Barriers to Help-Seeking for Suicidal Ideation

Potential barriers to help-seeking for suicidal ideation

There’s lots of information out there about crisis resources for people thinking about suicide, but resources accomplish very little if we don’t reach out to access them. There are many potential barriers to help-seeking, and I wanted to talk about a few of them here, based on my own experience with major depressive disorder and suicide attempts.

Fear of being a burden

No matter how much anyone might say “you’re not a burden”, I wouldn’t believe them. It’s not myself that I see as a burden; rather, it’s the suicidality. The suicidal thoughts were such a significant weight for me to carry, so why would I want to place some of that burden on anyone else? And it doesn’t feel like it is with pack animals where I can shift my rocks to someone else’s donkey and make it lighter for my donkey. It feels more like extra rocks getting dumped on both donkeys, so I’ve got extra weight that I have to carry as well.

Fear of others’ responses

There’s a lot of stigma out there in the world, about mental illness in general and suicide in particular. When the word “selfish” gets tossed around in relation to suicide, that’s only going to add to barriers to help-seeking. Being judged is the last thing someone needs when they’re feeling desperate.

For those of us who have been open with others about our illness, even if we’re not necessarily worried about stigma, there’s still uncertainty about how others might respond. People say well-meaning but just plain stupid things about depression all the time, so what kind of supportive idiocy is likely to come out of their mouths when faced with the topic of suicide? That I should be grateful for what I have, even though none of it matters? Or maybe something along the lines of oh, you should go out for a walk in nature?


My illness makes me feel like there is no hope for the future. It’s when that hopelessness gets particularly intense that I want to end my life. I’m not thinking oh, if only I could get help things would be so much better. At that point, I’ve given up and don’t want anyone trying and failing to help; in the end, that would just make things more difficult.

Over the entire course of my illness, it’s proven to be very hard to treat. In the past, I was able to achieve full remission eventually; now, though, it seems like that may be a thing of the past. Because of my professional background, I know what my options are, and I know there aren’t a lot of them. That only reinforces those feelings of hopelessness.


When mental illness steals away your whole sense of worth as a human being, it can start to feel like people would barely notice, much less care, if you weren’t around anymore.

Crisis lines/services

The only time I’ve ever used a crisis line myself was in the first few weeks after my first hospitalization. I had discharged myself against medical advice after they decided not to renew my involuntary committal. I’d been in hospital for 2 months, and out I went, with no discharge plan in place. I was cutting as a strategy to cope with suicidal thoughts, and mostly when I called the crisis line I talked about the cutting rather than what was underlying it. I guess it was nice to have someone to talk to, but I remember feeling like their responses were kind of formulaic, as if they’d been told these are the things you should say in these situations.

A lot of crisis lines have volunteers providing support. I’m sure they care and want to listen, but they don’t have the level of expertise of mental health professionals. &Part of that is that they don’t have training in assessing mental status, which makes me inclined to think they have a lower threshold of concern to call the police. I may be overestimating the risk of this, but if I’m thinking about ending my life, the last thing I want is the police banging on my door.

In some ways, it works against me that I’m a mental health professional. It means I know a lot of people working in local emergency and non-emergency mental health services. I have no desire to call the emergency mental health service or go into the hospital emergency department and have to deal with some asshole that I’ve worked with before and know is useless at their job.

Fear of police involvement

If someone does call the police on you, that won’t necessarily go down well. Canadian Chantel Moore was killed by police during a “wellness check” in 2020. Another Canadian woman, Mona Wang, was handcuffed, dragged along the floor and into the building lobby with no shirt on, and had her head stepped on by a police officer. It doesn’t always go this badly when police get involved, but it certainly happens enough to make people hesitate.

Until twe remove routine police involvement from mental crises, the prospect of police involvement will be a barrier to help-seeking for some people who are experiencing thoughts of suicide.

Fear of hospitalization

This is the single biggest barrier to help-seeking for me, and the reason why I keep my mouth shut when I’m thinking about suicide. I’ve been hospitalized four times, and these experiences were extremely difficult. Those experiences serve as significant barriers to help-seeking. When I’m at my lowest, given the choice between death and hospitalization, realistically death is going to win out. This reflects fundamental flaws in a system that disempowers and traumatizes patients, but there’s also a sense of personal failure that I connect with hospitalization.

This isn’t a judgment I pass on others, but in a personal sense, it feels like a failure to maintain the ability to make choices for myself, which I have serious issues with. This fear of hospitalization is deeply ingrained in me, so instead, I tell lies and keep secrets. I realize that this is something that puts me at risk, but I don’t see that just spontaneously changing.

