Depressed patient

on my neuro prac i was treating a middle aged man who had a debiltating stroke about 5 years earlier, he was a dense left hemi dependent with all transfers and in a wheelchair. he had no motivation during rehab sessions and was very depressed. during one of our sessions he arrived and started talking about how i didnt need to stretch out his left arm today because he no longer needed it. i explained why it was important to maintain the muscle length in his arms and he told me that it was no longer important as he was going to kill himself that night. i didnt know how to react or what to say. i started to flounder my way through reasons why he should not be thinking about suicide but my patient was adamant and had it all planned out, i started to get upset as this topic touched a personal raw spot with me. my supervisor saw that i was starting to get upset and came over and asked how everythinig was going and my patient said that he'd just come in this morning to say goodbye. my supervisor started talking to the patient about his problems at home and ways that we could get him help and people to talk to. my supervisor went to cal the patients wife who reported that he'd takken a knife from the draw last night and had tried to stab himself but she'd walked in on time and managed to take the knife away from him. she had no idea what to do and was exhausted from constantly being on quard with him and was in desperate need of a break. we spent the session talking to the patient about the help that was available to him, respite and positive things he had to look forward to. i felt quite useless in this sitatuation as i felt like i didnt know what to say to the patient and i felt like if somthing did happen when he went home then it would partly be our fault as we knew about it. what i found out that day is that there are so many services out there for patients in this situation. as he was an outpatient we organised suicide watch team for him and they went over that afternoon to see him and called him regularly that day/night and he was able to call them if he felt upset. we organsied a psych consult for him the next morning and a 2 week respite for him and his wife. unfortunately i did not get to see the patient again as he was at respite for the rest of my prac but i learnt in this situation that you cant personally take responisbility for the patient's wellbeing and that there are so many services available for patients in this situation. if i could change anything i did with this patient is how i reacted so emotionally when he was talking about suiciide, even though it touched a raw nerve i think its important to keep personal feelings separate as i found myself i a situation where i needed support as much as my patient did.