After an Attempt

A Guide for Taking Care of 

Yourself After Your Treatment

in the Emergency Department

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

www.samhsa.gov
If you are in crisis, please call:

National Suicide Prevention Lifeline

1-800-273-TALK (8255). 

http://www.suicidepreventionlifeline.org
After an Attempt

A Guide for Taking Care of Yourself 

After Your Treatment in the Emergency 

Department
Acknowledgements

This brochure was originally developed by the National 

Alliance on Mental Illness (http://www.nami.org) in partnership 

with the Suicide Prevention Resource Center 

(http://www.sprc.org) under Grant Number 1.U79 SM55029-01 

from the Substance Abuse and Mental Health Services 

Administration (SAMHSA), U. S. Department of Health 

and Human Services (HHS). 

Disclaimer

The views, opinions, and content of this publication are 

those of the authors and contributors and do not necessarily 

reflect the views, opinions, or policies of the Center for 

Mental Health Services (CMHS), SAMHSA, or HHS.

Public Domain Notice

All material appearing in this publication is in the public 

domain and may be reproduced or copied without 

permission from SAMHSA. Citation of the source is 

appreciated. This publication may not be reproduced 

or distributed for a fee without the specific, written 

authorization of the Office of Communications, 

SAMHSA, HHS. 

Recommended Citation 

Substance Abuse and Mental Health Services 

Administration. After an Attempt: A Guide for Taking Care 

of Yourself After Your Treatment in the Emergency Department. 

(SMA 08-4355; CMHS-SVP06-0157), Rockville, MD: 

Center for Mental Health Services, Substance Abuse and 

Mental Health Services Administration, U.S. Department 

of Health and Human Services, 2006. Reprinted 2009. 

For Copies of This Publication

• 

• 

Download copies from the National Suicide Prevention 

Lifeline Website: http://www.suicidepreventionlifeline.org

This publication may be downloaded or ordered at 

http://www.samhsa.gov/shin. Or, please call SAMHSA’s 

Health Information Network at 1-877-SAMHSA-7

(1-877-726-4727) (English and español).

Originating Office

Center for Mental Health Services

Substance Abuse and Mental Health Services 

Administration

1 Choke Cherry Road

Rockville, MD 20857

SMA 08-4355; CMHS-SVP06-0157

Printed 2006

Reprinted 2009
Recovering From a

Suicide Attempt

the 

This brochure was created to help 

you as you begin to work through 

challenges that led you to attempt to 

take your life. It offers information about 

moving ahead after your treatment in 

the emergency department and provides 

resources for more information about 

suicide and mental illnesses.

Today

Today may feel like the hardest day of 

your life. You have seriously thought 

about or perhaps attempted to end your 

life. You may be exhausted. A common 

experience after surviving a suicide 

attempt is extreme fatigue. You may 

be angry. You may be embarrassed or 

ashamed. The attempt itself, the reactions 

of other people, transportation to and 

treatment in an emergency department 

or other health care facility—all these can 

be overwhelming to you right now. But, 

recovery is likely, and all the feelings you 

are experiencing right now can get better.

After the Emergency Department

After you have been treated for a suicide 

attempt in an emergency department 

and the doctors believe you are medically 

stabilized, you will either be discharged 

(released) or you will be hospitalized.

1
If you are discharged after your suicide 

attempt, the staff in the emergency 

department should provide you with a 

plan for followup care.

The exact steps for followup care will vary 

with each person, but your plan should 

include:

• 

• 

• 

A scheduled appointment in the near 

future with a mental health provider 

(such as a psychiatrist or other licensed 

therapist). Make sure that the name and 

contact information for the provider 

is given to you before you leave the 

hospital and that your appointment will 

occur as soon as possible.

Information on any treatments that you 

received in the emergency department, 

such as medications, and what, if 

anything, you will need to do about 

those treatments after you leave.

Referrals to local and national resources 

and crisis lines for information and 

support. See the back pages of this 

brochure for more information.