Fear of getting blown off

Reaching out is all well and good, but if you reach out only to be kicked in the face, that doesn’t accomplish a whole heck of a lot. Yet that happens far too often; people show up in ER, they’re deemed not suicidal “enough,” and they’ve given the boot with nothing more than a pamphlet. England’s NHS even had a program euphemistically called Serenity Integrated Mentoring that involved denying frequent service users treatment in the ER, and in some cases used jail time as a penalty for something like showing up in ER after a suicide attempt.

So where does this leave us?

I know that reaching out for help dealing with thoughts of suicide is the right thing to do, and it’s what I’d urge to anyone reading. But, realistically, it’s just not always that simple, and I think it deserves some thought when we’re not in the midst of our deepest lows. We need better choices to be available so that suicide is not a choice people feel the need to make, and the mental health care system needs to stop failing suicidal people.

What has been your experience of accessing help in a crisis? Are there any barriers to help-seeking that have affected you?

Related posts

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The Straight Talk on Suicide page has crisis and safety planning resources, along with info on suicide-related topics from the perspective of someone who’s been there.

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31 thoughts on “Barriers to Help-Seeking for Suicidal Ideation”

  1. I called (or did someone call for me?) a local crisis intervention team that came out to my house to check on me and put me in touch with community resources. I was in between psychiatrists and going without meds. It was a good experience under the circumstances. My experiences with going to the ER were not good. My one hospitalization was unpleasant but served it’s purpose. I’ve never called a suicide hotline, I’m not sure why though. Maybe I hate the idea of putting all that on someone else, and I’m with you on not wanting cops showing up at my door, that is a definite concern. But would they even know where we are at to do that if we don’t tell them? I’ve thought about calling self injury helplines when I’m struggling with the urge to cut,because it’s not something I can talk about with my “support system”. Came close recently and could really have used someone to talk to, in the midst of it it did not even occur to me to call.

  2. My dear friend:

    You have started a phenomenon….a shift in the universe…
    Change is around the corner.

    Brilliant observations about the reality of us all…who are put in the Zoo…when we belong in the Circus!!

    Dr. Sues book…”put me in the zoo” is my favourite book!!
    Hugs n joy!

  3. I’ve learnt to write things down and give it to someone and tell them ‘hey,force me to show this. I’ll fight you on it, but make sure I show this’. Showing those ‘things’ to a mental health professional, i mean. Though I tend to forget mostly. I just think it’s a disservice to yourself to lie about your mental health state. You deserve better than a symptom missed. It’s hard, sure. But as much as it sucks you need to Nike the fuck outta that shit and be honest. That’s just my view, and what i hold myself to

  4. I’ve had much more positive experiences phoning crisis lines in the UK, although that hasn’t always been when I’m suicidal (The Samaritans are for anyone who needs to talk, not just suicidal people).

  5. What a fantastic post. Absolutely agree and I totally relate to every single point!
    I am lucky in that I have a psychiatrist who understands that if I were locked up every time I felt suicidal I would likely never leave the hospital and she instead offers coping strategies and support for getting through the feelings rather than jumping straight to hospital in return for my complete candour about my intentions. We have this as a verbal agreement and it is working well, she has not broken her word and neither have I (nearly 3 years since my last hospital stay).
    I did actually call the crisis line the other day for the first time (other than once when I was just sussing out how they operate) and the guy I spoke to was wonderful, more than anything I think I just needed to vent and he allowed me that opportunity. I wasn’t completely open with him about how suicidal I was feeling though as I wanted to talk about the underlying issue and I do get paranoid about the police turning up!
    xx Kate

    1. I think sometimes it’s just the sound of a voice, or comfort in someone’s smile or a hug or my girls smiling….that changes my suicidal climate! Resonate n resonating!! Hugs.

  6. Great post! The three-paragraph that I can relate the most, in order of importance, are hopelessness, worthlessness and fear of hospitalization. I am followed by a psychologist and a psychiatrist and under medication, despite all this support I still have dark thoughts but keep them for myself as I don’t want and will never go to a hospital.

  7. Thank you so much for this insightful post! I look forward to the end of sickness, sorrow, and pain which I feel will only be brought about by God’s Kingdom (Revelation21:3,4). Thank you for providing insights that will help me to be more compassionate and helpful for those suffering with mental illness.

  8. This is great, some really good points made. I did my dissertation research on help-seeking attitudes in males and some of the barriers they face, and found the topic very interesting.

  9. I really like this post. I think access to resources is a big barrier for most people and their families. People are afraid of being judged & nervous about asking for help. I hope there is even more education about access especially with everything that’s going on now.

    – Shelly P., RN

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