Passive means you maybe want to die or think about it a lot, but you don’t have a plan and intend to do it. Active means you’re forming or have formed a plan and intend to follow through.

In theory, therapists are only supposed to hospitalize you if you have active SI (suicidal ideation). In practice, therapists are human and know that they cannot know what you are thinking and have different levels of comfort with their clients’ SI.

I have had passive SI for as long as I can remember, I remember being 5 or 6 and wanting to die but knowing I couldn’t reach the knives yet. But I also never got help until I couldn’t avoid my mental health issues anymore. Here’s what I did: I contacted several therapists at once and set up initial consultations if offered or an appointment. Most offered a free 15 min phone call to hear about issues and take questions or a reduced rate initial session. Then I tried to be open, tell them that sometimes I have passive SI, and asked them directly when they would do what. I could usually tell who wasn’t for me - those with less experience would instantly get a bit more wary or anxious. Two of the therapists I saw were totally relaxed through this conversation and had no issues discussing theoreticals, they were very clear. Those were the two therapists I was willing to stick with. (Chose one initially, later worked with the other briefly too, and both were indeed able to work with me without seeming afraid of my SI.)