Once you have a plan for followup care 

that you understand and are comfortable 

with, you and, if appropriate, a family 

member should work closely with a 

therapist to ensure that your plan is 

meaningful and effective.

If the emergency department staff feel 

that you need more immediate care or 

2
longer-term care than the emergency 

department can provide, you will be 

referred for inpatient hospitalization. If 

hospitalization is necessary, you and your 

family, if appropriate, can begin to work 

with the hospital to develop a plan for 

the next steps in your care. Hospital staff 

(usually a social worker) should help you 

with this process. 

What if You Don’t Want To Go to the 

Hospital?

People generally have the right to consent 

to or refuse treatment. However, if the 

emergency physician believes you are a 

danger to yourself or someone else, he or 

she must consider having you hospitalized 

involuntarily for a limited period of time. 

Laws about commitment vary by State. If 

you have questions about your rights as 

a patient, you should contact your local 

Protection and Advocacy organization. 

These are legal centers that are funded to 

protect the rights of persons with mental 

health needs. You can either go to their 

national Web site at www.ndrn.org or call 

the office at 202-408-9514 to inquire 

about the Protection and Advocacy center 

in your State. 

Next Steps: Moving Ahead and Coping 

With Future Thoughts of Suicide

Recovery from the negative thoughts and 

feelings that made you want to end your 

life is possible. You may get to a place 

where you never have thoughts of suicide 

again and you can lead a happy, satisfying 

3
“Since the time 

I was in the 

ER, I have 

experienced 

thoughts of 

suicide, but 

luckily I 

have a strong 

support system 

in place.”

Quote from a 

national survey of 

individuals who 

attempted 

suicide.

life. You also may 

learn to live with 

these thoughts in a 

way that keeps you 

safe.

After you leave 

the hospital there 

are several things 

you can do to help 

in your recovery. 

It may feel hard 

and overwhelming 

right now, but over 

the next few days, 

following these tips 

can help turn things 

around.

Create a safety plan. 

You and your doctor, or other licensed 

therapist, should work together to develop 

a safety plan to help reduce the risk of a 

future suicide attempt. When creating a 

safety plan, be honest with yourself and 

your doctor to ensure that the plan meets 

your needs and that you feel comfortable 

with it. Although everyone’s safety plan is 

different, some

common things that may be in your plan 

include: signs that may indicate a return 

of suicidal thoughts or feelings and what 

to do about them; when to seek additional 

treatment; and contact information for 

your doctor, therapist, or a trusted friend 

or family member. Keep a written copy of 

your safety plan nearby so you can refer 

to it as needed.

4
Build a support system. A support system 

is a key part of recovering from a suicide 

attempt and preventing another one. It 

is important that you have at least one 

person in your life who can be your “ally.” 

This must be a person you trust and can 

be honest with—especially if you start to 

have thoughts of ending your life again. 

Family members or a close friend can 

serve this important purpose. A member 

of the clergy, mentor, or colleague also 

could be helpful to you at this time. 

Having more than one ally can be a great 

asset, as well.

Keeping your ally informed about your 

thoughts, feelings, and wishes can help 

in your recovery and may help prevent 

another suicide attempt. You will have to 

be honest with yourself and with your ally 

to make this work. Even when you are 

feeling alone, always remember that there 

are people in your life who care about you 

a great deal and are willing to help.

Learn to live again. When you are 

recovering, the world can look like a 

pretty bleak place. It may take a little 

while before your life starts to feel 

comfortable again. One thing you can do 

to help is to get back into a routine. Eat 

at regular times, exercise regularly, and go 

to sleep and get up at the same time each 

day. Try to join in your usual activities a 

little at a time, and add in more when you 

feel comfortable.

5
If you continue to have thoughts of 

suicide, reach out for help immediately 

and contact your ally, a doctor, or a 

crisis hotline (see the back pages of this 

brochure for listings). Remember: The 

emergency department is open 24 hours 

a day, 365 days a year to help you if 

you have thoughts of suicide or if your 

medical team is unavailable to provide 

you with the needed care. 

