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Exaggeration, colorful metaphor, and feeling miserable enough to say something are all different things, and aren't what we look for. Except that last one, because that last one actually correlates with bad outcomes. You're warning people to "know what you're getting into," but clearly have no idea what you're talking about. You may have experience with this, but clearly not from the clinician's side. Let me give you a real example: We look for /actionable/ ideation. You'd be amazed how many patients, expressing suicidal ideation, say something like "Oh, I'd just walk into the ocean and drown." Or, "I'd jump off a mountain and die" (living nowhere near a mountain). Etc. They express unrealistic or unachievable means of committing suicide that exhibit a pre-occupation with "dying", but not the process of death. Ceteris paribus, this is a reasonably low-risk person. Other folks, far less, say something like "Oh, I'd take a gun and shoot myself. My dad has one in his closet." It's realistic, it's achievable, and he could do it in an impulsive moment - that person is a real risk. (Caveat: these are obviously artificially constructed sentences to illustrate the variable under discussion. Please don't nitpick the exact wording/presentation in bad faith. Patients never spit out in one sentence "Oh, I'd take a gun and shoot myself, that one my dad has on his top shelf at home." ) Note that from the various speculation people have thrown out on this thread, not one has mentioned concrete achievability. Because, shockingly, people coming up with catastrophes about why they shouldn't seek help are really not the best sources of information about what care actually looks like. |