourself or someone else, you have the means (i.e. materials required to follow through), and you have a plan (i.e.) a thought out, premeditated strategy of how you will do this). Urges may or may not prompt some counselors to ask you to check yourself into a hospital, but in a busy ward, that usually is not enough to warrant you getting a bed. Past suicide attempts or self harm incidents also are not enough for commitment without future intent. They will only commit you or ask you to commit yourself if they have the belief that you are definitely going to harm yourself in the immediate future.
A counselor is required to commit someone to a hospital if they are showing suicidal or homicidal thoughts. Self harm and suicide are very far from one another on the spectrum. Admitting you have self harmed in the past is perfectly fine and is encouraged.
You can enter a psych ward either voluntarily or you can be committed under the mental health act. Normally, to be sectioned, three people - mental health professionals, doctors, close relatives (varies from country to country) must agree that you are suffering from a mental disorder and need to be detained either for your own safety or the safety of others. So if your self harming threatens your safety then it is the counselor's duty under law to get you evaluated for possible hospitalization. Talking about urges to self harm won't get you committed, in fact, talking about it, reaching out and ask for help is a first step on the path to healing.
This probably varies from country to country. Here (Australia) a health professional has no right to involuntarily commit someone to a hospital because of self-injury (cutting or burning). On the other hand a health professional is legally required to commit somebody if s/he has reasonable grounds for believing that a client is at serious risk of suicide (suicide and self-injury are different things).
The laws and rules about involuntary commitment are different from country to country and state to state. But in general, a counselor is required to take action when a person is in imminent danger of hurting themselves or someone else. In most places in the US, this initial period of observation in the hospital can only go on for 72 hours before more action is needed; this could take the form of the patient voluntarily admitting themselves to the hospital, or a court proceeding could begin determine whether the person should be held involuntarily. You should always tell your counselor if you've self harmed or feel like you might. The counselor is there to help you, and hospitalizing someone without their consent is a step that is only taken when imminent harm has or is going to occur.
Unless it is to a big extent , or the cuts you are in forcing is putting your life in danger they wont section you. Probably would want to speak to you more regularly. But it is highly unlikely they would section you with you just admitting it.
Counselors only have to pass on information if you are at risk to yourself or to other people. If you're self harming but are not suicidal then you may still risk being committed, but if you stress that you are not suicidal and self harm is used as a coping strategy then from my own experience i don't believe you will be committed
Hi there, I imagine there are probably at least slightly different rules in different places, but from what I know, a counselor would be required to involuntarily commit someone if that person is actively suicidal (i.e., has a plan and says they will act on it). As far as I know, telling your counselor that you have self-harmed or that you have urges to self harm would /not/ be grounds for being involuntarily committed. It is certainly still something that a counselor would take seriously, but I don't believe they would commit you. Also, this probably does vary by person, but at least some people self harm but are not actively suicidal or maybe even suicidal at all. If you are self harming or have urges to self harm, I do encourage you to speak to a counselor because you deserve to get help and be safe and cared for. I understand that this is easier said than done. You can also talk to listeners on 7 Cups about self-harm if you would like. Take good care!
Most therapists will not commit you for self harming unless you are at risk of killing yourself by means of what you are doing. You can absolutely tell them about your urges and actions and I think that will be very beneficial to you. You can also directly ask the question to your therapist and they will answer you without risk of committing you.
Yes, you can. If you come to them bleeding severely, then they may have to take you. Otherwise, they bandage you up, and you are fine.
From my personal experience. I have self-harmed.I trusted my wonderful therapist with my life .she had me sign a safety plan with her(she calls it my contract with her) . She knows me and knows I can cope with so much. Plus I promised myself and those around me I will go talk to her . After that happen we never spoke about it again. She never did I still told her it's been weeks since I self-harm. A promise to her is a promise . I never want to hurt her.my therapist has made a huge impact in my life sadly no longer see her because her internship is over
I would hope that any professional who has a good understanding of what purpose self harm serves would not even consider admitting someone involuntarily to a hospital because of a clients self harm. That being said, if it is believes that alongside self harm someone is seriously suicidal, then action may be taken to keep that person safe, which could involve involuntarily admitting someone to hospital if the person was not willing to accept treatment within a hospital environment. The only other time it could be considered is if a person self harms in public...but overall self harm is such a private act for many people who self-harm that they wouldnt choose to do this in a public place. Years ago doctors and other professionals found it difficult to differentiate between self harm and suicide and a question often asked to a self harmer who may have taken themselves to A&E for treatment for their injuries (if stitches were required etc) was "why were you trying to kill yourself?". The fact is without self harm, some people may have resorted to attempts on their life if they were unable to find any other alternate method of coping with their feelings etc. The goal of self harm is very rarely connected to suicide and therefore it would be unlikely that someone would be hospitalised for their self harm alone. Someone who self harms may have other mental health problems would could cause a team to consider hospitalising someone however.
I believe so. There may be different rules in different countries, but to my knowledge, a therapist is only required to intervene if you are actively suicidal or homicidal (or actively want to harm someone else).
Yes, you can let them know that you have self harmed without being committed. The only reason they would do this is if it seriously harmed your health (e.g. lost a lot of blood or starvation). From previous experience they have said it has to be serious to have someone committed to hospital. They will try to support you and will only feel the need to do this if they feel it could be life threatening. They will however inform you usually before they contact the hospital or other members of the mental health community.
Yes you can tell them without risk being sectioned. I am giving this information based on UK law and legislation. In the UK, you can only be detained under the Mental Health Act if professionals are concerned that you are an imminent danger to yourself or others and are too unwell to make decisions or understand that you need help. Even then, the counsellor would have to refer it and it will have to have two doctors who have seen you and an Approved Mental Health Professional (AMHP) all agree that sectioning you would be in your best interest. Normally they would also seek a voluntary section which is more flexible as you agree to it and only if refused (and you are assessed as being a serious and imminent danger to yourself or others,) then the decision may be made to make an involuntary section. So considering all of this, talking to your counsellor about self-harm is a very positive route to go down as they can help you overcome it, it shows that you are seeking help and want to get better, and unless you express that you are in immediate danger (this normally means immediate danger of committing suicide or hurting someone else) then sectioning won't be on the cards at all.
Depending one the situation and on the self harming. There is many ways and means to get commited and it can be hard it can be easy just all depends on the situation x
Yes. If you have self harmed before or are still strugglinf, in most cases a counselor will not admit you to a hospital. The only time when a professional is REQUIRED to call 911 or have you taken to a hospital is if you are suicidal or homicidal at the present moment.
Talking about self-harm to your counsellor is very important. A counsellor should only ever take someone to hospital if they feel there is serious and/or immediate danger to their health. Trust in your therapist and give them the chance to help you work through things.
Only when you're at a great risk of harming yourself badly. You should feel comfortable otherwise
I think it's based on if you are an immediate threat to yourself or anyone else. If your going to endanger someone then it's out of there hands
If they truly believe that you are a risk to yourself or to others then most likely yes they could admit you to a hospital, & I'm sure if you spoke to a professional about self harm, They may try to talk to you more often during the week but again if they believe that you are a risk to yourself or to others, They might take a different precaution.
When you show signs of being a risk to yourself or others, if they don't they aren't protecting you or the people close to you
This is very much up to the counselor. The key is to repeat that you are not suicidal and that the wounds don't require medical care. I've never had one even threaten to commit me and I've always done that.
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