Listen closely, and carefully consider 

the support and advice you receive. It is 

important to be honest with yourself, your 

doctor, or others about your feelings so 

that you get the best possible care.

Sometimes being under pressure and 

having thoughts of suicide can make 

it difficult for you to make the best 

decisions, and at those times, other people 

may have a more realistic view of your 

situation than you do. Your ally can help 

you work through these confusing and 

isolating thoughts and feelings and help 

keep you safe.

Everyone’s recovery is different. Some people 

have persistent thoughts of suicide. For 

others, such thoughts may accompany 

certain moods or circumstances. Here 

are some steps you can take to prevent 

negative and destructive thoughts in the 

future and to keep you safe. You also may 

want to consider adding some of these 

steps to your safety plan.

6
• 

• 

• 

Remove the means for hurting yourself from 

your environment: Work with your ally 

to remove methods of self-harm. It is 

better not to have these things around 

while you are recovering. If you use 

medication, keep only a few days’ 

supply on hand and ask someone else to 

hold onto the rest. For other means of 

self-harm, place them in someone else’s 

hands for a while; you can always take 

back these items when things feel more 

settled.

Identify what sets off or starts these thoughts 

for you: It may be an anniversary of a 

painful event, for instance, or seeing a 

knife in the kitchen. Plan to minimize 

the effect of these triggers on your life. 

Sometimes you can avoid them or train 

yourself to respond differently, or you 

can involve your allies ahead of time 

to help you face a difficult situation. 

Remember that life events do not cause 

a suicide, but they can increase the risk 

of an attempt.

Learn about mental illness: Someone 

who has had or is living with suicidal 

thoughts may be suffering from a 

mental illness such as bipolar disorder, 

schizophrenia, or major depression. 

Contact a doctor or see the back pages 

of this brochure for more information 

about mental illness and treatment.

• Learn about crisis hotlines: Hotlines provide 

you with a trained person to talk to 

when you are having suicidal thoughts. 

7
This person will listen to you and help 

you choose another path. The person 

you talk with may work with you on 

your safety plan, so have that plan close 

by when you make the call. If you do 

not have a safety plan in place, the 

crisis staff will help you create one. See 

the resources listed at the back of this 

brochure for more information on crisis 

lines.

• 

• 

Participate in a mutual peer-support group: 

There are many types of support groups, 

and you may wish to participate in one 

in your area. Learning from others and 

sharing your experience can make a big 

difference in the way you think about 

your life. It also may help save the life 

of someone else. The resources listed at 

the back of this brochure can link you 

to a number of peer-support centers in 

your area.

Get involved in life: Finding a hobby or

enjoying a favorite pastime—such 

as listening to music, watching your 

favorite movie, or collecting things—is 

a great way to help you cope when 

things get tough. Hobbies or activities 

that involve interacting with others are 

an especially good idea. Whatever your 

interests may be, make sure you have 

access to the things you enjoy. That way, 

if your negative thoughts come back, 

you can turn to something that brings 

you comfort and enjoyment.

8
Remember—there are reasons to live and 

make things better. You can survive, and 

even thrive, despite the way you feel at 

times. Recovery is likely.

To learn more about suicide and to get 

help, consider the following resources.

In a crisis, contact:

1-800-273-TALK (8255)

TTY: 1-800-799-4TTY (4889)

National Suicide Prevention Lifeline

A 24-hour, toll-free crisis hotline that links 

callers to a nearby crisis center.

http://www.suicidepreventionlifeline.org

For more information about suicide and 

mental illness:

American Association of Suicidology

A resource and education organization dedicated 

to the understanding and prevention of suicide.

http://www.suicidology.org or call 202-237-2280

American College of Emergency 

Physicians (ACEP)

A national medical society committed to 

advancing emergency care through continuing 

education, research, and public education. 

http://www.acep.org or call 1-800-798-1822

American Foundation for Suicide 

Prevention

Dedicated to advancing the public’s knowledge 

of suicide and its prevention.

http://www.afsp.org or call 1-888-333-AFSP

9
American Psychiatric Association

A national professional organization of 

psychiatrists.

http://www.psych.org or call 703-907-7300

American Psychological Association

A national professional organization of 

psychologists.

http://www.apa.org or call 1-800-374-2721

Befrienders International/Samaritans

An online resource that gives support through 

e-mail and offers a directory of local crisis 

helplines.

http://www.befrienders.org

Covenant House Nineline Hotline

1-800-999-9999

A 24-hour, toll-free crisis hotline offering 

confidential and immediate crisis intervention 

and referrals to community resources.

http://www.covenanthouse.org/programs_nl.html

Hispanic Community Resource Helpline

1-800-473-3003

(La Linea Nacional de Ayuda)

Offers support for Latinos who need information 

about educational, health, and human service 

providers.

Link’s National Resource Center for 

Suicide Prevention and Aftercare (LINK–

NRC)

Provides suicide-related community education in 

prevention, intervention, aftercare, and support.

http://www.thelink.org or call 404-256-9797

10
Mental Health America

Addresses all aspects of mental health and 

mental illness.

http://www.nmha.org or call 1-800-969-NMHA 

(6642)

National Alliance on Mental Illness 

(NAMI)

Offers information, support, and advocacy for 

persons affected by mental illnesses.

http://www.nami.org or call 1-800-950-NAMI 

(6264)

National Disability Rights Network

Serves individuals with a wide range of 

disabilities by guarding against abuse, 

advocating for basic rights, and ensuring system 

accountability. The Web site provides a directory 

of member agencies by State. 

http://www.ndrn.org or call 202-408-9514 or 

202-408-9521 (TTY)

National Institute of Mental Health 

(NIMH)

The leading Federal agency for research on 

mental and behavioral disorders.

http://www.nimh.nih.gov or call 1-866-615-6464

National Organization for People of 

Color Against Suicide

Addresses and raises awareness about suicide in 

minority communities.

http://www.nopcas.com or call 1-866-899-5317

National Strategy for Suicide Prevention

A comprehensive national plan to confront 

suicide in the United States.

http://www.mentalhealth.samhsa.gov/

suicideprevention 11
SAMHSA Health Information Network

The SAMHSA Health Information Network 

connects the behavioral health workforce and 

the general public to the most current and 

comprehensive information on the prevention 

and treatment of mental and substance use 

disorders. To speak with a trained Information 

Specialist (English/Spanish):

For treatment referrals, call 1-800-662-HELP 

(1-800-662-4357) 24 hours a day, 7 days a 

week.

For all other inquiries, call 1-877-SAMHSA-7 

(1-877-726-4727) M – F, 8 a.m. – 8 p.m. ET 

http://www.samhsa.gov

Suicide Awareness Voices of Education 

(SAVE)

Dedicated to preventing suicide through 

education, public awareness, and stigma 

reduction.

http://www.save.org or call 952-946-7998

Suicide Prevention Action Network 

(SPAN) USA 

A national organization dedicated to action 

and advocacy for suicide prevention.

http://www.spanusa.org or call 202-449-3600

Suicide Prevention Resource Center

Supports suicide prevention with the best of 

science, skills, and practice.

http://www.sprc.org or call 1-877-GET-SPRC 

(438-7772)

12
The Trevor Helpline

1-866-4U-TREVOR (488-7386)

A national 24-hour, toll-free suicide prevention 

hotline aimed at gay and questioning youth.

http://www.thetrevorproject.org

These resources may contain materials that 

express views, policies, and opinions that do not 

necessarily reflect those of the Substance Abuse and 

Mental Health Services Administration and the 

U.S. Department of Health and Human Services.

13
Your Notes Here:

14
For More Information:

http://www.nami.org

Printed 2006 • Reprinted 2009

SMA 08-4355; CMHS-SVP06-0157